The U.S. Childhood Schedule Still Has No Published Comparison to Peer Countries

American children are recommended more vaccine doses than peers in several developed countries, and the studies that would compare health outcomes across those schedules have not been published. David Gortler, a pharmacist writing in the Brownstone Journal, counts roughly 30 to 75 doses by age 18 in the United States, depending on the state, against lower totals he compiled for Denmark, Japan, Norway, and Sweden. President Trump signed Executive Order 14407 on May 29, 2026, directing HHS to realign U.S. childhood recommendations with peer-nation practice and, within 90 days, to present plans on timing, sequencing, and safety monitoring. Gortler writes that the 90 days passed without a public study design, a list of outside experts, safety endpoints, or a request for comment.

Section 3 of EO 14407 routes the work through the Task Force on Safer Childhood Vaccines, chaired by NIH Director Jay Bhattacharya. The White House summary of the order says a scientific assessment found the United States recommends more childhood vaccines than any peer nation, including more than twice as many doses as some European countries, and that most peers keep high uptake through trust and education rather than mandates. A second order, 14420, signed August 10, is described by Gortler as cutting recommended diseases from 17 or 18 to 11, spacing visits, and splitting the combined measles-mumps-rubella shot into three injections. The task force does not owe Congress a report until 2027. Plans were due in 90 days. Studies were not.

Gortler’s country counts, which he says he compiled from national schedules, are ranges, not single official totals:

No two of those schedules match. The questions the orders name — which schedule tracks with better short- and long-term outcomes, how far out adverse events are counted, and how the counts are collected — are not answered by a dose table.

Japan stopped using its combined MMR vaccine in 1993 after aseptic meningitis reports tied to the Urabe mumps strain in that formulation, a strain not used in the Merck product given in the United States. The government moved citizens to separate measles, rubella, and mumps components. Gortler’s point is regulatory precedent: a government asked manufacturers to unbundle a combination after a safety signal, and manufacturers complied. He writes that no manufacturer has offered separate components to meet EO 14420. The Japan record is also a warning on the other side. Researchers later tied the withdrawal to a multi-year vaccine gap and delayed introduction of other shots. Splitting a product is not the same as showing that fewer doses produce healthier children.

In 2013 the Institute of Medicine reported that studies of the long-term effects of the cumulative number of vaccines, or of other features of the schedule as a whole, had not been conducted, and recommended building that capacity into the Vaccine Safety Datalink. The same report said the committee found no evidence of major safety concerns from adhering to the schedule then in use. Both sentences are in the record. Thirteen years later, a congressional review still called postmarket vaccine surveillance limited. Gortler notes that neither the broader schedule nor the reduced one written to replace it has a published comparative-outcomes protocol.

HHS, he writes, asked on August 21, 2026, for comment on the right approach “when randomized controlled trial evidence is limited or absent.” The agencies already have the Vaccine Safety Datalink, discretionary funding, and the authority to publish a protocol before any child is enrolled. What is missing is the document: exposures defined as the U.S. schedule against peer schedules, combination products against single components, spaced visits against same-day shots, active follow-up instead of passive reports, and ingredient lists complete enough to study. Until that protocol is public, the orders are a deadline and a press release.