Trump executive order seeks to split combination childhood vaccines, prompting industry and health expert concerns

The White House announced an executive order that would require the separation of combination childhood vaccines, including the measles, mumps and rubella (MMR) shot, into individual injections and recommend spacing out other immunizations. Federal officials have 90 days to develop implementation plans, but experts say the changes could take years and cost tens of millions of dollars.

Currently, the United States uses only the three-in-one MMR vaccine, a practice in place since the 1970s. Reviving standalone measles, mumps or rubella vaccines would demand new clinical studies to demonstrate comparable immune responses, new manufacturing facilities, and separate FDA approvals for each product. Industry analysts estimate that designing, building and obtaining regulatory sign-off for new plants typically requires about five years.

"We do things that are less convenient and more expensive if there's a good reason to do it. There is no good justification for this. I think it's very bad public health policy," said Dr. Anna Durbin of the Johns Hopkins Bloomberg School of Public Health.

"The question is how much has changed since then and how comfortable will the FDA and the companies be relying on those comparisons?" said Dr. Jesse Goodman, a former FDA vaccine chief now at Georgetown University.

"I don't think there's any comparable example of removing hugely effective public health measures that protect babies for no documented scientific reason," Goodman added.

Manufacturers such as Merck and GSK, which currently produce only the combination shot, said the existing vaccine is safe and effective and noted that no scientific evidence supports separating it. Splitting the MMR series would double the number of doses from two to six, increasing the number of pediatric visits and associated costs for syringes and other supplies. Dr. Durbin warned that the added inconvenience could lead to missed appointments and lower vaccination rates.

"It's going to be less convenient, more expensive and you're going to have fewer people getting vaccinated," she said.

White House spokesman Kush Desai argued the policy would give parents more flexibility in timing and could boost overall vaccination rates. However, public-health researchers note that the order is not legally binding; only state governments can mandate school-entry vaccinations, and there is little commercial incentive for companies to develop competing individual products.

"They'd be competing against themselves, and there's no reason to do that," said Dr. Paul Offit of the Children's Hospital of Philadelphia.

"I think states will ignore this. I think that bottom line is that we don't need to look to Donald Trump for our medical advice," Offit added.

The order therefore faces significant logistical, financial and scientific hurdles, and its impact on vaccination practices remains uncertain.