President Trump signed an executive order on Monday calling for narrowing government recommendations for vaccination against several diseases that can be serious or even deadly.
The executive order was the administration’s latest attempt to change the country’s childhood vaccine schedule. In January, the Centers for Disease Control and Prevention tried to make the same changes, but a court blocked them, and legal proceedings are ongoing.
It is not clear whether the new executive order has any legal power. It suggests that vaccination against hepatitis A, hepatitis B, influenza, meningitis, respiratory syncytial virus and rotavirus should only be recommended for “high risk” children or under a framework called shared clinical decision making, which involves consultation with a medical provider. It also calls for the combined measles, mumps and rubella vaccine to be split.
Outside organizations, including the American Academy of Pediatrics, continue to broadly recommend all of these shots, including the combined M.M.R. vaccine. So does the C.D.C., whose proposed changes to the vaccine schedule are in limbo as the legal battle proceeds. The vaccines all remain available and covered by insurance.
The C.D.C.’s schedule was developed over decades, under presidential administrations of both parties, by a panel of experts who examined evidence, determined that the vaccines’ benefits outweighed any risks and recommended the timing of each dose based on when children’s immune systems could best benefit.
Here is a look at the vaccines Mr. Trump is targeting, and the diseases they prevent.
Hepatitis A
Hepatitis A is a highly contagious virus that can in rare cases cause liver failure and death. The virus lives in the stool and blood of infected people and often spreads through contaminated food or close contact.
Between the vaccine’s introduction in 1996 and 2011, the number of cases in the U.S. decreased by more than 95 percent.
The A.A.P. and the current C.D.C. schedule recommend two doses of the vaccine for all children. The executive order suggests it should be given only to “high-risk groups” or based on “shared clinical decision-making.”
Before it was routinely given, children played a major role in spreading hepatitis A: Most kids who become infected experience no symptoms and can shed it in their feces for months.
Hepatitis B
Hepatitis B is another very contagious virus that can lead to lifelong liver disease or injury. The disease can spread through sex or shared needles, but also through contact with household objects and from mother to child during birth. It can be up to 100 times as infectious as H.I.V.
Rates have fallen since the C.D.C. began widely recommending the vaccine for all newborns in 1991. Acute infections reported among children and teens dropped by 99 percent between 1990 and 2019.
A.A.P. and the C.D.C. recommend hepatitis B vaccination for all children, with the first dose being administered right after birth. But the executive order recommends it only for high-risk groups or under shared decision-making. The administration also previously tried to delay the birth dose.
Influenza
The 2024-25 flu season was one of the deadliest on record for children, with the vast majority of deaths occurring among the unvaccinated, and the 2025-26 season was difficult as well. The flu can be particularly dangerous for children under 5 because they are susceptible to potentially fatal complications like pneumonia, brain issues and severe dehydration.
While the flu shot may not stop people from contracting the virus, it does help prevent people from getting very ill and dying. The C.D.C. normally recommends annual flu shots for everyone 6 months and older.
Measles, mumps and rubella
For years, a single shot has protected children against measles, mumps and rubella.
Measles is an extraordinarily contagious virus that can cause pneumonia, brain inflammation and loss of immunity to other illnesses. It was declared eliminated in the U.S. in 2000 but has roared back, with more cases in the past two years than in the previous 24 years combined.
Mumps affects the salivary glands, causing puffy cheeks and a swollen jaw; in rare cases, it can cause swelling of the brain, pancreas, testicles or ovaries, and lead to long-term hearing loss. Rubella is usually mild for patients themselves, but can cause serious birth defects if a pregnant woman is infected.
Mr. Trump’s order calls for three separate shots. While those exist in some countries, they aren’t available in the United States. Even if they were, experts say splitting them serves no medical purpose and would likely lead to more unvaccinated children because of the burden of making three appointments. And they note that the combined M.M.R. shot is safe; in rare cases, children may experience fever-induced seizures, which can be frightening for parents but don’t cause lasting harm.
The A.A.P. continues to strongly recommend two doses of the combined shot; the C.D.C. also still recommends both doses of the combined shot.
Meningitis
Vaccines protect against five groups of bacteria that can cause meningitis, a potentially fatal inflammation of membranes around the brain and spinal cord.
This inflammation causes fever, neck stiffness, headaches, vomiting and cognitive changes. With prompt treatment, many people recover, regardless of their vaccination status. But about one in six people with bacterial meningitis die from it, while one in five survivors have serious complications like long-term hearing loss, muscle weakness, speech difficulties or memory problems, according to the World Health Organization and the National Foundation for Infectious Diseases.
The A.A.P. and the C.D.C. recommend that all children receive a combination vaccine against the A, C, W and Y groups of meningococcal bacteria over two doses, the first at 11 or 12 and the second at 16. Mr. Trump wants those shots only under shared clinical decision-making or for “high-risk groups,” which could include people with H.I.V. and first-year college students living in dormitories, because the infection spreads easily in communal spaces.
A separate vaccine protects against the B group, but it has long been recommended only for some children, including those who lack a functioning spleen or who live in a place with an outbreak.
Respiratory syncytial virus
R.S.V. is the leading cause of infant hospitalization in the United States, sending up to 80,000 children younger than 5 to the hospital every year. The virus is more likely to cause serious complications in children with compromised immune systems or chronic lung disease. However, healthy babies may also develop a severe case.
Early infections have also been linked to long-term complications, including asthma.
The A.A.P. and C.D.C. both say that if a mother was vaccinated during pregnancy, her infant may not need a dose at birth, but recommend immunization for babies born to unvaccinated mothers during the respiratory virus season. Mr. Trump’s order recommends it only for “high-risk groups,” which it doesn’t define. Experts worry about excluding children born to women whose vaccination status is unknown or who may need additional protection.
Rotavirus
Rotavirus is a diarrheal illness that most commonly affects children under 5, and killed hundreds of thousands per year worldwide before vaccines were available. While deaths are much less common in countries like the United States, which has access to quick treatment for dehydration, the virus used to cause tens of thousands of hospitalizations in American children.
Infection rates began to plummet after a vaccine was introduced in the late 2000s, and the National Foundation for Infectious Diseases estimates that vaccination prevents 40,000 to 50,000 rotavirus-related hospitalizations in the United States every year. An earlier vaccine was withdrawn in 1999 after it was linked to a serious type of intestinal blockage, but current versions are unlikely to cause that side effect.
The C.D.C. and A.A.P. advise all children to receive doses at 2 months and 4 months. (Depending on the brand of vaccine administered, some children are advised to get a third dose at 6 months.) The executive order suggests removing the recommendation, though parents could still seek the vaccine from a doctor.
The post What to Know About the Vaccines Targeted by Trump’s Executive Order appeared first on New York Times.
