Change the vaccination schedule for children

President Donald Trump broke his promise to slow down the vaccine schedule, a promise that doctors criticized as counter to public health recommendations.

As a candidate, Trump repeated the falsehood that vaccines are linked to autism, despite the fact that the connection has been debunked by scientists and the U.S. Centers for Disease Control and Prevention. Vaccine misinformation is dangerous. Falling immunization rates have been linked to outbreaks of vaccine-preventable diseases. Doctors say that delaying vaccines is risky.

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During a 2015 primary debate, Trump said: "Autism has become an epidemic… I am totally in favor of vaccines. But I want smaller doses over a longer period of time."

Doctors said Trump's promise countered scientific recommendations.

"Lower doses would not work," said Arthur Caplan, a professor at NYU School of Medicine and an expert on health reform and ethics. "The Food and Drug Administration approves effective doses. Less is not better."

Trump's tenure as president has not led to a dramatic shift in vaccine policy.

"The recommended childhood vaccination schedule continues to reflect the evidence-based consensus of the public health experts at the Centers for Disease Control and Prevention as well as major medical professional organizations," said Jason Schwartz, a professor at the Yale School of Public Health. "Minor updates to the schedule happen annually, as they have for decades, but there have been no major changes regarding vaccine doses or timing during the Trump administration."

The White House has limited control over the vaccination schedule. The CDC sets the immunization schedules based on the CDC's Advisory Committee on Immunization Practices.

The childhood and adolescent schedules are also approved by the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists. 

The CDC has not changed the schedules since Trump took office.

Since the COVID-19 pandemic started, immunization rates have dropped but are now slowly on the rise, according to the American Academy of Pediatrics, which encourages parents to continue to get their children vaccinated.

Trump was a vaccine skeptic long before he was a candidate for president. His rhetoric has changed in the past two years of his presidency. During the measles outbreak in 2019, he said this about vaccinations: "They have to get the shot. The vaccinations are so important. This is really going around now. They have to get their shot."

This year, the Trump administration announced Operation Warp Speed to fast-track vaccines for COVID-19 and has invested nearly $4 billion in companies pursuing vaccines

 Trump appears to have walked away from his promise to slow down the vaccine schedule. We rate this Promise Broken.

Before and during his campaign, President Donald Trump repeatedly linked vaccines to autism, despite the fact that the claim has been debunked.

At a 2015 Republican presidential candidate debate, CNN anchor Jake Tapper asked Trump how, if elected, he would handle overseeing the Centers for Disease Control and Prevention and the National Institute of Health, which both disagree with his stance on vaccinations.

Trump responded: "Autism has become an epidemic… I am totally in favor of vaccines. But I want smaller doses over a longer period of time."

When it comes to the vaccination schedule, the White House has limited control.

Federal recommendations on the schedule are chosen through the CDC's Advisory Committee on Immunization Practices. Members on the committee must go through a rigorous application process and are ultimately appointed to four-year terms by the U.S. Health and Human Services Department secretary, a position currently held by former U.S. Rep. Tom Price.

Even though the CDC's immunization schedule could possibly have some influence on state laws, the schedule and other CDC recommendations are not federal requirements.

As of February 2017, all states require immunizations as a condition of enrollment in public school and, in many cases, private school. However, depending on the state, parents can exempt their children from immunizations for medical or philosophical reasons.

In response to a question about implementing federal immunization requirements during his tenure, Price acknowledged in March that state governments tend to make those decisions, but evaded a question about whether vaccines should be required.

"I believe it's a perfectly appropriate role for the government -- this happens, by and large, at the state government level, because they're the ones that have the public health responsibility -- to determine whether or not immunizations are required for a community population," Price said during a CNN town hall event.

It is unclear where Price stands on vaccines. He agreed during his confirmation hearing that science has debunked the autism link, but he has also been a member of the Association of American Physicians and Surgeons, a group that believes in a link between vaccines and autism.

Because the federal government doesn't decide state immunization laws, changes to the CDC vaccination schedule won't necessarily result in any changes to vaccination requirements. Price could end up having some influence on the vaccination schedule through his Advisory Committee on Immunization Practices member appointments. But terms on the 15-member committee are staggered, meaning Price could only select a few members per presidential term.

It will be difficult for Trump to implement this promise, and we've seen no indication that Trump or Price intends to aggressively push for it. Since we've found no action on this promise, for now we rate it Stalled.