State-federal legislation news and updates from NCSL.

Aug. 18, 2026

This week: A new executive order recommends changes to state childhood vaccine schedules and immunization policies. And a proposed rule would remove certain federal requirements governing states’ administration of the Head Start program.

President Donald Trump signed an executive order on Aug. 10 directing federal agencies to adopt a new set of childhood vaccine recommendations and encouraging states to review school immunization requirements. The order includes a smaller core schedule of vaccines routinely recommended for all children, moves some vaccines to a shared clinical decision-making category, calls for the combined measles, mumps and rubella vaccine to be administered as separate shots (an option not available in the United States), and directs federal agencies to support greater parental choice in vaccination decisions. The administration also directed the Department of Health and Human Services to develop additional plans related to vaccine research and policy.

States have broad primary authority over vaccine policy and while the executive order does not directly change state vaccination laws, it encourages states to consider aligning school-entry vaccine requirements with the new federal recommendations. The order has drawn criticism from several major medical organizations including the American Medical Association, the American Academy of Pediatrics and the American College of Physicians, each of which issued statements citing the order’s lack of scientific evidence to support changes to childhood immunization recommendations.

► Fact Sheet: President Donald J. Trump Delivers Gold Standard Childhood Vaccine Recommendations for Americans (White House)

► An Overview of State and Federal Authority to Impose Vaccination Requirements (CRS)

► AMA statement on executive order changing childhood vaccine schedule (AMA)

► AAP Statement in Response to Executive Order on Vaccines (AAP)

► American College of Physicians: Executive order directing changes to U.S. vaccine schedule problematic, deeply concerning and creates barriers to access (ACP)

► State Non-Medical Exemptions From School Immunization Requirements (NCSL)

Administration for Children and Families Proposes Overhaul of Head Start Requirements | The agency’s proposed rule would remove many federal regulations for the Head Start program, which provides education and other services, including nutrition and health screenings, to children from birth to compulsory school age and pregnant women in low-income families. Instead, the agency would rely on federal statute and state and local requirements for aspects such as adult-child ratios, licensing, transportation and background checks. The program has historically been a federal-to-local program with a minimal state role. The rule would also reduce the cap on administrative expenses from 15% to 5% and add new nutrition and physical activity requirements, among other changes. The comment period closes Oct. 6.

► Notice of Proposed Rulemaking: Reducing Federal Burden for Head Start Programs (HHS)

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Capitol to Capitol was established in 1994 to provide up-to-date information on important federal legislation. NCSL is committed to enhancing the role of states and state legislatures in the federal system.

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