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WASHINGTON (AP) -- President Donald Trump on Monday signed an executive order calling for revamped childhood vaccine recommendations that promote his long-held but discredited theory that childhood shots should be spaced out into separate medical visits.
The order advocates separating the measles, mumps and rubella (MMR) vaccine into three different single-disease shots and administering all childhood immunizations at separate appointments whenever possible. It also directs the nation's health department to improve research on vaccines, which are already extensively studied, and present a plan to offer separate measles, mumps, and rubella vaccines for children, since that is not currently an option in the United States.
The renewed focus on vaccines marks a departure from the Trump administration's recent efforts to emphasize less controversial health policies related to healthy eating, drug price negotiations and medical fraud crackdowns ahead of November's midterm elections.
Public health experts have raised concerns that spacing out shots as Trump suggests can lead to an increased risk that children become infected with a vaccine-preventable disease before returning for another visit. Childhood vaccines -- and how and when to give them in combination -- go through rigorous studies, and safety tracking continues for years as the shots are used.
Trump called the announcement a "major victory for parents rights, religious and constitutional rights, and for the gold standard science."
Speaking about the order at the Oval Office on Monday, Trump repeatedly suggested the number or timing of vaccines could play a role in rising rates of autism spectrum disorder, even as scientific consensus and decades of studies have firmly concluded there is no link. The order also includes several changes to the childhood vaccine schedule that his health department has already attempted, but that have been blocked by a federal judge. A White House official who insisted on anonymity to brief reporters said Trump was within his right to provide his own recommendation to Americans through the executive order and said the lawsuit blocking the health department's schedule was a separate issue.
Dr. Andrew Racine, president of the American Academy of Pediatrics, said the announcement spreads uncertainty, fear and confusion where "there doesn't need to be any of that." He disputed Trump's recommendations and said previous ones should stand.
"Science about vaccines and their efficacy has not changed," he said. "The distribution of viruses and other pathogens in our environment has not changed. Children in this country have not changed in the last 48 hours."
Sen. Bill Cassidy, the Republican chair of the Senate health committee, slammed the executive order in a social media post, saying vaccines are safe and do not cause autism.
"I'm a doctor. This executive order is wrong," the Louisiana senator wrote. "The President does not have the expertise to make these changes."
Even as the order calls for revised vaccine recommendations, states, not the federal government, have the authority to require vaccinations for schoolchildren. The order advises states with school vaccine mandates to consider updating their laws to reflect the administration's preferred schedule, according to a White House fact sheet.
Last December, Trump ordered the Department of Health and Human Services to review how peer nations approach vaccine recommendations and consider revising U.S. guidance accordingly. The department responded by cutting the number of vaccines it recommends for every child, a move that has since been blocked in court.
Changes to federal childhood vaccine recommendations customarily require approval from the director of the Centers for Disease Control and Prevention. The newly Senate-confirmed CDC director, Dr. Erica Schwartz, oversaw policies promoting vaccination of service members while in a leadership position at the U.S. Coast Guard.
However, public health law expert Lawrence Gostin at Georgetown University said the Supreme Court's interpretation of Trump's power may allow him to supersede Schwartz if she does not agree to new recommendations.
"This is clearly the first test for Dr. Erica Schwartz," Gostin said in an email. "The President is placing her in an untenable position."
Asked on a call with reporters why the president was advocating splitting MMR into three single-disease vaccines, the White House official did not provide any studies supporting the decision. They said that was Trump's long-held view and that some countries provide individual measles vaccines in certain circumstances.
Studies of babies and toddlers in the U.S. have shown that the use of combination shots for childhood vaccines increased the likelihood of completing all recommended vaccinations by the age of 2.