Provided by: David Higgins, MD, MPH, FAAP
AAP-CO Vice President

As respiratory virus season approaches, the American Academy of Pediatrics has published an evidence-based immunization schedule that includes updated guidance for influenza, RSV, and COVID-19 immunizations for children and adolescents from birth to age 18.

The schedule, “Recommended Childhood and Adolescent Immunization Schedule: United States, 2025,” was published Aug. 19, 2025.

Why did AAP publish its own recommendations?
AAP has a long history of providing evidence-backed guidance on vaccines and worked with the Centers for Disease Control and Prevention (CDC) and others in recent decades to harmonize recommendations when possible. However, recent Federal actions, warrant the need for independent recommendations rooted in science because “children deserve better.” Further, the AAP recommendations identify the ages and conditions where the risk is highest while also supporting vaccine availability for families.

How do AAP recommendations differ from CDC?
The biggest difference between the AAP and CDC schedules is around COVID-19 vaccination. AAP recommends all young children ages 6-23 months get vaccinated as well as children ages 2-18 years in certain risk groups. It also calls for children whose parent or guardian desires their protection from COVID-19 to have access to the vaccine.

In addition, AAP’s immunization schedule includes updates to recommendations on respiratory syncytial virus (RSV) and flu. 

Will this impact vaccine coverage?
The AAP recommendations do not automatically guarantee insurance coverage. Unless insurers and policymakers act to align with the AAP recommendations, there is a risk that families would be forced to pay the costs out of pocket.

How did the just released FDA announcement change COVID-19 vaccine approval for kids?

In a move that AAP calls “deeply troubling”, the FDA’s update for the 2025 fall season includes approval for a narrower group of children than in prior years. Moderna is authorized for ages 6 months and older, Pfizer for 5 years and older, and Novavax for 12 years and older — all limited to children with high-risk conditions. While vaccines can be given off-label by pediatricians, these changes may limit availability for many children because of supply constraints, parental confusion, or provider uncertainty.
How can I help families who are confused or hesitant?
Pediatricians play a valuable role in a patient’s research and decision-making. As such, we should continue to encourage the families whom we serve to ask us questions as they are determining the best protection for their children.

The following resources from HealthyChildren.org may also help address confusion among patient families:

• All About the AAP Recommended Immunization Schedules
• How Vaccine Schedules Changed Over Time & Why
• How Pediatricians Can Teach Parents to Recognize, Resist Vaccine Misinformation
• Fact checked: Children’s Health, Not Financial Incentives, Guides Pediatricians’ Immunization Recommendations

How can medical professionals learn more?
With so much happening and so much confusion, AAP continues to be the best resource for up-to-date, evidence-based information for members and others, including:

• AAP 2025 Immunization Schedule
• AAP Policy Statement: Recommended Childhood and Adolescent Immunization Schedule: United States, 2025
• AAP Recommendations: COVID, RSV and flu
• AAP Immunization Webpage
• COVID-19 FAQ from AAP