GoKawiilChildren in the United States normally get two doses of the MMR vaccine: one at 12 to 15 months, and one at 4 to 6 years of age.Credit: Courtney Perry/Washington Post/Getty
Researchers are worried that an executive order signed by US President Donald Trump earlier this week will have negative consequences for children’s health across the country — and are laying out the scientific evidence that backs up their concerns.
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The 10 August order calls for children to be vaccinated against fewer diseases than they currently are, and it recommends that combination shots, starting with the one for measles, mumps and rubella — commonly known as the MMR vaccine — be split into individual jabs that are spread out over time.
The order is “not in any sense grounded in science”, says Paul Offit, a viral immunologist and director of the Vaccine Education Center at the Children’s Hospital of Philadelphia in Pennsylvania.
Trump’s authority to change the schedules that physicians use to vaccinate children is limited, because these schedules are typically set by US state health officials. But Nature spoke to paediatric vaccine specialists to learn what the effects of delaying kids’ vaccines — or even recommending a delay — could be.
What does the science say about splitting up vaccines?
When he signed the executive order, Trump justified the change by stating that combined vaccines contain a dangerous amount of fluid. A vaccination is “the size of a bottle of soda”, he said. But Offit says there is no evidence to support this claim. One dose of a childhood vaccine such as the MMR shot contains roughly one-tenth of a teaspoon (about half a millilitre) of fluid, he adds, which is a far cry from the “vats” that Trump said they contain.
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Previous research1,2 has shown that combined vaccines against multiple diseases can increase population-level immunity and decrease health-care costs, because families can visit the clinic fewer times to receive fewer shots, says Mark Jit, a health economist at New York University. For example, the proportion of people vaccinated against diphtheria, tetanus, pertussis and a bacterial infection called haemophilus influenzae type b increased by 8% in Belgium after the country introduced a jab that combined all four shots into one3.
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