AAP publishes 2026 childhood and adolescent immunization schedule

The American Academy of Pediatrics (AAP) has published the Recommended Childhood and Adolescent Immunization Schedule: United States, 2026, reaffirming routine immunization to protect infants, children, and adolescents against 18 vaccine-preventable diseases. The schedule continues long-standing AAP guidance for vaccines targeting conditions such as respiratory syncytial virus (RSV), hepatitis A, hepatitis B, rotavirus, influenza, meningococcal disease, measles, and pertussis.^1,2

A policy statement describing the updated schedule was released January 26, 2026, and published as an AAP policy statement in Pediatrics. The recommendations are revised annually to reflect the current evidence base for vaccines licensed by the US Food and Drug Administration and are intended to support pediatricians and other clinicians in delivering preventive care across childhood and adolescence.

Overview of the 2026 immunization schedule

The 2026 childhood and adolescent immunization schedule consists of several integrated components designed to guide routine and catch-up vaccination from birth through 18 years of age. These include a schedule organized by age, a catch-up schedule for children and adolescents who start vaccination late or fall behind, and a schedule organized by medical indication for children with underlying conditions that may alter vaccine timing or eligibility.

According to the AAP, the schedule continues to emphasize timely vaccination during infancy and early childhood, when children are most vulnerable to severe outcomes from infectious diseases. Recommendations are also designed to account for developmental immunology, ensuring that vaccine timing aligns with periods when immune responses are most effective.

“AAP recommends immunizations that have been designed to teach the immune system to recognize and resist serious diseases,” said Sean O’Leary, MD, MPH, FAAP, chair of the AAP Committee on Infectious Diseases. “They are carefully tested and monitored over time. The pacing and combination of vaccines are based on what we know about when your child’s immune system is ready to learn and respond best.”

Respiratory syncytial virus immunization

RSV prevention remains a prominent component of the 2026 schedule. RSV is the leading cause of hospitalization among infants younger than 1 year and is associated with substantial morbidity during the first RSV season of life. The AAP schedule continues to include recommendations for passive immunization strategies designed to provide antibody-based protection during periods of highest risk.

The policy statement outlines recommendations for maternal immunization during pregnancy and infant immunization with monoclonal antibody products, depending on maternal vaccination status and infant age at the start of RSV season. These strategies are intended to reduce the risk of severe RSV disease, including lower respiratory tract infection requiring hospitalization, particularly among infants younger than 8 months and those with high-risk conditions.

The schedule also provides guidance for RSV immunization in subsequent seasons for certain high-risk infants and young children, reflecting data on disease burden beyond the first year of life.

Influenza vaccination

Annual influenza vaccination remains recommended for all children starting at 6 months of age. The AAP policy statement emphasizes influenza as a persistent cause of pediatric hospitalization and mortality, particularly among young children and those with chronic medical conditions.

Historically, more than 80% of influenza-associated pediatric deaths have occurred in children who were unvaccinated or incompletely vaccinated. Children younger than 5 years, especially those younger than 2 years, are at increased risk for severe complications, including hospitalization and death.

The 2026 schedule continues to support annual vaccination as a core preventive strategy, particularly during seasons when influenza circulates alongside other respiratory viruses, such as RSV and SARS-CoV-2.

Hepatitis B vaccination

The AAP schedule continues to emphasize universal hepatitis B vaccination beginning at birth. Hepatitis B virus infection can lead to both acute and chronic disease, with chronic infection increasing the risk of cirrhosis, liver failure, and hepatocellular carcinoma later in life.

Administration of the hepatitis B vaccine within 24 hours of birth remains a key strategy for preventing perinatal transmission and early childhood infection. The policy statement underscores the extensive safety and efficacy data supporting hepatitis B vaccination and its role in long-term disease prevention.

Measles and measles-containing vaccines

Measles vaccination remains a priority in the 2026 schedule, particularly in the context of recent outbreaks in the United States. Measles is an extremely contagious viral illness, and complications can include pneumonia, encephalitis, hearing loss, intellectual disability, and death.

Over the past year, more than 2,200 measles cases and three associated deaths have been reported in outbreak settings, with young children disproportionately affected. The AAP schedule continues to recommend routine measles-containing vaccination as a cornerstone of outbreak prevention and community protection.

COVID-19 vaccination

The 2026 schedule incorporates updated recommendations for COVID-19 vaccination in infants, children, and adolescents, reflecting changes in vaccine authorization and evolving epidemiology. The policy statement outlines age-based and risk-based recommendations, with distinctions made between younger children and older pediatric populations.

These recommendations aim to reduce the risk of severe disease, hospitalization, and complications, particularly among children with underlying medical conditions.

Human papillomavirus vaccination

The AAP continues to recommend routine human papillomavirus vaccination beginning earlier in adolescence, consistent with AAP policy. HPV vaccination is intended to prevent HPV-associated cancers and other diseases later in life. The schedule reinforces the importance of completing the vaccine series at recommended ages to optimize immune response and long-term protection.

Meningococcal vaccination

The 2026 schedule provides detailed guidance for meningococcal vaccination, including vaccines targeting serogroups A, C, W, Y, and B. Recommendations address routine adolescent vaccination, booster doses, and additional considerations for children and adolescents at increased risk, such as those with certain medical conditions or those living in congregate settings.

Clarifications in the schedule aim to assist clinicians in selecting appropriate products and timing based on patient age, risk factors, and clinical circumstances.

Catch-up and medical indication schedules

In addition to routine vaccination, the AAP schedule includes a comprehensive catch-up schedule for children and adolescents who initiate vaccination late or fall behind recommended intervals. This component is intended to support clinicians in safely and efficiently bringing patients up to date without restarting the vaccine series.

The medical indication schedule provides guidance for children with conditions that may alter vaccine recommendations, such as immunocompromising conditions, chronic illnesses, or other risk factors for severe disease. These tables outline when vaccines are recommended, may be considered, or should be avoided, supporting individualized clinical decision-making.

Endorsements and differences from CDC guidance

The 2026 AAP immunization schedule is formally endorsed by 12 medical and health care organizations, including the American Medical Association, American College of Obstetricians and Gynecologists, American Academy of Family Physicians, Infectious Diseases Society of America, and the National Association of Pediatric Nurse Practitioners, among others.

Although the 2026 recommendations remain largely unchanged from AAP guidance released in August 2025, they differ from a recently issued immunization schedule from the Centers for Disease Control and Prevention. The AAP stated that recent CDC changes depart from longstanding medical evidence and do not reflect optimal strategies for preventing pediatric disease in the United States.

Perspective from AAP leadership and endorsing organizations

“The AAP will continue to provide recommendations for immunizations that are rooted in science and are in the best interest of the health of infants, children, and adolescents of this country,” said AAP President Andrew Racine, MD, PhD, FAAP. “Routine childhood immunizations are an important early step in the path to lifelong health. Every step you take alongside your child on that path is because you want them to grow up healthy, and as a trusted partner on that journey, your pediatrician welcomes conversations about all your child’s health care, including immunizations.”

Endorsing organizations emphasized the importance of consistent, evidence-based guidance for clinicians and families.

“Parents deserve clear, evidence-based guidance when making decisions about their children’s health,” said David H. Aizuss, MD, chair of the American Medical Association Board of Trustees. “At a time when unprecedented changes to the federal vaccine schedule threaten decades of scientific progress, the AMA strongly supports the American Academy of Pediatrics’ childhood and adolescent immunization schedule to keep children safe and healthy.”

Racine added, “For more than 60 years, millions of children and countless American communities have experienced the benefits of routine childhood vaccinations. The AAP is working with our partners across medicine and public health to ensure that parents have credible, science-backed vaccine recommendations they can trust. If parents have questions about vaccines or anything else, your child’s pediatrician is there to help.”

References

1. AAP. American Academy of Pediatrics Issues Recommended Childhood and Adolescent Immunization Schedule for 2026. AAP. Press release. January 26, 2026. Accessed January 26, 2026.
2. O’Leary ST, AAP Committee on Infectious Diseases. Recommended Childhood and Adolescent Immunization Schedule: United States, 2026: Policy Statement. Pediatrics. 2026; doi: 10.1542/peds.2025-075754