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Trump’s childhood vaccine order draws sharp scientific criticism

Experts and epidemiologists challenge the scientific basis of the new U.S. policy, warning that separate doses could complicate vaccination and delay protection

The new childhood vaccine policy signed by President Donald Trump has triggered strong criticism from Italian infectious disease specialists and epidemiologists, who question the scientific basis of the decision to reorganize recommended pediatric vaccinations in the United States.

The executive order introduces a new classification of childhood vaccines and calls, among other measures, for greater separation in the administration of certain vaccines. Experts quoted in the Italian news agency Adnkronos argue that the approach could make vaccination more complicated without providing demonstrated health benefits.

Infectious disease specialist Matteo Bassetti sharply criticized the measure on social media, saying Trump had signed a presidential order “against children’s vaccines” and arguing that the consequences would ultimately fall on future generations. Bassetti, head of the Department of Infectious Diseases at the IRCCS Ospedale Policlinico San Martino in Genoa (Italy), also accused the administration of placing people without adequate expertise in charge of medicine, vaccines and public health.

Pier Luigi Lopalco, professor of hygiene at the University of Salento (Italy), described Trump’s order as “another blow” to what he considers an already fragile U.S. public health system. He said much of the reasoning contained in the document lacks a scientific basis and reflects positions commonly associated with the anti-vaccine movement.

One of Lopalco’s main concerns is the recommendation to use individual vaccines rather than combined formulations. Separating vaccines, he argued, can mean more injections for children without reducing the risk of adverse reactions. Instead, he said, administering three injections rather than one may increase the likelihood of local reactions while also increasing discomfort for the child.

Lopalco also challenged Trump’s remarks about children being healthier in the past and the suggestion of a connection between vaccines and autism. Autism diagnoses have increased, he acknowledged, but he pointed to the large body of research finding no link between vaccination and autism. The claim that children were healthier before vaccines, he added, is also incorrect: before widespread vaccination, diseases such as polio and measles caused deaths among children, while infant mortality was considerably higher.

Fabrizio Pregliasco, director of the School of Specialization in Hygiene and Preventive Medicine at the University of Milan, described the latest executive order as particularly concerning. In his assessment, the measure goes beyond an administrative revision of the U.S. vaccination schedule and represents a political decision that could challenge prevention principles developed through decades of scientific research, epidemiological surveillance and vaccination programs.

The order, titled Delivering Gold Standard Childhood Vaccine Recommendations for Americans, calls for measles, mumps and rubella vaccinations currently administered through the combined MMR vaccine to be given as three separate single-antigen vaccines when available in the United States. It also states that, where possible, childhood vaccinations should be administered during separate medical visits.

Pregliasco questioned the scientific rationale for the approach. Separating vaccines that can safely be administered together, he said, does not automatically make them safer. Instead, it can increase the number of appointments required, create additional difficulties for families and health services, and potentially extend the period during which a child remains vulnerable to preventable diseases.

He also warned about the renewed political discussion surrounding a possible relationship between vaccination and autism. According to Pregliasco, decades of scientific evidence have not demonstrated that vaccines cause autism. Publicly suggesting such an association, particularly when the statement comes from the president of the United States, could turn a scientifically discredited claim into an apparently legitimate question for millions of parents.

The timing of the order is another concern raised by Pregliasco, who noted that the United States continues to face problems with vaccination coverage and measles outbreaks. The implications, he argued, cannot necessarily be confined to the United States because infectious diseases cross national borders.

Pregliasco also stressed that shared decision-making between doctors and patients remains fundamental, but that such decisions must be based on the best available evidence. Calling recommendations a “gold standard,” he said, does not make them scientifically authoritative: in science, the gold standard derives from the quality and reproducibility of evidence, independent assessment of data and international scientific scrutiny.

He urged European countries, including Italy, to watch developments in the United States closely, arguing that vaccine skepticism can spread rapidly through social networks and misinformation. At the same time, he said, rebuilding lost vaccination coverage can take years.

Epidemiologist Gianni Rezza, professor of hygiene at Vita-Salute San Raffaele University in Milan, also questioned the decision to split and delay childhood vaccinations. In his view, the policy does not appear to be based on new scientific evidence.

Rezza specifically addressed the separation of the vaccines included in the MMR combination, noting that the formulation now also includes protection against chickenpox in the combined vaccine used in some contexts. Administering the vaccines separately, he said, does not reduce the risk of side effects. Instead, it increases the number of injections and postpones protection against the diseases concerned.

He also noted that the measles, mumps and rubella vaccination cannot be administered before the age of 1 because it is a live attenuated vaccine and requires a sufficiently mature immune system.

Rezza criticized Trump’s remarks at the signing ceremony regarding autism as well. He recalled that a study suggesting an association between the measles vaccine and autism was withdrawn by the journal that had originally published it, while subsequent research found no correlation.

He also pointed to the position taken by Robert Kennedy Jr., the U.S. secretary of Health and Human Services, who, in the context of a measles outbreak, encouraged parents to vaccinate their children.

Another issue, Rezza said, is the decentralized nature of U.S. vaccination policy. Individual states can establish their own policies, including, in some cases, nonmedical exemptions based on religious or philosophical grounds. Increasing the complexity of the vaccination schedule without demonstrable benefits, he argued, would therefore add difficulties for both citizens and healthcare professionals.

As for possible consequences in Europe, Rezza said they are difficult to predict. In Italy, he noted, the vaccination system has undergone scientific review and includes recommendations for vaccines against meningococcal disease and pneumococcal disease that are not mandatory. He described the current schedule as rationally structured.

He also distinguished the U.S. and Italian approaches to influenza and COVID-19 vaccination for children, noting that influenza vaccination is not offered as extensively to children in Italy and COVID-19 vaccination has not been routinely offered to them for some time.

For Rezza, the current U.S. recommendations do not introduce significant scientific innovations and appear primarily political and directed at a domestic audience, making substantial international repercussions difficult to foresee.

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