WASHINGTON (AP) — President Donald Trump on Friday gave his endorsement to a January study by the Department of Health and Human Services that calls for cutting the number of vaccines recommended for every American child.

An executive order from Trump directs federal agencies to align their policies behind the study, which recommended an overhaul long called for by Health Secretary Robert F. Kennedy Jr. The study found that the United States recommends more childhood vaccines than many peer nations.

The Trump administration previously moved to narrow the number of recommended childhood vaccines in response to the report, but the move was blocked by a federal judge in Massachusetts. The administration is appealing the decision.

The study recommends vaccinating all children against 11 diseases. Several others would be recommended only for high-risk groups or when doctors recommend them in what’s called “shared decision-making.” That includes vaccines for flu, rotavirus, hepatitis A, hepatitis B, some forms of meningitis and RSV.

Trump’s order adds weight behind the study at a time when the administration had appeared to be trying to shift focus away from Kennedy’s more contentious vaccine policies and toward more mainstream topics like healthy eating.

The order directs the Centers for Disease Control and Prevention to review the study and “take any appropriate steps” to update its vaccine recommendations. It says the CDC should “provide maximum flexibility to parents and doctors” and directs agencies to make sure all actions, regulations and funding are aligned with the study.

The order adds that any changes should ensure that Americans retain their current access to vaccines.

States, not the federal government, have the authority to require vaccinations for schoolchildren. While CDC requirements often influence those state regulations, some states have begun creating their own alliances to counter the Trump administration’s guidance on vaccines.

Trump directed HHS to carry out the study in December.

Kennedy is a longtime activist against vaccines and has sought ways to inject his skepticism about the shots into national guidance. Last year, he announced the CDC would no longer recommend COVID-19 vaccines for healthy children and pregnant women, a move questions by public health experts who saw no new data to justify the change.

Last June, he fired a 17-member CDC vaccine advisory committee and later installed several of his own replacements, including multiple vaccine skeptics.

The January report found that vaccine recommendations for American children had increased in recent decades. It also highlighted countries where no vaccines are required to attend school.