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WASHINGTON — Public health experts have been quick to condemn an executive order from President Trump aimed at upending childhood vaccinations in the U.S., but the biggest obstacles may be the unprecedented financial and logistical challenges it would impose on parents, health providers and drugmakers.

Monday’s announcement by the Republican president calls for separating combination shots — including the measles, mumps and rubella, or MMR, vaccine — into separate injections. Appointments for that and other vaccinations should be spaced out whenever possible, the order states.

To accomplish that, drugmakers would need to revive a slate of individual vaccines that have not been marketed separately in the U.S. for decades. They would also have to build new manufacturing plants capable of producing millions more vaccine doses than the nation currently uses.

For parents, unbundling the MMR vaccine and spacing out the shots would mean returning to the doctor’s office many more times than is currently needed. Those appointments could also strain pediatricians who typically administer the shots, while driving up costs tied to syringes and other medical supplies.

Studies in the U.S. and other countries have shown that combination vaccines increase the likelihood that children will be fully protected from infectious diseases before starting school.

Health experts say there is no scientific basis for changing course.

“We do things that are less convenient and more expensive if there’s a good reason to do it,” said Dr. Anna Durbin, of the Johns Hopkins Bloomberg School of Public Health. “There is no good justification for this. I think it’s very bad public health policy.”

Trump’s plan would require vaccine manufacturing overhaul

Under Trump’s executive order, federal officials are instructed to develop within 90 days plans for breaking up the MMR shot and spacing out other vaccines.

But pharmaceutical scientists and former regulators say those changes would likely take years and require drugmakers to spend tens of millions of dollars on new studies and manufacturing facilities.

Currently, there are no individual vaccines in the U.S. for measles, mumps or rubella. All the vaccines approved for those viruses by the Food and Drug Administration are combination shots. That three-in-one approach has been the standard in the U.S. since the early 1970s.

Dr. Jesse Goodman, a former FDA vaccine chief, said companies would have to conduct large studies showing new individual shots produced immune system-boosting reactions in children similar to the current versions.

Companies might also have to demonstrate the safety of new manufacturing facilities and procedures, given that individual measles shots haven’t been widely produced in the U.S. for roughly a half-century.

“The question is how much has changed since then and how comfortable will the FDA and the companies be relying on those comparisons?” said Goodman, who is now a professor at Georgetown University.

Designing, constructing and getting federal sign-off for new vaccine plants typically takes about five years, according to industry experts.

Additionally, Goodman said the FDA would have to review and license each unbundled vaccine separately, a process with no precedent.

“I don’t think there’s any comparable example of removing hugely effective public health measures that protect babies for no documented scientific reason,” he said.

Individual shots for measles and related diseases tend to be used by lower-income countries that can’t afford the MMR shot. Merck, GSK and the handful of other companies that supply U.S. childhood vaccines make only the combination shot.

In separate statements, Merck and GSK said they stand by the safety and effectiveness of their products. Neither discussed plans to unbundle their shots.

“To date, there has been no published scientific evidence that shows any benefit in separating the combination MMR vaccine into three individual shots,” Merck said in an emailed statement.

Parents would need to make many more trips to the doctor

The MMR shot is currently delivered in two doses — the first at the age of 1 and the second dose after age 4. Splitting up the shot into its three separate components would mean six office visits. Spacing out other shots for pertussis and other infectious diseases could multiply the number of visits many more times.

As the number of visits goes up, parents are more likely to miss appointments or stop making them, according to Durbin.

“It’s going to be less convenient, more expensive and you’re going to have fewer people getting vaccinated,” she said.

Since last year, Trump has repeatedly expressed concern about the number of vaccinations U.S. children are receiving and called on Health Secretary Robert F. Kennedy Jr. to reduce the number. Kennedy and other officials have pointed to smaller countries, such as Denmark, that recommended slightly fewer vaccines than the U.S.

But breaking up combination shots will result in kids receiving many more individual shots than other comparable nations, Durbin notes.

White House spokesman Kush Desai said the Trump administration’s efforts on the MMR vaccine “will give parents more options on timing and frequency for their children, which ultimately will increase vaccination rates for all three diseases.”

Vaccine order is not legally binding

Despite the precedent-breaking nature of Trump’s order, some experts are skeptical it will result in meaningful changes.

Neither the White House nor the FDA can compel drugmakers to develop and seek approval for new vaccines. And from a business perspective, companies have little incentive to develop individual versions of vaccines they already sell in combination shots.

“They’d be competing against themselves, and there’s no reason to do that,” said Dr. Paul Offit, a Children’s Hospital of Philadelphia vaccine researcher and former government adviser.

While Trump’s order calls for more federal research and recommendations, only state governments have the legal authority to require vaccinations for schoolchildren. The order simply advises states to consider updating their laws to reflect the Trump administration’s approach.

“I think states will ignore this,” Offit said. “I think that bottom line is that we don’t need to look to Donald Trump for our medical advice.”

Perrone writes for the Associated Press. AP videojournalist Mary Conlon in New York contributed to this report.

Miami authorities on Tuesday night responded to a residence after a disturbing video was posted on social media that appeared to involve celebrity blogger Perez Hilton.

The Times has not confirmed the authenticity of the video. But the Miami-Dade Sheriff’s Office said in an emailed statement that authorities had received an influx of calls on Tuesday reporting that an individual was livestreaming acts of self-harm on social media.

After surrounding the Miami residence of a man who was not named, the Sheriff’s Office said around 9 p.m. that he had been “safely recovered and transported by Miami-Dade Fire Rescue to a local hospital, where he is receiving medical attention.”

Deputies had arrived earlier and said they spoke with family members at the scene and confirmed that the man was alone inside the home.

“In many incidents involving a person experiencing a mental health crisis or actively harming themselves, deputies prioritize de-escalation by creating time, distance and opportunities for communication,” the statement read. “Unless there is an immediate threat to others, slowing the situation and utilizing crisis intervention techniques can reduce the likelihood of a suicide-by-cop encounter and minimize the risk of injury to the individual, deputies and the public.”

Authorities said they had “tactically disengaged while continuing to monitor the situation.” In their later update, the Sheriff’s Office said that after the man had been transported to a hospital, mental health professionals were at the scene “providing support and resources to the individual’s family.”

A representative for Hilton did not immediately respond to The Times’ request for comment.

In the TikTok live video, a person who seems to be in distress harms himself. The video has since been removed from the platform.

Police and fire personnel converged on the Miami home Tuesday night. NBC6 News reported that some neighbors said Hilton lived at the home, but police would not confirm that.

Hilton, born Mario Lavandeira Jr., has been a pop culture personality since the early aughts when he launched his eponymous celebrity gossip rag. The venture garnered the columnist social status but also made him persona non grata among many celebrities who weren’t fans of his controversial coverage, which was often deemed disparaging, especially toward women.

WASHINGTON — The Trump administration has filed a first-ever petition to a secretive and dormant court created 30 years ago to consider government requests to deport “alien terrorists” from the United States.

The Alien Terrorist Removal Court was established in 1996 but had never received a petition until Wednesday, when the Justice Department filed an application seeking the removal of an individual whose name is withheld from the single-page document posted on the court’s website.

The chief judge of the five-member court, Joan Ericksen, said in a written response to the petition that a hearing was held Thursday during which the court had “questions about the nexus that the government alleges between the actions of the respondent and the specific sections and subsections it invokes with respect to those actions.”

“The answers persuaded the Court that the Government could benefit from the opportunity for more thoughtful consideration,” wrote Ericksen, a federal judge in Minnesota.

She directed the Justice Department to provide more information by Wednesday.

The court’s authorities emerged from the Antiterrorism and Effective Death Penalty Act of 1996, which permits the attorney general to file under seal applications for the deportation of a suspected “alien terrorist.” If an application is granted, the court must hold a public hearing at which the government has the burden to prove that the individual satisfies that definition. Applications must be approved by the attorney general or deputy attorney general.

Federal law says that an individual could qualify as an “alien terrorist” by, among other factors, having “engaged in a terrorist activity,” endorsing or espousing terrorist activities and by belonging to a political or social group that encourages terrorist activity.

The court has been dormant since its creation, having received — until last week — no applications and conducting no hearings, according to a summary posted on the Federal Judicial Center website. It comprises five judges selected by Chief Justice John G. Roberts Jr.

The Trump administration has moved aggressively over the last year to carry out deportations, including invoking a 1798 wartime law, the Alien Enemies Act, to remove Venezuelan migrants who officials accuse of being part of a terrorist gang. During a hearing in that case last year, the Washington judge presiding over it, James Boasberg, indicated that the Alien Terrorist Removal Court would be the natural forum to consider a request for deportation on national security grounds.

“In fact, Congress has an answer for us, doesn’t it? Because they created the Alien Terrorist Removal Court,” he said. “So if there’s a national security concern with having these hearings … you can always go to the ATRC, which would be a first, but that’s what it’s there for, right?”

The petition was first reported by Court Watch, an independent news site.

Tucker writes for the Associated Press.

SACRAMENTO — Disability rights advocates on Monday gathered outside the state Capitol to push back on Gov. Gavin Newsom’s proposed cuts to in-home supportive services.

“These aren’t just numbers in a budget; these are real people,” said Assemblymember Jeff Gonzalez (R-Indio). “These are children, seniors, veterans and individuals with disabilities whose independence and quality of life depend on these services every single day.”

The In-Home Supportive Services program helps disabled and elderly people remain in their houses by providing in-home care. It pays assistants to help with tasks such as showering, cooking or attending doctor appointments. Newsom’s revised budget proposal, which was unveiled last month, would cut $367.7 million from the program and shift some of that financial burden onto counties.

Gonzalez explained that the issue hits close to home for his family. He said his son has cerebral palsy and a seizure disorder, and relies on assistance to live with dignity.

“Families should not have to wonder every budget season whether the support they rely on will be taken away,” Gonzalez said. “These services should not be treated as bargaining chips in budget negotiations.”

Assemblymember Laurie Davies (R-Laguna Niguel) questioned why a successful state like California would need to enact such cuts.

“It’s hard to go a day without hearing the governor or the administration brag about how we are the fourth-largest economy in the world and yet we can’t fully fund [this program for] the most vulnerable?” Davies said.

The governor has previously explained that difficult decisions must be made as the state could soon face an economic downturn. The budget proposal relies on a tax windfall, largely attributed to the stock market success of artificial intelligence companies, to erase California’s deficit — but some analysts have warned that the AI bubble could burst.

H.D. Palmer, deputy director for external affairs for the California Department of Finance, on Monday said some of the proposed cuts are a byproduct of the federal government’s changes in funding and eligibility for health and human services programs.

The so-called “Big, Beautiful Bill” signed by President Trump last year shifted federal funding away from safety-net programs, he said.

Palmer stressed that state budget negotiations are ongoing.

“Until we land on an agreement, speculation regarding the resolution of any specific differences between the Governor’s budget plan or the Legislature’s respective budget proposals would be premature,” he stated by email.

Monday’s event drew some bipartisan support. Brody Fernandez, communications director for Assemblymember Esmeralda Z. Soria (D-Fresno), said the legislator had been fighting for In-Home Supportive Services funding since she was elected.

Fernandez said his daughter has special needs and her mother had to give up her career to become a full-time caregiver. “This is personal for us and for many of the incredible individuals standing behind me,” he said.

Graham Knaus, chief executive of the California State Assn. of Counties, told The Times that he appreciated efforts to raise awareness about the burden these changes would place on counties.

“We applaud the Senate and Assembly for recognizing counties’ concerns and rejecting this proposal,” he said. “We ask them to hold the line in final negotiations.”

Elizabette Guecamburu, a bookkeeper who has a rare neuromuscular disorder, spoke at Monday’s rally and implored the governor to remember the teachings of their shared alma mater Santa Clara University, a Jesuit-led private school.

“I want him to remember where he came from,” she said, adding that students were taught to value compassion and community. “Don’t forget your Jesuit roots.”