WASHINGTON — The Department of Health and Human Services on Friday outlined potential changes to the childhood vaccine schedule, suggesting kids shots should be spread farther apart in contrast to recommendations from pediatric groups.

The request for information fulfills directives outlined in President Donald Trump’s executive order from Aug. 10 that seeks to stagger vaccine doses in childhood and asks whether new vaccine categories are warranted, such as “recommended, but not in infancy.”

It also asks for input on whether shared clinical decision-making, in which people consult with healthcare providers before getting a vaccine, should be applied more broadly. It questions whether that’s confusing to people and may be leading to lower vaccine uptake. The document suggests, however, that shared clinical decision-making could be the default category for all vaccines, while different terms may be employed for other situations.

“Since shared decision-making describes a clinical process applicable to all vaccine decisions, should the Department reserve that phrase for use across all categories and instead adopt ‘conditional recommendation’ or ‘recommendation based on individualized assessment’ for recommendations whose expected benefit varies materially among individuals?” it asks.

The request follows actions by the Centers for Disease Control and Prevention earlier this year that moved toward spacing out vaccines. The agency in January recommended reducing the number of vaccines for children to 11 from 17, which this month’s executive order also recommends.

More than two dozen states and the District of Columbia have rejected the recommendations, with most of them following guidelines from the American Academy of Pediatrics.

The administration’s renewed interest in vaccine policy brings the controversial issue into the spotlight ahead of the midterm elections this November. The actions emphasize Trump’s long-held belief that splitting up routine childhood vaccinations across multiple visits lessens the risk of acquiring autism. Scientists have found no credible risk between vaccinations and autism.

The request, which is set for publication in the Federal Register on Monday, comes with CDC Director Erica Schwartz in the job for just over a week. Schwartz faced scrutiny from Sen. Bill Cassidy, R-La., who chairs the Senate Health, Education, Labor and Pensions Committee, over whether she would be able to push back against superiors who ask her to make decisions that go against science. Cassidy ultimately threw his support behind her.

HHS did not respond to a question about whether Schwartz was involved in the information request.

Trump on Wednesday selected his domestic policy adviser Heidi Overton to be his nominee for Food and Drug Administration commissioner. She appeared next him during the vaccine executive order signing, drawing backlash from Cassidy, who said her support for the order was “almost disqualifying.”

The CDC, in consultation with the Advisory Committee on Immunization Practices, sets recommendations for childhood vaccines. The FDA, in consultation with its Vaccine and Related Biological Products Advisory Committee, makes decisions on clearing vaccines for the market.

People can choose to opt out from any recommended vaccine, but states set vaccine mandates in schools. They may use the CDC’s recommendations though they are not required to.

Respondents have until Sept. 20 to submit comments.

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