Today the President issued a new E.O. About vaccines, and held a press conference that included several weirdly inaccurate statements.

I thought it might be helpful for me to explain what the E.O. does and does not do and add some comments. 

Sorry for the length, and I hope it's useful to at least some of you. Here is the Executive Order: whitehouse.gov/presiden…

whitehouse.gov/presiden… has several parts.it

I. parts.it repeats a change to the childhood schedule that the Secretary tried to announce in a memo on January 5, 2026, and that a court stayed in March 2026. That change would make 6 of the vaccines we have as routine recommendations downgraded to other categories - either only for high risk groups, or shared clinical decision making, which is a legal term that means "consult with your doctor, it's not worth a general recommendation but there may be special circumstances." That earlier recommendation was based on an assessment that compares us to "peer countries" - hhs.gov/sites/default/f… - all of which have universal healthcare coverage, without addressing the differences between the country. It then decided to align our schedule with Denmark, which has less routinely recommended vaccines than other countries in the assessment list. It spent 5 pages on each vaccine it downgraded, giving a very biased and cursory discussion of why they are downgraded. The E.O. Refers to that assessment and embraces it, downgrading the recommendation for vaccines against Hepatitis A, Hepatitis B, meningococcal disease, rotavirus, influenza, COVID-19 and also RSV monoclonal antibodies.

What does this mean? 

• It should not be valid legally, and CDC should not be changing its immunization schedule table. The previous memo was stayed because the process did not involve a required consultation with the Advisory Committee on Immunization Practices (AcIP), and this did not either. ACIP's role is encoded in several Congressional statutes. 

• It is very likely to cause serious confusion for parents.

• The  E.O. Calls on state to revise their recommended schedule and school mandates, and in the press conference, administration official Heidi Overton suggested they will put pressure on states to do that, and I suspect that is the main goal. California dissolved its reliance on federal recommendations in 2026 - in response to previous efforts. So no direct effect here, but in other states, express pressure.

II. A call for the secretary to push to individual vaccines. This is tricky: right now there are no licensed vaccines for measles, mumps and rubella (the E.O. Mentions MMR expressly, and the President addressed it in the press conference), and their licenses have elapsed, so there would have to be relicensing, and I don't see manufacturers rushing to do clinical trials or go through the process for licensing factories for this (for vaccines, you need to license both the vaccine and the plant that makes it). The other options is allowing individual vaccines from other countries. The countries that currently make individual mumps, measles, rubella vaccines are China, India, Indonesia, and Japan. None of these are licensed in the U.S, and even if FDA is willing to cut corners, I don't know how vaccines from these countries will play with the biases of Trump's followers.

On this see: skepticalraptor.com/ske…

III. A call to adopt adjuvants different from the usually used aluminum adjuvants (on that, see: chop.edu/vaccine-educat…). Here, too, I don't see companies rushing to do this. And it would require clinical trials for the adjuvant and/or vaccines that use it. Not likely any time soon.

IV. Asking the DOJ to bring lawsuits against states that have vaccine mandates without - or without sufficient - religious and medical exemptions. Asking the Department of Education to cut grants for states that don’t have them. The first could happen. California has no non-medical exemption and review of the medical, so we could be among the targets. There  is already litigation on this, so DOJ could join it or bring its own, and I don't know how that will play

my reading is that the most immediate practical effects of this is pressure on the states, directly or indirectly, and creating confusion for parents, rather than direct legal changes.Happy to address questions.