How democracy dies amid anti-scientific nonsense. The American case

There are certain documents that will go down in the universal history of nonsense, such as Trump’s executive order of 10 August 2026, ‘Delivering Gold Standard Childhood Vaccine Recommendations for Americans’. Let’s start with the premise. The order claims that the United States recommends more vaccines than anyone else and that it needs to align itself with ‘peer countries’. The model chosen is Denmark. It is regrettable that, upon analysing the vaccination schedules of 38 countries, one finds an average of 14 diseases covered for children, and that the only country on a par with Denmark was Vietnam — which is, in any case, adding four more vaccinations. Even when restricted to the 20 countries that the government report itself defines as “peers”, the average is 13.6. Canada recommends 16. Guinea-Bissau, a low-income country, recommends 12. The US has dropped to 11. In short: in an attempt to correct one anomaly, they have created a worse one, by elevating the outlier of the distribution to the status of ‘international consensus’. It is the epidemiological equivalent of calculating the average height of a class by measuring the shortest child.

Second statement: the majority of countries would achieve high vaccination coverage "through trust, not through obligations". In 2024, thirteen European countries had at least one compulsory paediatric vaccination. Italy has had 10 since 2017, whilst France increased its number from 3 to 11 in 2018. And between 2014 and 2024, six countries — Croatia, France, Germany, Hungary, Italy and Poland — introduced or extended mandatory vaccination. Where the rationale is documented, it contradicts the order’s claims: the report accompanying Germany’s 2020 Masernschutzgesetz states in black and white that the measures taken up to that point to increase willingness to be vaccinated had not been effective, after measles cases had doubled in 2018. Europe has tightened its requirements precisely because trust alone was not holding up; Washington cites Europe as a reason to relax them. Then there is section 2(b), the ideological core. It mandates splitting the trivalent measles-mumps-rubella vaccine into three separate injections and administering each vaccination during distinct visits. But there are no authorised monovalent vaccines in the US; there is no published evidence of any benefit in splitting them; and splitting them up increases the number of injections for children, resulting in incomplete vaccination schedules. The American Academy of Paediatrics established this back in 2009. The monovalent vaccines were withdrawn from the market that year: recreating them would mean new clinical trials, new manufacturing facilities and new FDA approvals. Years.

The truly incredible detail, however, is something else entirely. The proposal to separate the MMR vaccine has an author and a date: Andrew Wakefield, at a press conference in 1998, following the article subsequently retracted by The Lancet due to fraud. In 2026, a presidential decree made the operational recommendation of the author of a study retracted for fraud into national health policy. Regarding aluminium, section 3 calls for alternative adjuvants. The matter has already been settled: a systematic review published in the BMJ on 6 May 2026, comprising 59 clinical studies including 11 randomised trials, data up to November 2025, and a formal assessment of the risk of bias. No association with autism, type 1 diabetes, asthma or myalgia. As for the rest, reports from small studies, at risk of serious or critical bias; no credible evidence of causality. The authors work for the Canadian public health agency, not for a vaccine manufacturer.

Other recommendations are also flawed: hepatitis A and hepatitis B appear simultaneously in both the ‘high-risk groups’ category and the ‘shared clinical decision-making’ category. A paediatrician consulting this guide to understand what to do would be at a loss. Four paragraphs, two incompatible lists. And here comes the part that explains everything else. Section 4 does not mention vaccines: it instructs the Department of Justice to bring legal challenges against state laws and makes federal funding conditional upon the granting of religious exemptions. Except that no federal right to a religious exemption from state vaccination requirements exists, and it is Congress—not a presidential order—that conditions federal funding. It will end up in court, and whoever drafted it knows this full well: Section 5(c) states that the order does not create any new legal rights. What we have here is self-certification as a political signal. A signal aimed at whom, and above all, when? As of 7 August 2026, the United States has recorded 2,465 cases of measles – more than in the whole of 2025, the worst year since 1991. Ninety-three per cent of these cases involve unvaccinated individuals or those with unknown vaccination status. The threshold for maintaining elimination status is the interruption of endemic transmission of the measles virus for a period of 12 months or more, under high-quality surveillance: the US had already recorded over ninety cases at the start of the year, involving local rather than imported transmission, and the outbreak in Utah has been ongoing for more than twelve months.

The Pan American Health Organisation will make its decision in November. The mid-term elections are held in November. One of these deadlines appears to have dictated the timetable for the other, and it is not the one relating to public health. Democracy, as always, dies in anti-scientific charlatanism.