President Trump signed an executive order Monday that makes sweeping, unilateral changes to federal vaccine recommendations. The order aims to reduce the number of lifesaving vaccines all children are recommended to get—from 18 to 11—while also splitting them up and spacing them out over more medical visits. The changes are not backed by evidence but based on false anti-vaccine fearmongering about harms, including the debunked claim that they cause autism and that multiple vaccinations can overwhelm children’s immune systems.

During the signing event, Trump falsely claimed pediatricians have a vaccine "the size of a bottle of soda" that is "poured into a little child's body, and bad things happen." He tied the recommendations to finding out "what's going on with autism," despite dozens of high-quality studies on millions of children finding no link between immunizations and autism.

Under the new recommendations, the US becomes an outlier by recommending only 11 vaccinations. According to Stat News, only Denmark—a small, relatively homogenous country with universal healthcare—recommends so few vaccines.