Ahead of the upcoming respiratory virus season, the American Academy of Pediatrics (AAP) has updated its recommended childhood vaccine schedule, presenting guidance that diverges from the latest recommendations issued earlier this year by the CDC’s Advisory Committee on Immunization Practices (ACIP). The ACIP overhaul, which included input from groups advocating vaccine skepticism and others without vaccine expertise, prompted the AAP to reaffirm its long-standing commitment to science-based immunization guidance for doctors and families.
What’s new in the AAP schedule
– The updated schedule covers routine immunizations for 18 diseases, including respiratory syncytial virus (RSV), influenza, and COVID-19, and introduces other changes such as a pentavalent (five-strain) meningococcal vaccine, a revised starting age for the human papillomavirus (HPV) vaccine, and the removal of a hepatitis vaccine that is no longer available.
– Susan Kressley, MD, the AAP president, stressed that the recommendations are grounded in science and designed to protect infants, children, and adolescents, noting that pediatricians play a crucial role in keeping families and communities healthy.
Context and reaction to shifting recommendations
– The new AAP guidance arrives amid ongoing debate over vaccine policy dynamics in Washington. Critics have expressed concerns that recent HHS moves could blur lines around vaccine coverage and access, given that insurer policies often align with official recommendations.
– In May, then-HHS Secretary Robert F. Kennedy Jr. announced sweeping changes that removed the COVID-19 vaccine from the standard recommendation for healthy children and pregnant women. A few days later, the CDC updated its own schedule to reflect only a partial alignment with Kennedy’s position, stating that children aged 6 months to 17 years may receive the COVID-19 vaccine based on parental choice and clinical judgment.
– The AAP emphasized the importance of broad insurer coverage for vaccines on its updated schedule and pledged to work with partners at local, state, and federal levels to ensure that every child has access to vaccines.
– In parallel, the Vaccine Integrity Project (VIP), an alliance of health experts that promotes science-based vaccination guidance, hosted discussions on safety and effectiveness data for RSV and COVID vaccines across pregnant people, children, and immunocompromised individuals, highlighting ongoing efforts to keep vaccine recommendations scientifically grounded. CIDRAP News and related outlets have covered these developments.
COVID-19 vaccination guidance for 2- to 18-year-olds
– The AAP’s COVID vaccine recommendations emphasize that data show higher risk of severe disease in certain age groups. The plan calls for vaccination of all children aged 6 to 23 months to protect against serious illness.
– For children aged 2 through 18, the AAP supports a single-dose regimen for those at higher risk of severe disease, residents of long-term care or congregate settings, children who have never been vaccinated, and those with household contacts at high risk. The AAP also states that vaccination should be available for children in this age range whose families desire it, even if they don’t fall into the listed risk groups.
– Sean O’Leary, MD, chair of the AAP’s infectious diseases committee, noted that extensive reviews of the literature indicate COVID vaccines are safe for all populations. The shift toward a risk-based approach for healthy older children reflects the ongoing high hospitalization risk for younger children and those with underlying conditions.
Influenza and RSV guidance
– The AAP recommends influenza vaccination for all children aged 6 months and older each season, unless there is a medical contraindication, to protect both individuals and communities when other respiratory viruses circulate.
– For RSV, the AAP suggests monoclonal antibody immunization (such as nirsevimab or another approved product) for infants younger than 8 months whose mothers did not receive the RSV vaccine during pregnancy, whose RSV vaccination status is unknown, or who were born less than 14 days after their mother’s vaccination.
– The guidance also covers RSV vaccination for babies aged 8 through 19 months who are at high risk of severe disease and those beginning their second RSV season, with high-risk defined to include chronic lung disease, immune suppression, and other conditions.
Additional context and expectations
– The updated 2025–26 season vaccines are anticipated to receive FDA approval soon, with discussions surrounding potential changes to manufacturing and supply. There is particular attention to how new vaccine formulations will be distributed and whether supply will be sufficient for younger children, given uncertainties about emergency use authorization status for some pediatric vaccines.
– The AAP called on insurers to cover all vaccines included in the schedule and reiterated its commitment to collaborating with partners at multiple levels of government to improve access for every child.
Potential implications and value for readers
– For families, the updated schedule offers clearer guidance on which vaccines are recommended and in what age ranges, including specifics for RSV and COVID-19 prevention.
– For clinicians, the schedule provides a framework aligned with current science while highlighting areas where state policies and insurer coverage can influence implementation.
– The push from the AAP to maintain science-based recommendations aims to support consistent vaccination practices across communities, regardless of shifting political or regulatory pressures.
Summary and outlook
– The AAP’s update reinforces a science-based approach to pediatric immunizations, emphasizing protection against RSV, influenza, and COVID-19, while adjusting the vaccination landscape with changes to meningococcal, HPV, and hepatitis vaccines. As vaccine formulations and regulatory statuses evolve, the AAP plans to stay aligned with evidence and to advocate for broad access through insurers and policy makers. The overall message is one of safeguarding child health through reliable, research-backed immunization strategies, with a hopeful emphasis on improving protection for all children as new vaccines and data become available.
Additional comments
– A proactive stance by the AAP to engage insurers and policymakers could help minimize disruptions in vaccine access, especially for families navigating vaccine hesitancy or logistical barriers.
– Keeping families informed about evolving recommendations, the rationale behind risk-based approaches, and the anticipated role of new vaccines will be key to maintaining high coverage rates and protecting public health during the respiratory season.
If you’d like, I can provide a concise at-a-glance summary for a sidebar, or draft a version tailored for readers prioritizing family health guidance and practical vaccination steps.