HOUSTON – A new executive order from President Donald Trump reshapes federal childhood vaccine recommendations, but it does not change the vaccines currently required for students attending Texas schools, according to the Texas Department of State Health Services.
The president signed the order Monday, establishing what the White House calls its “Gold Standard Childhood Vaccine Recommendations.” The new framework prioritizes parental choice and reduces the number of diseases covered by universal childhood immunization recommendations from 18 under the Centers for Disease Control and Prevention’s 2024 schedule to 11.
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The order places childhood immunizations into three categories:
- Immunizations recommended for all children
- Immunizations recommended for certain high-risk groups
- Immunizations based on shared decision-making between families and health care providers
Vaccines protecting against measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus and chickenpox remain in the universal category.
Vaccinations for diseases including hepatitis A, hepatitis B, rotavirus, meningococcal disease, influenza and COVID-19 are assigned to either high-risk groups, shared clinical decision-making or both.
Houston pediatric neurologist Dr. Audrey Nath, who is also a mother, said she is concerned the changes are not supported by science.
“I’m frustrated,” Nath said. “It doesn’t appear to be based on any sort of systematic evidence.”
Texas and federal recommendations now differ
The Texas Department of State Health Services told KPRC 2 that the president’s order does not change the state’s existing school vaccine requirements.
Texas currently requires students to receive certain vaccines protecting against diseases including measles, mumps, rubella, polio, hepatitis A, hepatitis B, diphtheria, tetanus, pertussis and chickenpox.
A meningococcal vaccine is also required for Texas students in grades seven through 12.
Those state requirements now differ in several ways from the new federal framework. Hepatitis A and B vaccinations are no longer universally recommended under the executive order, while meningococcal vaccinations are limited to high-risk groups or individual decisions between doctors and families.
The order encourages states and territories to review their school vaccine requirements and consider changing them to align with the new recommendations. However, it does not directly override Texas law.
Texas already permits vaccine exemptions for medical reasons and reasons of conscience, including religious beliefs, when families provide the required documentation.
Nath worries Texas could eventually follow the federal government’s lead or that changes to federal funding could affect whether some vaccines remain affordable.
“It’s entirely possible that Texas could follow the lead of this federal executive order,” Nath said.
She said any reduction in vaccine access or coverage could increase the risk of outbreaks in schools.
“Measles is so incredibly contagious,” Nath said. “Those virus particles can hang in the air for hours. So a breakout in a school would be catastrophic.”
Order calls for separating the MMR vaccine
Trump’s order also calls for the combined measles, mumps and rubella vaccine, known as MMR, to eventually be offered as three separate vaccines.
Separate measles, mumps and rubella vaccines are not currently available in the United States. Under the order, the Department of Health and Human Services is instructed to develop a plan for making the individual products available while preserving access to the combined vaccine.
The order also recommends administering childhood vaccines during separate medical visits “to the maximum extent feasible.”
Nath said she has not seen evidence showing that the combined MMR vaccine presents a safety problem. She also questioned whether children would benefit from receiving additional injections and attending more appointments.
“You can ask my kid,” Nath said. “She would prefer not to have three needle sticks to get the vaccine if possible. There really is the child’s comfort as well. And there’s just no evidence to show that the combined vaccines present a safety issue.”
Trump references autism while discussing order
While announcing the recommendations, Trump also referenced autism.
“Today we’re proud to officially announce the United States of America’s gold standard childhood vaccination recommendations, and that has to do with many subjects, but including autism in particular,” Trump said.
Decades of peer-reviewed studies involving hundreds of thousands of children have found no association between the MMR vaccine and autism.
Nath said signs of autism can become noticeable around the same age children receive their first MMR vaccination, which can create the appearance of a connection. However, she said studies have not found that the vaccine causes autism.
“We know from studies of hundreds of thousands of children that there is no link between the MMR vaccine and autism,” Nath said. “We know that autism tends to present at around the same time as the first MMR being given, which is why it can seem like they’re related.”
What Texas parents need to know
For now, families enrolling their children in Texas schools must continue following the state’s existing vaccine requirements.
The executive order directs the HHS Task Force on Safer Childhood Vaccines to present plans to the president within 90 days. Those plans are expected to address the timing and sequencing of childhood vaccines, vaccine safety monitoring and options for offering separate measles, mumps and rubella vaccines.
Nath urged parents to speak with their pediatricians before changing or delaying any vaccinations.
“Nothing has changed here in Texas regarding what vaccines are recommended and what vaccines are needed to enroll in school,” Nath said. “Stay in touch with your pediatricians. They’re going to have recommendations for you, but I would not be making any changes to plans to vaccinate. I’m a physician, and my kids are fully vaccinated.”