President Trump signed an executive order on August 10, 2026, that could turn getting your kid vaccinated into a multi-visit ordeal. The order, dubbed “Gold Standard Childhood Vaccine Recommendations,” directs that childhood vaccines — including the combined measles-mumps-rubella (MMR) shot — be given at separate appointments “to the maximum extent feasible.” The order also encourages states to loosen school vaccine mandates. One infectious disease physician argues the fallout reaches far beyond U.S. borders.
In an op-ed for STAT News, Krutika Kuppalli, M.D., an infectious diseases physician and former World Health Organization medical officer, writes, “The ability to prevent a deadly infectious disease is an extraordinary privilege”— one she argues Americans are at risk of forgetting precisely because vaccines have made deadly childhood diseases so rare.
Splitting shots, multiplying risk
The MMR vaccine has protected kids against measles, mumps, and rubella in a single shot for decades, delivering roughly 97% protection against measles after two doses. Breaking it into three injections means three appointments — and three more chances for a missed one. The U.S. has logged 2,465 measles cases so far this year, the highest annual total in 35 years, in a disease officially declared eliminated from the country back in 2000.
The cost of skipping vaccination is well documented, too. A 2025 measles outbreak in New Mexico cost an estimated $5.4 million, or roughly $53,000 per case, according to an analysis published in Annals of Internal Medicine — versus the roughly $27 per dose the federal Vaccines for Children program pays for the MMR shot.
Kuppalli draws on her field experience to make her case, including running an Ebola treatment unit in Sierra Leone and later helping vaccinate more than 300,000 people during the 2018-2020 Ebola outbreak in the Democratic Republic of Congo — an effort detailed in a Lancet Infectious Diseases analysis. “I have seen what the world looks like without vaccines,” she writes. “We should not choose to go back there.”
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A ripple effect far beyond U.S. borders
The consequences don’t stop at the U.S. border. Kuppalli notes that “American scientific institutions have helped shape global vaccine policy for generations, and U.S. funding and technical guidance support immunization programs around the world,” so “changes in American vaccine policy therefore do not occur in isolation.”
Altering a decades-old vaccine formulation, she warns, can strain the supply chains and manufacturing agreements that immunization programs in lower-income countries depend on. “A parent thousands of miles away may never read an American executive order,” she writes, “but they may hear that the U.S. changed its vaccine recommendations because of safety concerns,” adding: “Misinformation crosses borders as easily as viruses do.”
