2026-08-11T20:55:38.612Z / 路透社
华盛顿8月11日电（路透社）——美国总统唐纳德·特朗普周一签署一项行政令，呼吁减少常规儿童疫苗接种，并指示司法部挑战州级疫苗法律，此举随即遭到医生和疫苗生产商的反对。
该行政令推进了卫生部长小罗伯特·F·肯尼迪长期以来的目标，并重申了今年1月曾被联邦法院叫停的疫苗接种计划改革方案。
这一举措呼应了特朗普和肯尼迪所称的疫苗与自闭症存在关联的说法，但这与数十年来表明两者并无关联、且免疫接种对重大疾病具有多重益处的科学研究结果相悖。
这项行政令有何内容？
该行政令建议将针对11种疾病的儿童全民免疫接种范围，从美国疾控中心（CDC）2024年末推荐的18种疾病中缩减，其中包括麻疹、脊髓灰质炎、破伤风和百日咳。
从全民接种清单中移除的疫苗包括新冠疫苗、流感疫苗、轮状病毒疫苗、甲型肝炎疫苗、乙型肝炎疫苗、细菌性脑膜炎疫苗以及呼吸道合胞病毒（RSV）疫苗。
这些疫苗将被归入“高风险人群”类别，仅建议存在基础疾病或暴露风险的儿童接种，或归入“共同临床决策”类别，需与医生协商后推荐接种。部分疫苗，如甲型和乙型肝炎疫苗，可同时归入这两类。
行政令还建议将麻疹、腮腺炎和风疹联合疫苗（MMR）拆分为三种单疾病疫苗，并将免疫接种安排在多次单独的医疗就诊中进行。
在法律层面，行政令指示司法部长就其认为与父母自主权、宗教自由、残疾 accommodations 和平等保护原则相冲突的州法律提起诉讼，其中包括针对疫苗强制令的宗教和医疗豁免条款。
对于决定儿童免疫方案的家庭而言，会有哪些变化？
短期内机制变化不大：家长仍可申请将疫苗移至“共同临床决策”清单，白宫表示该行政令不会影响“疫苗儿童计划”——该计划为经济困难家庭提供免费疫苗，且与CDC指导方针挂钩。
政府预计但未保证，私人保险公司将继续为调整后的疫苗提供报销。蓝十字蓝盾保险集团和CVS药房表示，将继续免除CDC推荐的儿童疫苗的自付费用，同时对该行政令进行评估。
更大的影响是间接的。将疫苗拆分到多次就诊中进行（特朗普建议在1岁时接种五次）意味着家庭需要更多就诊次数，并可能产生自付费用，政府官员未说明相关费用将如何承担。儿科医生警告称，联邦政府传递的矛盾信息将导致部分家长推迟或跳过疫苗接种。
部分内容无法立即生效。拆分MMR疫苗目前无法实现，因为美国尚无企业获批销售单独的麻疹、腮腺炎或风疹疫苗。官员表示，联邦卫生部门将在90天内与制造商合作寻求解决方案。
由于学校入学要求由各州而非联邦政府制定，行政令将施压各州采用缩减后的接种计划，并依托司法部针对州豁免法律的诉讼指令提供支持。
医学专家对此行政令有何看法？
主要医学团体普遍反对该行政令，称没有新的科学依据支持这一变革。
美国儿科学会表示，该行政令会造成家长困惑并推迟疫苗接种。该学会重申，数十年的研究表明疫苗与自闭症之间不存在关联。该学会估计，将联合MMR疫苗替换为单疾病疫苗可能需要约十年时间。
包括传染病学会和美国国家传染病基金会在内的多个团体表示，此举将使更多儿童暴露于可预防的疾病和死亡风险中。
该接种计划背后有何科学依据？
公共卫生专家制定接种计划时，会研究疾病的传播方式、感染人群及发病年龄，以在最安全、最有效的时机为儿童提供保护。这也是为何大多数免疫接种安排在儿童12至18个月大时进行，此时儿童可能面临疾病暴露风险。
美国儿科学会表示，疫苗接种的时机和组合契合疫苗发挥最佳作用以及儿童最脆弱的阶段，且多种疫苗不会 overwhelm 儿童的免疫系统。
各国的接种计划存在差异，原因包括疾病威胁、人口结构、成本和接种系统各不相同。
此前美国的接种计划针对18种疾病，而可比国家的平均接种数量约为14种，韩国和巴西同样针对18种疾病，这削弱了政府所称美国接种计划过于激进的说法。
艾哈迈德·阿布勒内恩报道；朱莉·斯滕休森在芝加哥补充报道；米歇尔·格斯伯格和大卫·加夫编辑
Explainer: Trump’s childhood vaccine order: what it does and what doctors say
2026-08-11T20:55:38.612Z / Reuters
WASHINGTON, Aug 11 (Reuters) – President Donald Trump on Monday signed an executive order calling for fewer routine childhood vaccinations and directing the Justice Department to challenge state vaccine laws, a move physicians and vaccine makers swiftly rejected.
The order advances a long-standing goal of Health Secretary Robert F. Kennedy Jr. and reaffirms a January vaccine schedule overhaul later halted by a federal court.
It reflects Trump and Kennedy’s claim of a link between vaccines and autism that contradicts decades of scientific studies showing no association between the two, as well as many benefits of immunization against major diseases.
WHAT DOES THE EXECUTIVE ORDER SAY?
The order recommends universal childhood immunization against 11 diseases, down from 18 the U.S. CDC recommended in late 2024, such as measles, polio, tetanus and whooping cough.
Those dropped from the universal list are vaccines for COVID-19, the flu, rotavirus, hepatitis A, hepatitis B, bacterial meningitis and RSV.
They move into a “high-risk groups or populations” category, recommended only for children at heightened risk from an underlying condition or exposure, or a “shared clinical decision-making” category, recommended in consultation with a doctor. Some, including hepatitis A and B shots, fall into both.
It also recommends splitting the combination measles, mumps and rubella vaccine, or MMR, into three single-disease shots and spreading immunizations across separate visits to a healthcare provider.
On the legal front, the order instructs the attorney general to sue over state laws it says conflict with parental authority, religious freedom, disability accommodations and equal protection, including religious and medical exemptions from vaccine mandates.
WHAT CHANGES FOR FAMILIES DECIDING HOW TO IMMUNIZE CHILDREN?
The immediate mechanics change little: parents can still request vaccines moved to the “shared clinical decision-making” list, and the White House says the order does not affect the Vaccines for Children program, which provides free shots to families who cannot afford them and is tied to CDC guidance.
The administration expects, but has not guaranteed, that private insurers will keep covering the shifted vaccines. Blue Cross Blue Shield and CVS said they would keep covering CDC-recommended childhood vaccines without copays while reviewing the order.
The bigger effects are indirect. Splitting shots across separate medical visits (Trump suggested five at age 1) means more appointments and potential out-of-pocket costs for families, with officials not saying how they would be covered. Pediatricians warn the conflicting federal message will lead some parents to delay or skip shots.
Some elements cannot take effect right away. Splitting MMR is not currently possible because no company sells licensed standalone measles, mumps or rubella vaccines in the United States. Officials said the federal health department would work with manufacturers on a solution within 90 days.
Because states, not Washington, set school-entry requirements, the order pressures states to adopt the narrower schedule, backed by the Justice Department directive to sue over their exemption laws.
WHAT DO MEDICAL EXPERTS SAY ABOUT THE ORDER?
Major medical groups broadly rejected the order, saying no new science justifies a change.
The American Academy of Pediatrics said it would sow parental confusion and delay vaccination. It reiterated that decades of studies show no link between vaccines and autism. It estimates replacing the combined MMR shot with single-disease versions would take about a decade.
Several groups, including the Infectious Diseases Society of America and the National Foundation for Infectious Diseases, said it would expose more children to preventable illness and death.
WHAT IS THE SCIENCE BEHIND THE SCHEDULE?
Public health experts build a schedule by studying how a disease spreads and who gets sick, and at what age, to protect children at the safest, most effective times. That is why most immunizations come in the first 12 to 18 months, before likely exposure.
The AAP says the timing and combination of shots matches when they work best and when children are most vulnerable, and that multiple vaccines do not overwhelm a child’s immune system.
Schedules differ by country because of varying disease threats, demographics, costs and delivery systems.
The previous U.S. schedule targeted 18 diseases versus an average of about 14 across comparable nations, with South Korea and Brazil also at 18, undercutting the administration’s claim that the U.S. is an outlier.
Reporting by Ahmed Aboulenein; Additional reporting by Julie Steenhuysen in Chicago; Editing by Michele Gershberg and David Gaffe
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