Trump dives headfirst back into vaccine minefield

• But the announcement could further erode trust in vaccines and public health, in the midst of foodborne and infectious disease outbreaks, including measles.
• And it undercuts the agencywide reset the Department of Health and Human Services has been charting over the past several months, through filling vacancies with more mainstream picks and promoting efforts to lower prescription drug prices and make the food supply healthier.

Driving the news: Trump on Monday signed an executive order calling for a slimmed-down childhood vaccine schedule and breaking the measles-mumps-rubella vaccine into three separately administered shots.

• It also advises states to review federal vaccine recommendations and update their requirements for school enrollment.
• At an Oval Office signing event, Trump suggested the MMR vaccine could be "quite lethal," though, when pressed, acknowledged he had no evidence, adding there are "some people that say it is that way."
• "The worst thing that would happen would be, nothing happens," he told reporters. "We're not going to lose anything. At the same time we could gain tremendous — save hundreds of thousands of lives, millions of lives."

Reality check: The overwhelming majority of scientists and public health experts say the benefits of vaccines greatly outweigh the risks, and though the shots do have rare side effects, no link to autism has been found in numerous studies.

• The Centers for Disease Control and Prevention itself says there's "no published scientific evidence [that] shows any benefit in separating the combination MMR vaccine into three individual shots."

Between the lines: Though Trump and his health officials have already tried to overhaul the federal childhood vaccination schedule, the new order suggests he isn't through with ordering significant changes after being stalled by courts.

• Trump, by all accounts, is genuinely concerned about the vaccine schedule and vaccines' alleged links to autism, though there's widespread scientific agreement that there is no link.
• "President Trump's Executive Order is dangerous & unlawful. It will not go into effect and will almost certainly be blocked by the courts," Georgetown law professor Lawrence Gostin said in an email.
• Imposing a narrower vaccine schedule by importing recommendations from foreign countries wouldn't reflect gold standard science, said Mike Ybarra, chief medical officer of the drug industry trade group PhRMA.
• "It would mean accepting a lower bar of protection against diseases that remain serious and, in some cases, life-threatening for children in the United States," he said.

The other side: Democrats and their allies immediately denounced the new order in terms that are likely to be repeated on the campaign trail.

• "If Trump's baseless, science-free decree is followed, the end result will not be fewer children with autism, but far more in the ER or even the morgue," health advocacy group Protect Our Care said in a statement.
• "All Trump is doing is fanning more unfounded fear, pressuring a further drop in vaccination rates, and welcoming a resurgence of preventable diseases once thought eradicated."
• "It is simply astonishing that this administration would continue to respond to ongoing measles outbreaks and the return of other vaccine-preventable diseases by playing politics with children's lives," said Richard Besser, CEO of the Robert Wood Johnson Foundation.

What they're saying: "I'm a doctor. This executive order is wrong. The President does not have the expertise to make these changes," Republican Sen. Bill Cassidy of Louisiana posted on X shortly after the signing.

• "Parents should listen to their child's pediatrician about vaccines rather than listening to an inaccurate executive order," said Cassidy, who chairs the Senate health committee.

What we're watching: The order requires HHS, within 90 days, to present plans for offering combination vaccines like MMR as single shots, assessing "the ideal timing and sequencing of all core childhood vaccines" and adjusting the federal vaccine schedule as needed, as well as developing new vaccine ingredients as alternatives to aluminum.

• That guarantees another round of vaccine headlines even closer to the midterms.