The AAP recommends that all children aged 6 months to 23 months receive a COVID-19 vaccine, as this group has the highest risk for severe infection.
The American Academy of Pediatrics (AAP) has released an evidence-based immunization schedule that includes updates for the upcoming fall vaccine season regarding influenza, respiratory syncytial virus (RSV), and COVID-19.1
A leading voice in vaccine recommendations across the pediatric population, the AAP comprises over 67,000 pediatric health care providers and, according to its immunization schedule announcement, has been working with other professional societies, payers, and organizations to develop evidence-based clinical guidance on COVID-19, flu, and RSV.2
“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,” said Susan Kressly, MD, FAAP, president, AAP, in a statement. "Pediatricians know how important routine childhood immunizations are in keeping children, families, and their communities healthy and thriving."1
As the fall season approaches, so do the typical infectious disease challenges for COVID-19, which continues to impact the pediatric population, including the most vulnerable population––those aged 6 months to 23 months. The AAP recommends that all persons in this age group receive a COVID-19 vaccine to protect against serious illness. Children under 2 years of age are particularly vulnerable to severe COVID-19, according to the academy, and should be prioritized unless they have a known allergy to a vaccine or its ingredients.
Additionally, the AAP recommends that all children and adolescents aged 2 through 18 years receive a single dose of age-appropriate vaccine in the following risk groups:
The academy is also recommending that the vaccine be available for children aged 2 to 18 years who are not part of the above risk groups, but whose parents or guardians desire to have the vaccine administered.
"We extensively reviewed the most recently available data about COVID-19 risks in kids, as well as [the] safety and effectiveness of available COVID-19 vaccines. It's clear they are very safe for all populations," said Sean O’Leary, MD, FAAP, chair of the AAP Committee on Infectious Diseases, in a press release. "Among the reasons we decided to move to a risk-based recommendation for healthy older children is the fact that the hospitalization rate for young children and children [with] underlying medical conditions remains high, in line with rates for many of the other vaccine-preventable diseases for which we vaccinate."
In May 2025, the CDC pulled the recommendation for routine COVID-19 vaccination among healthy children and pregnant women. Shortly after the updated guidance, the CDC changed course on the recommendation, stating that children aged 6 months to 17 years who are not moderately or severely immunocompromised may receive the vaccine in situations where the parent wishes their child to get the vaccine, along with clinical judgment provided by a health care professional on a case-by-case basis.3
These initial changes from the CDC prompted the AAP and several other medical societies, in July, to
In July, the AAP released its updated influenza recommendations via a prepublication. To read these recommendations as reported,
The AAP recommended that all children aged 6 months and older receive an annual flu vaccine, unless they have a medical reason not to be immunized. The 2024-2025 influenza season was a high-severity season for individuals of all ages, according to the CDC, the AAP noted. The CDC reported 267 influenza-related pediatric deaths through August 2, 2025. Of those, 43.6% occurred in children without a high-risk medical condition.1
Historically, up to 80% of influenza-associated pediatric deaths have occurred in unvaccinated or incompletely vaccinated children. Children younger than 5 years, especially those less than 2 years old, are especially vulnerable to severe illness, hospitalization, or death due to influenza.
RSV is the leading cause of hospitalization among babies younger than 1 year. The respiratory disease spreads easily through the air and through physical contact with germs. Immunizations for pregnant mothers and newborns provide antibodies that offer necessary protection.
“Babies who become infected with RSV can get much sicker than older kids because their lungs and airways are so tiny,” said Kristina Bryant, MD, FAAP, a member of the AAP Committee on Infectious Diseases. “There are [2] ways to help your baby get ahead of this serious respiratory illness. Moms who get the RSV vaccine during their pregnancy can pass important antibodies to their developing baby through the placenta. Or new babies can get an RSV shot for RSV season. Well-timed RSV immunizations help babies stay healthy."
Nirsevimab and clesrovimab are FDA-approved monoclonal antibodies that are recommended to prevent RSV. The AAP noted that palivizumab, a shorter-acting monoclonal antibody, is no longer recommended for use.
For RSV, the AAP recommends the following:
For the full immunization schedule from the AAP,
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