When parents walk into a pediatrician’s office, they bring with them something extraordinarily precious: their trust. That trust is built over years. Pediatricians are there for newborn visits, first steps, middle-of-the-night fevers, school physicals, developmental questions and the sometimes-challenging transition into adolescence. We celebrate milestones, help families through frightening moments, and answer difficult questions.
Through it all, pediatricians and parents share the same goal: keeping children healthy, safe and thriving. That relationship does not begin at the ballot box, and it does not end there.
On Aug. 10, Donald Trump signed an executive order directing changes in the federal approach to childhood vaccinations, including the timing and sequencing, cutting the vaccine schedule from 18 diseases to 11 and administering measles, mumps and rubella vaccines separately.
Here’s a problem: these vaccines don’t exist, and there’s no credible path to making them available in the near term. The MMR vaccine has been a safe, effective combination product for decades. Manufacturers would need years, and likely millions in investment, to develop, test and gain FDA approval for separate components. In the meantime, this directive creates confusion, delays and logistical nightmares.
Most importantly, there is real-world impact on our families. This executive order will make it harder — not easier — for families to protect their children. There will be more visits, not fewer. The order recommends administering vaccines at separate medical visits. For working parents already struggling to manage multiple appointments, this isn’t about choice; it’s about burden. More visits mean more time off work, more childcare coordination, more transportation challenges and more disruption to family life.
This also means higher costs for families, multiple office visits, multiple copays and administrative fees. For families already facing financial strain, that’s a real barrier to vaccination. We’ll see the very outcome the order claims to prevent: lower vaccination rates and gaps in protection. When vaccines are separated, more children end up partially vaccinated or unvaccinated. Life happens and visits are missed. Combination vaccines exist because they improve completion rates.
Informed consent requires choice and information. The order frames itself as restoring parental choice. But choice without information is not informed consent; it’s ideological positioning dressed up as autonomy. Parents deserve accurate, evidence-based information to make decisions. They deserve clear explanations of what we know, what we do not know and why we make the recommendations we make. They deserve information grounded in rigorous science and a pediatrician who understands their child as an individual. Good pediatric care has always depended on those conversations.
The American Academy of Pediatrics — the gold standard in pediatric medicine — has called this order “not only disheartening but dangerous.” Dr. Andrew Racine, AAP president, noted that measles cases have reached a 35-year high in the U.S., and we’re heading into cold and flu season. This is the moment to strengthen vaccination protection, not weaken it.
When powerful figures in the federal government make ideological claims about children’s health, these trickle down to our state and local levels of government, impacting our rights and choices here in New Hampshire. This government intrusion unilaterally narrows vaccine recommendations without clear scientific consensus, and parents lose the ability to make truly informed decisions. We do not want our choices constrained by the unavailability of products that don’t exist. We do not want our ability to protect our children’s health compromised by logistical barriers and cost.
Here in New Hampshire, we need to be clear about what this order actually is: a directive to federal agencies, not a law that binds our state. Our legislature and our governor maintain the authority to set New Hampshire’s own vaccine requirements. Whether a family voted Republican, Democratic, independent or did not vote at all is irrelevant to the care we provide. Inside the exam room, pediatricians and parents are on the same side.
We’ve been here before. Earlier this year, the New Hampshire legislature rejected a bill that would have eliminated all vaccine requirements. When that proposal was presented, legislators heard from their constituents. Families in New Hampshire believe that vaccines matter. Our state epidemiologist confirmed that our current system, requiring core vaccines while allowing exemptions for religious and medical reasons, represents a reasonable balance.
The New Hampshire Chapter of the American Academy of Pediatrics relies on the most rigorous scientific evidence available when making recommendations about children’s health. That commitment does not change based on which political party controls the White House. Recommendations should change when strong scientific evidence tells us they should. Our message to New Hampshire families is simple: Talk with your pediatrician. Ask your questions. We are here to listen.
Dr. Christine Arsnow is the president and Dr. Frances Lim-Liberty is the vice president of the NH Chapter of the American Academy of Pediatrics. Both live in New London.