Trump vaccine order faces steep logistical, financial hurdles

President Donald Trump's executive order aimed at reshaping childhood vaccination schedules has drawn sharp criticism from public health experts, but the practical obstacles may prove even more daunting than the scientific objections. The order, announced Monday, directs federal agencies to develop plans within 90 days for separating combination vaccines — including the measles, mumps, and rubella (MMR) shot — into individual injections and spacing out other immunizations.

Drugmakers would face a formidable task: reviving individual vaccines for measles, mumps, and rubella that have not been marketed separately in the United States for decades. No such standalone vaccines are currently approved by the Food and Drug Administration. The three-in-one MMR formulation has been the standard since the early 1970s.

Building new manufacturing facilities and conducting required safety and efficacy studies would likely take years and cost tens of millions of dollars, according to pharmaceutical scientists and former regulators. Dr. Jesse Goodman, a former FDA vaccine chief now at Georgetown University, noted that companies would need to prove new individual shots produce immune responses comparable to current versions — a process with no clear precedent.

For parents, the practical impact would mean significantly more doctor visits. The MMR vaccine is currently given in two doses, but splitting it into three components would require six separate appointments. Spacing out other vaccines could multiply visits further. Dr. Anna Durbin of Johns Hopkins warned that added inconvenience and cost would likely reduce vaccination rates rather than increase them.

Industry experts note that drugmakers have little commercial incentive to develop standalone vaccines that would compete with their own combination products. Merck and GSK, the primary suppliers of U.S. childhood vaccines, issued statements affirming their confidence in current formulations but did not indicate plans to unbundle them.

White House spokesman Kush Desai defended the order, saying it would give parents more options on timing and frequency, which he argued would ultimately increase vaccination rates. However, legal authority over school vaccine requirements rests with states, and the order only advises them to consider changes. Dr. Paul Offit of Children's Hospital of Philadelphia predicted states would ignore the directive, adding, "We don't need to look to Donald Trump for our medical advice."