With twelve weeks remaining before the midterm elections, and early voting in some states even closer on the horizon, you might expect the most powerful politician in America to be laser-focused on the issues that actually keep ordinary people up at night: the cost of living, health care, the future of democracy, the state of the economy. But Donald Trump has never been an ordinary politician, and his priorities have never really been about what the majority of Americans care about. Instead, in recent weeks, the president has invested remarkable amounts of time and energy into things that would hardly register on the public’s list of urgent concerns: the appearance of the Reflecting Pool, the tangled mythology of the 2020 election, and a vanity project connected to the White House ballroom. It is the kind of behavior that has become almost expected, yet it still manages to surprise in its sheer stubbornness. So it should come as no surprise that, with the clock ticking down to an election, Trump decided to turn his attention to another favorite fixation: vaccines. Not the science of vaccines, not the staggering evidence that they save millions of lives, but the misinformation, the suspicion, and the political value of giving anxious parents something to worry about. This is not a story about public health. It is a story about a man who, at the most consequential moment of the political calendar, chooses to feed the fire of fear with a garden hose full of gasoline.
The latest chapter began quietly enough, with a report from The Wall Street Journal revealing that Trump had privately lobbied his own Health and Human Services Secretary, Robert F. Kennedy Jr., to investigate something that has been thoroughly debunked for years: the false idea that vaccines are linked to autism. For most of the medical community, this is not a debate; it is a settled question, and the answer is no. But for Trump, it has always been a useful cudgel, a way to appeal to distrustful voters and to create a sense of chaos around institutions he does not control. Then, as the new week got underway, the president moved from private pressure to public action. On Monday, he signed an executive order designed to upend the childhood vaccine schedule. The order, as outlined by press reports, recommends slimming down the number of immunizations children receive from eighteen different diseases down to eleven. The vaccines being removed from the universal list include hepatitis A and hepatitis B, along with the Covid-19 and flu shots. Those vaccines would still be available, but only for certain high-risk groups or for what the order calls “shared clinical decision-making,” a phrase that sounds reasonable enough until you realize it is really just a way of saying: we are shifting the responsibility from public health experts to parents who may not have the training or the information to make those calls alone. The order also recommends breaking the combined measles, mumps and rubella vaccine, known as the MMR vaccine, into three separate shots, and administering vaccines during separate visits. The stated goal is to give parents “more options,” but the practical effect is to make vaccination more complicated, more expensive, and more burdensome for families who are already stretched thin.
It is important to pause here and ask what this executive order actually does, because the answer is far less dramatic than the headlines might suggest. Vaccine recommendations in the United States are made by a committee of medical experts that advises the Centers for Disease Control and Prevention, and those recommendations are then adopted by the CDC’s director. The federal government does not, by itself, require vaccinations for children to attend school or day care; that authority belongs to the states. So Trump’s executive order, unless it is followed by a cascade of state-level changes, is largely symbolic. But symbolic is not the same as harmless. The power of the presidency does not come only from the laws a president signs; it comes from the platform, the microphone, and the ability to make people believe that the White House has looked into an issue and found something alarming. When Trump stands in the Oval Office and announces what he calls “gold standard childhood vaccination recommendations,” he is not simply issuing a policy memo. He is telling millions of American parents, many of whom are already anxious and uncertain, that the scientific consensus is up for debate, that experts cannot be trusted, and that their children are at risk. That message lands in a country where vaccine hesitancy has already led to outbreaks of diseases that were once all but eliminated. It lands in a country where parents genuinely worried about their children may now wonder whether they should delay a vaccine that could protect them from measles or whooping cough. And it lands at a time when public trust in medicine is already under enormous strain.
The events that followed the signing of the order made the misinformation problem even more painfully clear. During a forty-minute gathering in the Oval Office, Trump offered a bizarre cascade of claims that would be laughable if they did not have real consequences. He said, for example, that he had seen “proof” of a “vaccination thing” in which something the size of a bottle of soda gets “poured into a little child’s body.” That is not a fact; it is not even a reasonable metaphor. It is a conspiracy-adjacent image, designed to trigger an emotional reaction rather than an intellectual one. He also argued that the combined measles, mumps and rubella vaccine could be “quite lethal” when administered as a single shot. This is so far outside the bounds of established medicine that even a reporter in the room sensed the need to ask for evidence. Trump, to his credit, was honest in that moment. “No,” he replied. “What I’ve heard is that there are some people that say it is that way.” Let that sink in. The President of the United States was announcing a major public health directive, changing the way the government advises parents on vaccinations, and his evidence was something he had heard, from unnamed people, with no data, no studies, no medical review, no credible source. He was not quoting a pediatrician; he was not citing a peer-reviewed journal; he was not even pointing to a reliable news article. He was repeating gossip, elevating rumor to the level of official policy, and asking the country to take it seriously.
This would be troubling from any politician, but it is especially troubling from a president who appears to genuinely believe he has the credibility needed to advise the American people on medicine and science. The evidence to the contrary is everywhere. In January, for instance, Trump told The Wall Street Journal that he routinely ignores his own physicians’ advice about taking daily aspirin to protect his heart. He said he ignores that advice, in part because he is “superstitious” and in part because he wants “nice, thin blood pouring through my heart.” That is not the language of a careful, knowledgeable patient. It is the language of someone who trusts his gut more than he trusts the professionals who spent their lives studying the human body. It is the same instinct that led him to suggest, during the early days of the pandemic, that injecting disinfectant into the lungs might be a promising idea. It is the same instinct that has led him to embrace fringe quacks and celebrity doctors over public health officials. And now, with the power of the executive order behind him, that instinct has been let loose on the childhood vaccine schedule. This is not a man who has done the homework. This is not a man who has sat down with pediatricians and immunologists and asked difficult questions with an open mind. This is a man who hears a scary story, likes the way it fits into his worldview, and repeats it until it becomes his policy.
At the end of the day, the real tragedy here is not the executive order itself, or the legal battle that may or may not follow. It is the message being sent to parents who are already struggling to make the best choices for their children. Parenting is hard. It is full of uncertainty and anxiety, and the last thing a parent needs is to hear that the shots protecting their child from deadly diseases might themselves be deadly. It is the cruelty of false equivalence, the way that a man who has spent years ignoring doctors’ advice now stands behind a presidential seal and tells the country that the medical establishment has it wrong. It is the cynical use of public health as a culture war weapon, a way to energize a political base by making them feel empowered to distrust the experts. And it is the broader pattern of a leader who, when he should be focused on the real problems of the American people, is instead obsessed with his own grievances, his own theories, and his own image. Six weeks before early voting begins, twelve weeks before the midterms, the man in the Oval Office is not worried about what the voters care most about. He is worried about what he cares most about, and he appears willing to risk the health of the nation’s children to chase those obsessions. The question now is whether the rest of the country is willing to follow him down that dangerous path, or whether we will finally decide to listen to the doctors, the scientists, and the evidence instead.