Separating the measles, mumps and rubella vaccine could decrease access for Colorado parents

Some parents in Colorado question the safety and timing of vaccines, including the measles, mumps, and rubella (MMR) vaccine. They prefer to make independent decisions based on their children’s perceived needs rather than following standard medical schedules. This perspective has been observed in interviews with Colorado parents, pediatricians, researchers, and policymakers over nearly two decades. Parents often feel overwhelmed by conflicting information from online discussions, media, and official sources. They may delay or skip vaccines they consider less urgent, even if they are not fully opposed to vaccination. This approach is sometimes called an alternative vaccine schedule or slow vaccine schedule.

In August 2026, President Donald Trump signed an executive order calling for the separate administration of the MMR vaccine components (measles, mumps, and rubella) instead of the combined vaccine. The order was framed as offering parents more flexibility, but it did not provide a clear plan for implementation. Trump claimed that the combined MMR vaccine was 'quite lethal' and that separate shots would be 'very effective,' though these claims lack scientific support. The executive order is largely symbolic and does not change existing vaccine policies or manufacturing processes.

The combined MMR vaccine has been used since 1971 and became the only available option around 2008. It is recommended by the Centers for Disease Control and Prevention (CDC) to be given in two doses: the first at 12–15 months of age and the second at 4–6 years. The vaccine has a strong safety record, and some studies suggest it may even provide a stronger immune response than separate shots. The CDC states there is no scientific evidence showing benefits to separating the MMR vaccine into three individual doses.

Colorado allows parents to opt out of required vaccines for school attendance, leading to a higher exemption rate than the national average. During the 2025–26 school year, only 87.7% of kindergartners in Colorado had received both measles vaccine doses, ranking sixth-lowest in the country. This is below the 95% threshold needed for community immunity against measles, which protects even those who cannot be vaccinated. The state’s vaccination rates have declined since the COVID-19 pandemic, raising concerns about outbreaks.

No separate measles, mumps, or rubella vaccines have been manufactured in the U.S. since 2008. Producing individual vaccines would require significant investment from manufacturers like Merck and GSK to rebuild the supply chain, which could cost millions of dollars and take up to a decade. Given existing medication shortages, this is unlikely to be a priority. The MMR vaccine is not patented, reducing financial incentives for manufacturers to make changes.

Pediatricians already face financial and logistical challenges in providing vaccines, including high costs for storage, ordering, and administration. A 2017 study found that 36% of pediatricians had considered or already stopped stocking vaccines. If required to offer separate MMR vaccines, pediatricians would need to manage three times the number of vials, increasing costs and complexity. Some may stop offering vaccines altogether, limiting access for families. Pharmacists can administer vaccines but are legally restricted from vaccinating children under 3 years old, when vaccines are often most critical.

In rural Colorado, access to healthcare is already limited by distance, provider shortages, and high travel costs. The average cost for rural patients to travel outside their community for healthcare is $718 per trip, including $235 in lost wages. Rural areas like Kit Carson, Cheyenne, Lincoln, and Elbert counties face measurable shortages of primary care providers. Increasing the number of required appointments from two to six for the MMR series could make it harder for families to complete vaccination, especially during disease outbreaks.