Realigning United States Core Childhood Vaccine Recommendations with Best Practices from Peer, Developed Countries
This Presidential Action directs the Department of Health and Human Services (HHS) to review and update the United States core childhood and adolescent vaccine schedule based on a prior scientific assessment that compared U.S. recommendations to those of peer developed countries.
The policy prioritizes aligning the schedule with international best practices, ensuring continued cost-free coverage for recommended vaccines, while explicitly committing the Federal Government to protecting religious liberty and parental authority regarding these medical decisions.
Arguments For
Supporting evidence from a prior scientific assessment comparing U.S. recommendations to peer nations, indicating the U.S. recommends more vaccines and doses than many peers, thus justifying a review for alignment with global best practices.
Upholding the policy commitment to ensure Americans receive the best scientifically supported medical advice while simultaneously protecting constitutional rights like religious liberty and parental authority in medical decisions.
Encouraging flexibility in immunization timing and sequencing through recommendations from the CDC and ACIP, empowering parents and doctors to tailor schedules based on individual circumstances.
Ensuring continued, cost-free coverage for essential immunizations through private insurance, Medicaid, CHIP, and the Vaccines for Children Program, preserving access during the transition.
Arguments Against
Potential public health risk if certain vaccines removed or delayed from the existing schedule are reintroduced or if vaccine uptake decreases following revisions based on non-U.S. standards.
Implementation challenges may arise in coordinating changes across federal agencies (HHS, CDC, ACIP) and ensuring uniform adoption by state health officials, potentially leading to patchwork compliance.
Concerns that aligning with peer nations, which rely more on trust and education than mandates, may lead to lower national vaccination rates compared to the current system, reversing gains against infectious diseases.
The order preserves existing legal protections for mandates but directs alignment away from them, challenging established public health mandates that currently enforce high immunization levels.
By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered:
This standard introductory clause asserts the President’s constitutional and legal authority to issue the subsequent directives within the document.
Section 1. Purpose and Policy. Pursuant to the Presidential Memorandum of December 5, 2025 (Aligning United States Core Childhood Vaccine Recommendations with Best Practices from Peer, Developed Countries) (Memorandum), the Department of Health and Human Services (HHS) completed a scientific assessment that compared United States childhood immunization recommendations with those of peer nations, analyzed vaccine uptake and public trust, evaluated clinical and epidemiological evidence and knowledge gaps, and examined vaccine mandates (scientific assessment). The scientific assessment found that the United States currently recommends more childhood vaccines than any peer nation, including more than twice as many vaccine doses as some European nations, and identified a set of consensus vaccines that are consistently recommended in all peer countries. The scientific assessment also found that, instead of implementing vaccination mandates, most peer nations maintain high childhood vaccination rates through public trust and education.
My Administration is committed to ensuring that Americans are receiving the best scientifically supported medical advice in the world. Additionally, my Administration is committed to protecting religious liberty and parental authority. Therefore, it is the policy of the United States that the core childhood vaccine schedule should be aligned with scientific evidence and best practices from peer, developed countries while preserving access to vaccines currently available to Americans and that the Federal Government will continue to protect religious freedom and enforce all legal protections for parents.
Section 1 establishes the document’s objective and policy.
It refers to a prior 2025 Memorandum that initiated a scientific assessment comparing U.S. childhood vaccine recommendations to those of peer nations.
The assessment found the U.S. recommends significantly more vaccines and doses and that peer nations achieve high vaccination rates through trust rather than mandates.
The resulting policy commits the Administration to aligning the core vaccine schedule with best practices from peer countries while maintaining current vaccine access and protecting religious liberty and parental authority.
Sec. 2. Updating the Childhood Vaccine Schedule. (a) The scientific assessment, with its proposed updates to the categories of the vaccine schedule, is acknowledged as a guiding resource for the Federal Government.
(b) The Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP) shall review the scientific assessment and the latest clinical data and, to the extent permitted by law, take any appropriate steps to update the United States childhood and adolescent vaccine schedule. ACIP’s review should consider ways to provide maximum flexibility to parents and doctors through recommendations for timing and sequencing of the administration of routine immunizations.
(c) Each executive department and agency shall ensure all actions, regulations, funding, and coverage related to child and adolescent immunizations align with the schedule recommended by the ACIP and adopted by the CDC, including fulfilling all legal obligations with respect to parental authority, religious freedom, disability accommodations, and equal protection under the law. Specifically, consistent with the Memorandum and as recommended in the scientific assessment, all the immunizations that are in any category on the schedule recommended by the ACIP and adopted by the CDC should continue to be covered without cost sharing by private insurance and covered by Medicaid, the Children’s Health Insurance Program, and the Vaccines for Children Program.
(d) The HHS Director of the Office of Intergovernmental and External Affairs shall ensure that State government and health officials are informed of the policies in this order and should ensure that the scientific assessment is available as a resource to inform their consideration of State vaccination laws.
Section 2 outlines the actions for updating the vaccine schedule.
The prior scientific assessment is designated as a guiding federal resource.
The CDC and ACIP are mandated to review this assessment and clinical data to update the U.S. schedule, focusing on providing maximum flexibility for parents and doctors regarding timing.
All federal departments must align their regulations and funding with the new schedule, ensuring all immunizations remain covered without cost-sharing by private insurance and various government health programs.
Finally, HHS must inform state officials about these policies and make the scientific assessment available for their consideration of state laws.
Sec. 3. General Provisions. (a) Nothing in this order shall be construed to impair or otherwise affect:
(i) the authority granted by law to an executive department or agency, or the head thereof; or
(ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.
(b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.
(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
(d) The costs for publication of this order shall be borne by the Department of Health and Human Services.
DONALD J. TRUMP
THE WHITE HOUSE,
May 29, 2026.
Section 3 covers general provisions, ensuring the order does not override existing statutory authority granted to executive departments or the functions of the Office of Management and Budget concerning budgets or legislation.
It specifies that implementation must comply with existing law and available funding.
Furthermore, it clarifies that the order does not create new enforceable legal rights or benefits for any party against the government.
The Department of Health and Human Services is assigned responsibility for the publication costs of the order, which is dated May 29, 2026, and signed by Donald J. Trump.
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