President Donald Trump is seeking major changes to the way
childhood vaccines are recommended in the United States, including a proposal that
gives parents the option of choosing whether they want to break up one of the
country’s longest-standing combination vaccines: MMR.
The measles, mumps and rubella vaccine began in 1971. It was a practical and
safe alternative to vaccinating all three contagious diseases separately. Now,
the Trump administration is calling for the three vaccines to be offered
separately, which would mean six separate shots instead of two.
Trump’s Executive Order follows the administration’s effort to reduce the
number of diseases covered by routine federal childhood vaccine
recommendations, from 18 to 11, while encouraging more flexibility in how and
when children receive vaccines. It also directs federal officials to encourage
states to consider changes to vaccine requirements.
The Executive Order says, “It is the policy of my
Administration that Federal programs and funding should support maximal
parental choice over childhood vaccines.”
But one part of the order is drawing particular attention:
the call to separate MMR.
What is MMR?
MMR protects children against three viral diseases:
Under the current U.S. schedule, children receive two doses
of MMR — the first at 12 to 15 months and the second at 4 to 6 years.
The combination vaccine has been a cornerstone of childhood
immunization globally for decades.
The individual vaccines came first. Measles vaccine was
licensed in the United States in 1963, mumps vaccine in 1967 and rubella
vaccine in 1969. In 1971, they were combined into the MMR vaccine.
In 1989, federal health officials recommended a second dose
of MMR for all children following a resurgence of measles. The two-dose
schedule became the standard used today.
That vaccination strategy helped drive measles to
elimination status in the United States in 2000.
Why does President Trump want to separate the shots?
Trump has questioned whether children should receive the
three vaccines together.
He made the argument publicly in September 2025:
“The MMR I think should be taken separately. This is based
on what I feel. The mumps, measles and – the three should be taken separately.
It seems to be when you mix them there could be a problem,” said Trump.
The Executive Order now turns that idea into federal policy
direction. The EO, titled “Gold Standard Childhood Vaccine Recommendations,” says
“the combined measles, mumps, rubella (MMR) vaccine should be administered in
three separate single-disease shots once such products are domestically
available and that, to the maximum extent feasible, all childhood immunizations
should be administered at separate medical visits.”
The EO does indicate the existing MMR vaccine availability should
also be available for people.
But there is an important practical hurdle: individual
measles, mumps and rubella vaccines are not currently available as licensed
products in the United States.
That means the proposal would require manufacturers to
develop, license and produce vaccines that have not been routinely available in
the U.S. for decades.
Globally, MMR is the standard vaccine practice in developed countries
around the world.
The United Kingdom goes a step further, cautioning against breaking
up MMR.
The country’s government website says “Using single vaccines
for the diseases would be experimental. It’s unclear how long a gap to leave
between each vaccine, as there’s no evidence on giving the vaccines
separately.”
What does the science say about separating MMR?
There is no evidence that breaking up MMR makes vaccination
safer or more effective.
The CDC says plainly that there is no published scientific
evidence showing a benefit to separating the three MMR components.
The current MMR vaccine is also highly effective. According
to the CDC, two doses are about 97% effective against measles and 86% effective
against mumps, while one dose is about 97% effective against rubella.
The question has become particularly sensitive because of
long-running and unfounded concerns about vaccines and autism.
Those concerns trace in large part to a 1998 study published
in The Lancet that suggested a possible connection between MMR and
developmental disorders. The study was later retracted after serious problems
were identified.
Since then, numerous studies involving much larger
populations have found no causal relationship between MMR vaccination and
autism. The World Health Organization’s vaccine-safety committee reviewed 31
studies published between 2010 and 2025 and reaffirmed that there is no causal
link between vaccines and autism.
The CDC likewise says there is no link between MMR and
autism and that no published evidence shows a benefit from separating the
shots.
The timing matters: Measles is making a comeback
The debate comes as the United States is experiencing its
worst measles resurgence in decades.
As of August 6, 2026, the CDC had recorded 2,465 confirmed
measles cases in the United States — already more than the 2,289 cases reported
during all of 2025 and the highest annual total in 35 years. More than 90% of
cases in both years have occurred among people who were unvaccinated, according
to federal data.
Measles was declared eliminated in the United States in
2000, meaning there was no continuous transmission of the virus within the
country. The CDC says widespread vaccination was critical to achieving that
milestone.
The recent increase has occurred as vaccination coverage has
declined and as measles continues to be brought into the country through
international travel. Outbreaks can then spread in communities where
vaccination rates are low.
More shots could mean more appointments
There is also a practical question: What would separating
MMR actually mean for families?
Josh Michaud, assistant director of global health and public
health policy at KFF, said there is no evidence that separating the vaccines
would make them safer or more effective. He also pointed to the logistical
consequences.
“It also introduces logistical considerations and hurdles,”
said Michaud. “Parents have to take kids to three separate visits instead of
just one visit, and you end up giving six injections instead of two injections.
All of that can add up to more time more cost spent getting vaccinated.”
The concern is that adding appointments and injections could
make it harder for some families to keep children on schedule.
Combination vaccines are, in part, designed to make
vaccination more practical: children can receive protection against multiple
diseases during the same visit instead of requiring separate appointments.
So what happens now?
For now, the proposal does not mean parents can walk into a
doctor’s office and choose between an MMR shot and three individual vaccines.
Standalone measles, mumps and rubella vaccines are not
currently licensed in the United States. The order calls for the separate
vaccines once they become domestically available.
And states retain significant authority over school
vaccination requirements. The Executive Order encourages states to align their
mandates with the administration’s approach, but it does not immediately
rewrite every state’s school immunization laws.
In North Carolina, the Department of Health and Human
Services said it does not currently expect a change.
“At this time, North Carolina does not anticipate changes to
our clinical guidance regarding childhood immunization.”
So for North Carolina families, the immediate situation
remains largely unchanged.
But the administration’s broader effort could eventually
reshape the federal vaccine schedule — and, if standalone vaccines are
developed and licensed, give parents a choice that has not been widely
available in the United States for decades.
For some parents, that choice may be welcome.
For others, public health experts say, separating vaccines
could add cost, complexity and opportunities for children to fall behind on
protection against serious diseases.
Publishing note: AI assisted in the formatting of this article. All reporting, research, interviews, fact-gathering and fact-checking were conducted by WRAL journalists.