Under anti-vaccine Health Secretary Robert F. Kennedy Jr., the US health department is considering changing how vaccine recommendations are categorized and described. The move creates the possibility that vaccinations currently considered "routine" or "universal" could be given new designations that sound less definitive or more conditional, such as "recommended with qualification" or recommended based on "shared clinical decision-making."

Kennedy has made no new rules or recommendations for the categories yet. However, he laid out ideas and possibilities in a Request for Information (RFI) posted online Friday and published in the Federal Register on Monday. In the 10-page document, Kennedy poses questions about the current categories and asks the public to weigh in on ideas for how to change or replace them. The deadline to comment on the questions and ideas is September 20.

Currently, there are three categories of vaccination recommendations granted by the Centers for Disease Control and Prevention, which is informed by a panel of independent expert advisors, the Advisory Committee on Immunization Practices (ACIP). The three categories are: routine, otherwise considered universal (a recommendation that everyone should get a vaccine); risk-based recommendations (only certain groups at higher risk should get a vaccine); and recommendations based on "shared clinical decision-making," or SCDM (a flexible but uncommon recommendation for vaccination based on the characteristics, values, and preferences of a patient and the judgment of their healthcare provider).

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The Centers for Disease Control and Prevention on Monday released data on the vaccination rates of US kindergarteners in the 2025–2026 school year, revealing that rates have once again decreased from the previous school year.

Vaccination rates have been slipping since the 2019–2020 school year, when the US had obtained rates of around 95 percent, the threshold needed to keep outbreaks of vaccine-preventable diseases from spreading in communities. The latest data shows the US is moving further away from that target.

Nationally, only 92.4 percent of kindergartners were vaccinated with the measles, mumps, and rubella (MMR) vaccine in the 2025–2026 school year, down from 92.5 percent last year. Coverage with the DTaP vaccine, which covers diphtheria, tetanus, and acellular pertussis (whooping cough), similarly fell from 92.1 percent to 92.0 percent.

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Backlash to Trump's vaccine order on Monday has been swift and sharp, with various public health and medical organizations and independent experts calling it "dangerous," "unscientific," "false and misleading," "so wrong," and saying it is "putting children's health at risk."

The responses are unsurprising; the medical and health communities have consistently fought against the anti-vaccine, anti-science agendas pushed by Trump and his health secretary, Robert F. Kennedy Jr., who has no background in science, medicine, or public health. The American Academy of Pediatrics—which called the order "not only disheartening but dangerous"—is leading a lawsuit against previous changes to federal childhood vaccine recommendations under Trump and Kennedy. In March, the organization, along with other medical groups, won a temporary injunction reversing most of the changes.

However, less expected among the scorn for Trump's order is the immediate pushback from the pharmaceutical industry.

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President Trump signed an executive order Monday that makes sweeping, unilateral changes to federal vaccine recommendations. The order aims to reduce the number of lifesaving vaccines all children are recommended to get—from 18 to 11—while also splitting them up and spacing them out over more time and more medical visits.

The vaccine changes are not backed by evidence or spurred by new findings. Rather, they are based on false anti-vaccine fearmongering about harms, including the debunked claim that they cause autism, and misinformation that multiple vaccinations can "overwhelm" children's immune systems. This false claim has also been repeatedly debunked and explained.

During a signing event at the White House on Monday afternoon, Trump falsely claimed that pediatricians "have a vaccination that looks like the size of a bottle of soda," that is "poured into a little child's body, and bad things happen in too many cases. This is an explosion; this is an epidemic," Trump said.

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The White House is drafting an executive order on the disproven link between vaccines and autism, according to independent reports from The Washington Post and Bloomberg, which both cited unnamed sources with knowledge of the efforts.

Bloomberg reported that the executive order, which is still taking shape and is subject to change, could be issued as soon as next week. The Post said the order's drafting so far is aimed at the childhood vaccine schedule, autism research, and parental choice for vaccinations.

Dozens of high-quality studies encompassing data from millions of children worldwide have already been carried out on the topic and have consistently found no link between childhood vaccines and autism. The claim of a link stems from an unethical, fraudulent study that was retracted years ago, and its author was stripped of his medical license.

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Despite significant drama from Trump officials this year, the Food and Drug Administration has for the first time approved a flu vaccine that uses mRNA technology.

On Thursday, vaccine maker Moderna announced that its flu shot, mRNA-1010, aka mFLUSIVA, had earned approval for use in all adults ages 50 and up. The approval announcement follows a unanimous vote by FDA advisors in June to approve the vaccine. That vote was based on its superior efficacy to existing seasonal flu shots and a good safety record demonstrated in trials that included nearly 44,000 people. After that vote, the FDA set a goal of August 5 for a decision on the vaccine's fate.

While the unanimous support from FDA advisors boded well for Moderna's shot, the overall path to approval was treacherous and uncertain, even until the end. For one thing, current Health Secretary Robert F. Kennedy Jr. is a well-established anti-vaccine advocate who has worked diligently in his time in office to thwart vaccinations. One of his first acts as health secretary was canceling a federal campaign to encourage people to get flu shots in the midst of a bad flu season—despite the fact that the Centers for Disease Control and Prevention had already paid for the campaign and the flu season was killing relatively high numbers of children.

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In a 51–44 vote Wednesday, the US Senate confirmed Erica Schwartz as director of the Centers for Disease Control and Prevention, despite failing miserably to convince senators last month that she could stand up to anti-vaccine Health Secretary Robert F. Kennedy Jr.

The confirmation ends a nearly yearlong vacancy for the position since Kennedy fired the previous CDC director, Susan Monarez, last August. Monarez was ousted after she refused to rubber-stamp vaccine recommendations from a panel of Kennedy's hand-selected advisors, who hold similar anti-vaccine views to his own.

Schwartz is highly qualified for the role, coming to the CDC with a medical degree, a master’s degree in public health, and a law degree. She previously had a long stint as a Navy officer and held leadership roles including chief medical officer for the US Coast Guard and deputy surgeon general in the first Trump administration. Notably, she has been a public advocate for vaccines and outbreak preparedness.

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