Vaccine guidance gap widens between Trump administration and state health officials, Long Island doctors

President Donald Trump’s vaccine executive order Monday is the latest in a growing divergence between federal and New York State authorities on immunization policy, a rupture underlined by the state’s announcement earlier in the day that it would recommend a broader vaccine schedule for pregnant women than those set by the Centers for Disease Control and Prevention.

New York and several other states have increasingly rejected changes to federal vaccine policies advocated by the Trump administration and Health and Human Services Secretary Robert F. Kennedy Jr., who has publicly been skeptical of vaccines.

Instead, they are following guidance from professional medical groups, some of which Monday released statements slamming the executive order, which slashes the number of vaccines recommended for children, as going against scientific evidence. The executive order also suggested spacing out the time vaccines should be administered.

On Monday, the state Department of Health and the New York City Health Department sent out a joint statement endorsing the maternal immunization schedule from the American College of Obstetricians and Gynecologists, which advocates routine vaccination against COVID-19 and influenza as well as pertussis (whooping cough) and respiratory syncytial virus (RSV). Suffolk County Department of Health Commissioner Dr. Gregson Pigott told Newsday in a statement it would follow the state's vaccination recommendation. A Nassau County Department of Health spokesperson did not respond to a request for comment.

The CDC guidelines do not recommend the COVID-19 vaccine for pregnant women. It also says they should only receive flu shots free of the preservative thimerosal. The ACOG said “there is no scientific evidence that thimerosal-containing vaccines cause health or developmental problems “ to children of pregnant women who receive them.

“Vaccination during pregnancy provides critical protection for both pregnant people and their babies during a time when they may be especially vulnerable to serious illness,” State Health Commissioner Dr. James McDonald said in the statement. “New York State remains committed to ensuring providers have the latest evidence-based guidance and that families have access to recommended immunizations that help keep communities healthy.”

Trump signed the executive order at the White House with Kennedy Jr., who released a report in January saying hepatitis A, hepatitis B, rotavirus, meningococcal disease, influenza, RSV and COVID-19 should be removed from the childhood immunization schedule.

Additionally, the executive order said the critical measles, mumps and rubella (MMR) vaccine that is given together in two shots, one when a child is 12 to 15 months old and the second when a child is 4 to 6 years old, should be administered in three separate single-dose shots. Those formulas are not currently available in the U.S.

 In a statement released Monday night, McDonald said the executive order "doesn’t change New York State’s immunization requirements or recommendations ... to be clear: no new research was presented."

He said the MMR vaccine has been protecting children for over 55 years and splitting it into three visits offers no clinical advantage. 

Infectious disease experts also expressed concern that Trump and Kennedy continue to link vaccines and autism.

Dr. Sharon Nachman, chief of pediatric infectious diseases at Stony Brook Medicine, echoing what major pediatric and medical organization advises, said years of research have shown that vaccines are safe and protect children against severe disease.

“There are many, many studies that autism is not caused by these vaccines,” she said.

Likewise, she said, there is no evidence giving the measles, mumps and rubella shots together is potentially “quite lethal,” as Trump said.

“There is strong evidence,” she said, “that it does save children’s lives.”

Diseases like the measles and diphtheria killed thousands of American children a year before vaccines against them were developed.

Dr. Willie Underwood, president of the American Medical Association, the nation’s largest physicians’ group, said in a statement that vaccines have been extensively studied.

“Decisions about how and when vaccines are used should be driven by rigorous scientific evidence, patient safety, and independent medical and public health expertise,” he wrote. “Altering a proven vaccination schedule without credible evidence risks weakening public confidence and putting children’s health at risk.”