US vaccination executive order: making sense of it

US vaccination executive order: making sense of it August 11, 2026US President Donald Trump signed another executive order on Monday, August 10, 2026: "Delivering gold standard childhood vaccine recommendations for Americans." The order reduces the current recommendation of 18 vaccines for children down to 11, which puts it almost in line with the World Health Organization (WHO) recommendations. As DW reported in May 2025, there are vaccines against 30 infectious diseases. The World Health Organization recommends that every child get vaccinated against 12 of those: - Tuberculosis - Hepatitis B - Polio - Diphtheria - Tetanus - Pertussis (whooping cough) - Haemophilus influenza type B - Pneumococcal disease - Rotavirus - Measles - Rubella - Human papillomavirus This is the WHO making recommendations for all nations — both rich and poor. Many poor countries face challenges around access to vaccines at prices they can afford and distributing them safely to people living in remote areas. Rich countries, on the other hand, can afford and therefore usually offer more vaccinations than the WHO's base level of 12. But not all of them do. Germany, for example, recommends 14 vaccinations for children in their first two years after birth. Germany no longer recommends the BCG vaccine against tuberculosis (TB), which is on the WHO list. It does recommend vaccination against Respiratory Syncytial Virus (RSV), which is not on the WHO list. This just goes to show that there are variations around the world. It's not just the US. These variations often depend on which diseases are considered by local health experts to be an ongoing threat to any given community. Taking the example of TB in Germany: In 1998, the country's Standing Committee on Vaccination (STIKO) decided the risk of TB infections was low, and herd immunity was deemed high enough at 50-80%. Therefore the STIKO stopped recommending the vaccine. What does Trump's new childhood vaccine recommendation say? Trump wants to create three distinct categories for vaccination. The first category includes immunizations recommended for all children: measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (meningitis), pneumococcal disease, human papillomavirus and varicella (smallpox). That removes vaccination against hepatitis b, rotavirus, influenza and RSV from this baseline category that were on the recommended list until now. These illnesses however can still affect newborns. As we reported in 2022, cases of RSV have risen in the US and Europe. Babies who don't receive the vaccine would remain unprotected against the illness. By contrast, Germany recommends vaccination for RSV, rotavirus and hepatitis B in a child's first six months. Trump's executive order also recommends that the combined MMR vaccine for measles, mumps and rubella — which is a global standard — be split into individual jabs, spaced over time. This appears to be a reflection on long-held rhetoric from the Trump administration suggesting that the combined MMR vaccine causes autism. The US Centers for Disease Control and Prevention (CDC) says there is no published evidence to suggest there is any benefit in single jabs. In fact, its advice on the MMR vaccine states that "the CDC and the American Academy of Pediatrics (AAP) agree that MMR vaccine is not responsible for recent increases in the number of children with autism." But Trump and Robert F. Kennedy Jr. have long suggested vaccines are dangerous in general. Kennedy also thinks that the common painkiller Tylenol causes autism when taken during pregnancy. It is the only painkiller allowed during pregnancy in the US. And as we reported in September 2025, no high-quality scientific evidence substantiated their claim. Trump's second category would include immunizations for high-risk groups or populations: respiratory syncytial virus monoclonal antibodies, hepatitis A, hepatitis B, meningococcal B, meningococcal ACWY, and dengue. The third would include vaccines to be given "based on shared clinical decision-making" — so, doctor and patient or parent of a patient would have to agree. These include: hepatitis A, hepatitis B, rotavirus, meningococcal disease, influenza and COVID-19. The effect of political — rather than scientific — rhetoric on vaccines While there's no direct recommendation to ban any vaccine, the second Trump administration has repeatedly attempted to destabilize public consensus over vaccination. That can cause confusion in the community and rising rates of infection. For example, in July 2026, DW reported how "amnesia" about measles and how dangerous it is had led to a rise in measles infections in the US. People had missed opportunities to get vaccinated because infection rates had been low, but then they rose again. This is not just the case in North America. Germany has also seen measles infections rise, with experts citing anti-vaccination rhetoric that emerged during the COVID pandemic. Allowing bird flu to spread Kennedy however takes his hands-off rhetoric to farming communities, too. In March 2025, DW reported how the health secretary suggested bird flu should be allowed to spread through bird populations, even in places where it had already infected cattle. Kennedy said it would enable researchers to develop "super" chickens. But instead, more than 150 million birds got infected. Bird flu virus was detected in raw milk. And there were bird-to-human infections as well. On Monday, when Trump's executive order was released, the AAP's Andrew Racine said it was "not based on 'gold-standard science.' There is no new evidence to justify significant changes to childhood immunization guidance." Edited by: Carla Bleiker