The news: President Trump signed a new executive order recommending that children be routinely immunized against fewer diseases and asked the HHS to review whether to spread out the doses over a longer period of time. The order reaffirms a January CDC recommendation to cut the schedule from 17 to 11. The proposed changes have been blocked by a preliminary injunction since May, following a lawsuit by the American Academy of Pediatrics and other medical associations.

The order also directs the HHS to develop a plan within 90 days to offer combination vaccines as separate shots, starting with the measles, mumps, and rubella (MMR) vaccine, and to reassess the timing and sequencing of all core childhood vaccines.

Why it matters: The order intensifies political attention on childhood vaccines without immediately changing clinical practice.

Perceptions of vaccine safety are declining and a sizable share of Americans support scaling back the childhood immunization schedule. Just over half (57%) of US adults consider childhood vaccines “very safe,” down six percentage points YoY, while 42% support reducing the number of vaccines on the childhood immunization schedule, according to an April survey from the Harvard T.H. Chan School of Public Health. Among those who support reducing the schedule, 63% say it’s because children get too many vaccines too early, and 57% do so because it gives parents more control over decision-making.

Implications for health systems and vaccine makers: The growing divide between federal vaccine policy and medical consensus could create more confusion for parents. Health systems will need to equip clinicians to field questions spurred by the order and related media coverage. Health systems can track the most common questions and use those insights to keep messaging consistent across providers, digital channels, and call centers.

For vaccine makers, actual clinical changes would take much longer. Splitting the MMR vaccine into separate shots would require new pediatric trials and individual FDA approvals, a process that would take at least a decade, according to the American Academy of Pediatrics.

Manufacturers should still be prepared to reinforce the evidence supporting the safety and efficacy of combined vaccines like MMR. They’ll need to provide healthcare systems and medical groups with evidence-based talking points for doctors, or unbranded public health brochures to inform skeptical parents.