There is a wide disparity across the globe when it comes to childhood vaccination policies. American kids receive up to 75 vaccines; twice as many as kids in other countries. That is why if Dr. Heidi Overton is confirmed as the next director of the Food and Drug Administration (FDA), one of her top priorities should be helping to drive President Trump’s mandate to study the safety and comparative outcomes current vaccine schedule to that of other countries.
By David Gortler, Pharm. D
High on her list of priorities will surely be the two executive orders President Trump signed this year to promote the health of American children, especially since there doesn’t appear to be any movement on either.
He issued Executive Order 14407 on May 29, 2026, directing the federal government to realign US childhood vaccine recommendations with best practices from peer nations. Section 3 of the order directs HHS, through the Task Force on Safer Childhood Vaccines, to present plans within 90 days to assess timing and sequencing, as well as “improve vaccine safety monitoring, transparency, and research.”
Next, on August 10, the president signed Executive Order 14420 to reduce immunization recommendations from 17–18 diseases down to 11, spacing out shots across more doctor visits, and splitting the combined MMR vaccine into three separate injections.
The president is fulfilling his commitment to vaccination study and reform, but it doesn’t appear that anyone is listening. Ninety days have passed and the task force, chaired by NIH Director Jay Bhattacharya, just recently resurrected in August 2025 after 27 years dormant, still hasn’t shared the names of anyone (other than the always present HHS heads) who have been appointed to take charge of designing the study, along with statistical plans, according to a rudimentary internet search.
To date, there has not been any publicly proposed draft study design, outline, list of experts needed, proposed safety endpoints, request for public comment, or even a single primary or secondary safety or efficacy study objective shared.
The Task Force does not owe Congress a report until 2027.
Comparing Childhood Vaccination Schedules to Peer Countries
The inaction on this priority is concerning because the president has good reason to scrutinize the current vaccine schedule. A cursory review of international vaccine standards reveals that no two countries are quite the same when it comes to the number of vaccines or recommendations versus mandates.
For example, by age 18, a child in the United States will receive roughly 30 to 75 total vaccine doses depending on the state. All 50 states mandate a robust set of childhood vaccines. On top of CDC requirements, some states follow American Academy of Pediatrics guidelines and recommend even more.
Various peer countries have a mixture of mandated or recommended schedules when it comes to their childhood schedules. For example, Denmark recommends 30 to 38 vaccines. Bulgaria recommends 56 to 61. France and Italy mandate most of their vaccines in kids. Norway, Sweden, and Spain mandate none.
Here is a breakdown of the various countries I looked up:
United Kingdom:
19 injections, 44 different vaccines by age 14
Australia (NSW):
As many as 26 total vaccines by the age of 10, with recommendations varying for aboriginal versus the European populations.
China:
Up to age 7, there are 26-29 total vaccines, depending on if the live versus inactivated strains are used. There are no vaccine mandates in China, and there are “no punishments associated with noncompliance.”
Yes, you read that correctly.
After Chinese citizens contended that the mandate violated the principles of “informed consent and voluntariness” the government withdrew its Covid mandates after just one day. And Chinese children aren’t mandated to take any other vaccines either.
Despite the fact that China is a one-party authoritarian government run by the ruling Chinese Communist Party, Chinese citizens face less pressure to obey vaccine mandates—. American citizens had Covid shot and vaccine mandates before they could attend schools, restaurants, or even go to work.
Japan:
By the age 16 in Japan, 14 injections total, 29-32 total vaccines, depending on the population and/or vaccine product used.
Norway:
Through the age of 15 years, Norway has 37-44 total vaccines/boosters recommended, depending on the population and/or vaccine regimen used. In Norway, no vaccine is mandatory.
Sweden:
Through the age of 18 years, Sweden has 41-50 vaccines/boosters recommended, depending on the population and/or vaccine regimen used. In Sweden, no vaccine is mandatory.
Austria:
Through the age of 18 years, Austria has 49-54 vaccines/boosters recommended, depending on the population and/or vaccine product used. In Austria, no vaccine is mandatory.
Belgium:
Through the age of 18 years, in Belgium 49-57 vaccines/boosters are recommended or mandated, depending on the population and/or vaccine product used.
Bulgaria:
Through the age of 18 years, in Bulgaria 56-61 vaccines/boosters are recommended, depending on the population and/or vaccine product used. In Bulgaria, no vaccine is mandatory.
Czech Republic:
Through the age of 18 years, in Czechia 46-59 vaccines/boosters are recommended or mandated, depending on the population and/or vaccine product used.
Denmark:
Through the age of 18 years, in Denmark 30-38 vaccines/boosters are recommended, depending on the population and/or vaccine product used. In Denmark, no vaccine is mandated.
France:
Through the age of 18 years, in France 46-53 vaccines/boosters are recommended or mandated, depending on the population and/or vaccine product used.
Italy:
Through the age of 18 years, in Italy 45-50 vaccines/boosters are recommended or mandated, depending on the population and/or vaccine product used.
Spain:
Through the age of 18 years, in Spain 42-51 vaccines/boosters are recommended, depending on the population and/or vaccine product used. In Spain, no vaccine is mandatory.
Germany:
Through the age of 18 years, in Germany 49-53 vaccines/boosters are recommended or mandated, depending on the population and/or vaccine product used.
As is clear, peer nations significantly differ from each other and the United States, when it comes to the number of vaccines they recommend and/or require.
Buried in that variation are the questions Trump wants his HHS officials to answer. They include: Which country’s vaccine schedule produces the best short- and long-term overall health outcomes? With both severe and serious adverse events reported and important questions about safety, how far out would those safety evaluations take place after vaccine administration? What will be done to assure that those measurements will be accurately collected?
No one has answered these or a multitude of other important questions, and the delays in appointing a team to ask, plus address these questions, make it seem like nobody’s even trying.
Separate MMR Shots: Japan Got a “Yes”…Will Trump Get a “No?”
Trump’s Executive Order 14420 separating vaccine combinations and spreading them out across doctor’s visits signed in August has both a regulatory and clinical precedence in the real word, rooted in bona fide drug-safety epidemiology findings.
Japan withdrew its combined measles, mumps, and rubella (MMR) vaccine in 1993 because data showed that it had led to an unexpectedly high incidence of meningitis (an inflammation of the membrane surrounding the brain – a clinical emergency). When the government became aware of that, they requested that manufacturers split apart the triple combination MMR, allowing Japanese citizens the option to take separate components. While pharmaceutical manufacturers accommodated Japan’s request, no manufacturer has stepped up to accommodate Trump’s order.
Task Force on Safer Childhood Vaccines
Trump’s executive order on childhood vaccines mandates to present plans within 90 days to assess timing and sequencing and “improve vaccine safety monitoring, transparency, and research.”
Plans. Not studies. Ninety days to plan a study of a schedule that had already been rewritten by declaration. And we don’t even know any details about those planned studies. Are Trump’s executive orders being ignored? Are these childhood vaccine study plans confidential? When are they planning on their first meeting? How often will they meet? The task force still hasn’t shared the names of whom (if anyone) has been appointed to take charge of designing a study according to a rudimentary internet search. Are the task force members’ names a secret?
In sum: It’s been two months following the second of two executive orders, and to date, there’s been no publicly proposed draft study design, study outline, list of experts, proposed safety endpoints, request for public comment, or even a single primary or secondary study objective.
HHS Delays Needed Vaccines Studies for Over a Decade
While the time it is taking to address this issue is disappointing, Trump’s HHS is not the only one to blame. Questions regarding vaccine safety go back much further. In 2013 the Institute of Medicine reported that “studies designed to examine the long-term effects of the cumulative number of vaccines or other aspects of the immunization schedule have not been conducted.” The Institute of Medicine authors recommended building that capacity into the Vaccine Safety Datalink. Will that be part of the testing methodology for Trump’s EO?
Your guess is as good as mine.
Thirteen years later, a Congressional report aptly calls our postmarket vaccine surveillance “limited” and “underutilized.” The same finding, twice, under both parties, with nothing built in between.
The 18-disease schedule the courts restored following the reduction proposed by Secretary Robert F. Kennedy, Jr. in March 2026 was never tested as a whole or in comparison to peer-developed countries. And neither was the 11-disease schedule written to replace it. Washington has now rewritten the schedule twice without producing a single proposed study design for comparative outcomes measurement.
Trump Ordered Childhood Vaccine Schedule Scrutiny for Good Reason
The assessment that the FDA and CDC keep citing declares that manufacturers: “have inadequate incentives to study vaccine adverse effects” and that vaccine “safety and risks are therefore often poorly characterized, quantified, or understood.” The same Congressional report called for gold-standard, double-blind, placebo-controlled trials. If manufacturers can’t or won’t conduct objective data, NIH officials are obligated to do so. Not immediately proceeding with studies is to surrender to the status quo on providing Americans answers vaccine safety and efficacy.
The pattern held on August 21, 2026, when HHS sought input on whether its recommendation labels are the right ones and invited comment on: “The appropriate approach when randomized controlled trial evidence is limited or absent.”
Did you catch that?
You might want to read that sentence again:
It appears that officials are on track to blow past their 90-day EO deadline. They have not publicly mentioned assembling a team of outside experts for input on how to design and generate better vaccine evidence to protect America’s kids…they appear to be asking for advice on how to proceed without it!
Agency and Outside Experts Need to Do Their Jobs
Studying the childhood schedule doesn’t require new Congressional authority, novel theory, regulatory modification, or even special permission. The NIH, FDA and CDC already have that ability and discretionary funding – and have had so for decades – they just need to do their jobs to protect kids.
First, they should build the study around the variation that already exists: our schedule against peer countries’ schedules, combination products against single–injection components, spaced administration versus concomitant. Create strict criteria to make sure that investigators diligently collect all safety and efficacy failures, and report their findings in real time.
Second, they should share the study protocol and publish it before a single child is enrolled. Ask for input from a multi-disciplinary group of experts to make sure important details are not omitted. After all, an essential dialectic of science is discussion and debate between experts on how to best answer a clinical question.
With that, design a study protocol with an independent, multi-disciplinary team, including experts in pharmacology, statistics, epidemiology, and clinical trial design — not manufacturers, not “sponsored” special-interest groups, not a biased panel hand-picked to ratify a premeditated conclusion. Carefully design primary and secondary endpoints, so it is done correctly the first time. Hold all overseers and career federal employees who design and author the trial accountable.
Third, they should convert passive adverse-event reporting into active surveillance and fund it permanently. Demand complete ingredient transparency of all vaccine ingredients from manufacturers. After all, one cannot fully evaluate the safety or efficacy of any type of vaccine unless the exact vaccine ingredients are known (which they aren’t).
Finally, they must finish what was proposed in 2013. Prominently publish all data, positive or negative, and have the HHS scientists who designed and conducted the studies hold public town halls and press conferences to discuss those findings and give careful and measured answers to all questions, perpetually as dose rollouts and data rolls in.
In sum, Americans have had questions about their vaccines for many years now, and that number has only exploded with mRNA development. Americans are desperate for answers, but are instead getting even more mRNA FDA approvals.
Trump appointees and career employees at the CDC, NIH, and FDA now have the chance to provide Americans with answers and be transparent, if they choose. Under Trump, we finally have the opportunity to study and learn about the risks and benefits of the childhood vaccine schedule.
DISCLAIMER: This article is NOT medical advice. Do not start or discontinue any drug without first discussing it with a pharmacist or physician you know and trust.
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