President Trump signed Executive Order 14420 on August 10, 2026, establishing what the administration calls "Gold Standard Childhood Vaccine Recommendations." The order reorganizes the federal childhood immunization framework into three tiers: vaccines recommended for all children (covering 11 diseases, down from 17 currently recommended), vaccines for high-risk groups, and vaccines left to shared clinical decision-making—a category that now includes influenza and COVID-19. The order also calls for splitting the combined MMR vaccine into three separate shots once single-disease products become domestically available, and directs the Justice Department to challenge state laws it deems inconsistent with parental and religious-exemption rights. The order is the administration's third attempt to reshape childhood vaccine policy after earlier HHS actions were blocked in March 2026 by a federal court, which found that restructuring the Advisory Committee on Immunization Practices likely violated the Federal Advisory Committee Act. Insurers and the Vaccines for Children program are not immediately affected, as those programs remain tied by law to ACIP recommendations. Ongoing litigation means the practical reach of the order remains uncertain.