AMA, ACP Criticize Trump's Executive Order on Vaccine Recommendations

The American Medical Association came out swinging this weekend at an executive order President Trump signed Friday that reaffirms intentions to model US childhood vaccine recommendations after those of Denmark—a country with universal healthcare, less diversity, and a population about the size of Maryland’s.

“There is no credible scientific evidence to support,” such a change, AMA President Bobby Mukkamala said in a statement. The current vaccine schedule “is built on decades of rigorous research and real-world data, and it is designed to protect children in the US when they are most vulnerable based on our nation’s disease burden,” he said.

The plan to align federal childhood vaccine recommendations with Denmark’s was first revealed by anti-vaccine Health Secretary Robert F. Kennedy Jr. in January. The overhaul would see the total number of recommended immunizations drop from 17 to 11, walking back recommendations for shots against rotavirus, COVID-19, influenza, meningococcal disease, hepatitis A, and hepatitis B. It stemmed from a December executive order by Trump to align US vaccine recommendations with the “best practices from peer, developed countries.”

From that order, Trump administration officials carried out a “comprehensive scientific assessment,” which concluded the US should emulate Denmark. The work was carried out by two Trump administration political employees, Tracy Beth Høeg, a sports medicine doctor, and Martin Kulldorff, a biostatistician, neither of whom has expertise in vaccine policy, but both are anti-vaccine allies of Kennedy.

The acting director of the Centers for Disease Control and Prevention at the time—Jim O’Neill, a technology investor—signed off on the changes. But in March, a federal judge issued a temporary injunction that reversed the changes, finding that Kennedy violated federal regulations in implementing them.

“Crazier and crazier”

While the federal government is appealing that injunction, the new executive order on Friday reaffirms Kennedy’s plans to adopt Denmark’s strategy, calling for “realigning” US vaccine policy with “best practices from peer, developed countries."It states that the scientific assessment written by Høeg and Kulldorff is a “guiding resource for the Federal Government” and that the CDC shall ” take any appropriate steps to update the United States childhood and adolescent vaccine schedule.”

As before, the AMA is strongly against the unilateral change made without backing from scientific evidence.

“Altering [the vaccine schedule] without clear, evidence-based justification risks continued confusion for parents and patients, undermining trust in vaccines, and ultimately lowering vaccination rates,” Mukkamala said. “That would put more children and communities at risk of preventable illness.”

On Monday, the American College of Physicians also released a statement, saying it was “deeply concerned” by Trump’s order. “This is the second time the administration has attempted to unilaterally substitute vaccine guidance from other countries to replace the US vaccine schedule which was developed for the specific needs of the US population,” ACP President Jan Carney said. “The changes that this executive order directs cannot be allowed to move forward.”

Even researchers in Denmark find the move bizarre. Anders Hviid, who leads research on vaccine safety and effectiveness at the Statens Serum Institut, Denmark’s equivalent of the CDC, told The New York Times in December that it did not make sense to compare the US to Denmark. “It’s not at all fair to say look at Denmark unless you can match the other characteristics of Denmark,” he said.

Hviid also told the Times that the US public health policies under Kennedy “get crazier and crazier” by the month. “It is surreal, and it is difficult, from a Danish perspective, to understand what’s going on.”

As for whether Denmark even represents the best practices of “peer countries,” as Trump’s executive orders direct, an analysis in January by Stat News found that this is not the case. First, the outlet found that the US has not been recommending a wildly larger number of vaccines compared with other affluent countries and was in line with countries such as South Korea and Brazil. Denmark, however, is an extreme outlier on the other end of the spectrum, having the fewest recommended vaccines (10) among 20 peer countries. All other countries in the comparison recommended between 13 and 16 vaccines.