Trump's childhood vaccine order will threaten children's safety, even if it doesn't directly change policy ...Middle East

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However, the more important issue with the order may be something more fundamental: What happens when vaccine policy is divorced from the scientific processes designed to guide it?

It's very possible that the immediate impact of the executive order will be limited. Many pediatricians, state public health agencies and professional medical organizations are likely to continue following established immunization schedules that were developed through decades of scientific review and real-world experience. The order itself does not magically change how vaccines work, how doctors practice medicine, or how states set school vaccination requirements.

Nevertheless, it would be a mistake to conclude that the order does not matter, because the true risk it poses is that it creates confusion and uncertainty for parents and caregivers, who only want to protect their children as best they can.

We are seeing this right now. U.S. kindergarten vaccination rates have continued to drop, falling farther below the thresholds needed for herd immunity. This is especially concerning at a moment when the U.S. is experiencing one of its worst measles outbreaks in decades, while other preventable infectious diseases are making a resurgence.

Here's why. Today, during their first years of life, children receive two doses of the combined MMR vaccine, administered in two separate injections. Under the approach outlined in the executive order, children would need six separate injections to achieve the same protection.

The changes to the childhood vaccination schedule proposed in the executive order are not backed by scientific evidence. (Image credit: adamkaz via Getty Images)

These practical consequences shouldn't be ignored. Every additional visit creates another chance for a child to fall behind on vaccinations. Every added logistical hurdle disproportionately affects families with fewer resources, less schedule flexibility or less access to healthcare.

In short, the proposal would require substantial new costs and complexity just to replace a system that has been working exceptionally well and protecting children for decades. The combination MMR vaccine was developed precisely because combining vaccines reduces the number of injections, thus improving vaccination rates by ensuring children receive protection as early and efficiently as possible.

What is the rationale behind the executive order? Administration officials have pointed to differences between U.S. vaccine recommendations and those from some other developed countries, such as Denmark, which recommends fewer routine vaccines than the U.S. does. On the surface, that argument may sound reasonable — if another country administers fewer doses, why shouldn't the U.S.?

It is therefore unsurprising that schedules vary among nations, and the motivation to match other countries' schedules is arbitrary, rather than science-led. What matters more is whether recommendations are supported by evidence and whether they effectively protect children in America, specifically.

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It may be months or years before we see the consequences of this executive order and the wider attacks on vaccines. It will be reflected through declining confidence in public health institutions, growing uncertainty among families, and increasing difficulty in maintaining high vaccination rates, leading to higher rates of disease and death.

Whether formal policy changes will be implemented now or in the future is less the issue. What's more at stake is whether the order will drive Americans to rely less on scientific evidence and expertise when they're making decisions that affect their children's health.

This article is for informational purposes only and is not meant to offer medical advice.

Opinion on Live Science gives you insight on the most important issues in science that affect you and the world around you today, written by experts and leading scientists in their field.

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