WASHINGTON — President Donald Trump on Monday signed a sweeping executive order that aims to reshape guidance surrounding childhood vaccines, standing alongside Health and Human Services Secretary Robert F. Kennedy Jr., and was met with immediate pushback.

The order — which calls on federal programs and funding to “support maximal parental choice over childhood vaccines” — came as Trump continued to erroneously connect vaccines with autism during the White House event and his administration has sought to de-emphasize childhood vaccinations’ importance. 

“This updated recommendation finally aligns the United States with other advanced and developed nations around the world,” Trump said during a signing ceremony in the Oval Office, joined by Kennedy, a longtime opponent of vaccines, as well as National Institutes of Health Director Jay Bhattacharya and “Make America Healthy Again” advocate Jayme Franklin, also founder and CEO of The Conservateur lifestyle brand, and others.

“More importantly, it aligns us with common sense and knowledge,” Trump added.

What the order can legally accomplish was unclear as it’s up to states to decide which recommendations to follow.

GOP Sen. Bill Cassidy of Louisiana, a physician and chairman of the Senate Health, Education, Labor and Pensions Committee, rebutted the new order on social media. “I’m a doctor. This executive order is wrong. The President does not have the expertise to make these changes,” Cassidy said. “Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines DO NOT cause autism.”

Splitting up MMR vaccine

The order recognizes “gold standard childhood vaccine recommendations” and divides the childhood immunization recommendations into three categories. 

The order recommends all children receive immunizations for 11 diseases, including for “measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus, and varicella.” 

Immunizations recommended for certain high-risk groups or populations include: “respiratory syncytial virus monoclonal antibodies, hepatitis A, hepatitis B, meningococcal B, meningococcal ACWY, and dengue.” 

The order also lists “hepatitis A, hepatitis B, rotavirus, meningococcal disease, influenza, and COVID-19” as immunizations “based on shared clinical decision-making.” 

Trump’s executive order also calls for splitting up the combined measles, mumps and rubella, or MMR, vaccine into three separate single-disease shots and recommends that “all childhood immunizations should be administered at separate medical visits.” Such single-disease shots are not currently available in the United States, White House officials acknowledged on a background call, but said they believe work will occur in the private sector to make that option eventually available. 

“For example, at one year, you should have five separate visits for vaccines rather than getting them all in the same day,” Trump said during the signing ceremony. 

Trump said the order also directs the attorney general “to advance legal challenges against states that violate children’s rights to religious or medical vaccination exemptions.” 

‘Uncertainty and fear and confusion’

Meanwhile, Dr. Andrew Racine, president of the American Academy of Pediatrics, told reporters Monday during a press briefing after the Trump event that “the only thing that I can see is going to happen as a result of the announcement from today is an injection of greater amounts of uncertainty and fear and confusion, when there doesn’t need to be any of that.” 

Many states rely on the AAP, rather than the federal government, for guidance surrounding childhood vaccines, according to the health research organization KFF, following earlier moves on vaccines during the Trump administration.

Rep. Frank Pallone, ranking member of the House Energy and Commerce Committee, blasted Trump’s order, saying the effort “lets political appointees attempt to overrule decades of peer-reviewed science and dictate vaccine schedules to American families,” in a statement. 

The New Jersey Democrat added that “parents deserve accurate, trusted medical guidance, not a White House-curated list designed to rubberstamp Secretary Kennedy’s radical anti-vaccine agenda.” 

Democrats from a coalition of states filed suit earlier this year over Trump administration changes to the federal vaccine guidelines, as did medical groups, but White House officials said Trump’s recommendations were not related to the litigation and were within his authority.

WASHINGTON — Advocates and public health experts urged Republicans in Congress on Wednesday to implement a two-year delay on requiring states to begin sharing the costs for Supplemental Nutrition Assistance Program benefits. 

Provisions of the Republican-backed law that President Donald Trump signed last year that go into effect in October 2027 will require states with high SNAP error rates — the percentage of benefits that are overpaid, underpaid or go to recipients who are ineligible — to begin covering some of the program’s costs. It marks a stark change for SNAP, which is solely funded by the federal government. 

In an online briefing hosted by the left-leaning think tank Center on Budget and Policy Priorities, the American Academy of Pediatrics and Invest in Louisiana, speakers said Congress should use the government funding process to protect access to affordable food for American families. 

Sharon Parrott, the center’s president, said that Republicans are “looking right past this emergency” and using their current budget resolution to help farmers struggling with increased costs that have resulted from Trump’s tariffs and oil prices that have been driven up by the war with Iran — but not low-income grocery shoppers.

“Republican leaders in Congress are ignoring the urgent need to help low-income families and kids who are losing SNAP and can’t afford groceries,” she said. “Congress could use the budget process to help both farmers and families. At a minimum, Congress needs to slow down the hasty implementation of the massive cost-shift in SNAP costs to states.”

She said that since the GOP law, called the One Big Beautiful Bill Act, altered SNAP eligibility requirements, more than 4.5 million people have stopped receiving food assistance benefits. Nearly one-third, 1.5 million, are children. 

The nonpartisan Congressional Budget Office estimated the changes to SNAP would reduce federal spending by nearly $190 billion over the next 10 years.

Local leaders push back

Wednesday’s briefing comes amid similar calls from community organizations and state and local leaders from across the country. 

On Monday, the United States Conference of Mayors sent a letter to leaders of the Senate Agriculture Committee asking them to reconsider SNAP changes enacted over the last year and shifting funding to states. 

“At a time when many Americans continue to face economic challenges, we should be working to expand opportunity and food security, not create new barriers to assistance,” the letter, signed by more than 200 mayors, read. 

Senate Minority Leader Chuck Schumer said in a statement Monday that Republicans and Democrats must work together to draft a farm bill that restores SNAP and protects funding for food assistance. 

Schumer added that he will not support any farm bill that does not provide states more time to prepare to shoulder the program’s costs. 

Time is running out to get a cost-shift pause through Congress. 

The House is scheduled to adjourn Friday, and won’t be back in session until Aug. 31. Even then, it will just be back for a few weeks, before again adjourning for almost all of October. The Senate will adjourn after the first week in August and will similarly be out for the beginning of September and almost all of October. 

All about the error rates

The One Big Beautiful Bill Act will require most states with error rates of above 6% to cover between 5% and 15% percent of the benefits’ total cost. States under a 6% error rate will be exempt. 

But some states with the highest SNAP error rates — of about 13.3% or higher — will be given an extension to lower their error rates before being forced to bear some of the program’s costs. Depending on the error rate, the states will be granted up to an extra two years to begin sharing costs. 

“Congress can act right now to stop the bleeding and steer us away from this oncoming childhood hunger crisis by extending that same two-year delay to every state — not just the few that benefit from the existing carveout,” said Ty Jones Cox, the budget and policy center’s vice president for food assistance. 

States with the highest error rates in fiscal 2025 included Alaska at 23%, and Delaware and New Mexico both at approximately 16%, according to U.S. Department of Agriculture data. 

Cox said the center estimates nearly half of U.S. states will likely have to pay $100 million or more because of the cost-sharing changes. 

“These are huge costs,” she said. “States are working hard to reduce their error rates, but they’re up against the wall. The law didn’t give them any time or resources to do so.”

Cox said that states that plan to maintain SNAP benefits will have to find the funding from other places, if they are unable to generate more revenue. She said some states may choose to eliminate summer EBT or end universal school meals to continue funding the program. 

Given the steep costs, some states, such as Alabama, have floated the possibility of cutting their SNAP programs entirely if they are unable to lower error rates, Parrott said. 

Public health impacts

The effect of losing SNAP benefits extends beyond food insecurity, said Andrew Racine, president of the American Academy of Pediatrics. 

Besides clean air and water, and a supportive family and environment, he said, food is the most important determinant of a child’s health and future success. 

Racine added that the long-term benefits of SNAP are not being taken into account when decisions regarding its future are made. 

“The benefits of SNAP accrue to that child, accrue to that family, but they accrue to people around them,” he said. “[If] you have a child who’s not suffering from hunger in the classroom, and their ability to concentrate is improved, that has impact on their fellow classmates who are not on SNAP.”