American Academy of Pediatrics releases immunization schedule

News
Article

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.

American Academy of Pediatrics releases immunization schedule | Image Credit: © Konstantin Yuganov - © Konstantin Yuganov - stock.adobe.com.

American Academy of Pediatrics releases immunization schedule | Image Credit: © Konstantin Yuganov - © Konstantin Yuganov - stock.adobe.com.

What you need to know:

  • The American Academy of Pediatrics (AAP) released its updated immunization schedule for fall 2025, covering influenza, RSV, and COVID-19.
  • The new guidance emphasizes protecting children under 2 years old against COVID-19 and introduces risk-based recommendations for older children.
  • Annual flu shots are recommended for all children 6 months and older, while RSV prevention strategies include maternal vaccination during pregnancy or antibody shots for infants.

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

AAP's updated immunization schedule

COVID-19

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:

  • Individuals at high risk of severe COVID-19
  • Residents of long-term care facilities or other congregate settings
  • Individuals who have never been vaccinated against COVID-19
  • Individuals whose household contacts are at high risk for severe COVID-19

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."

RELATED: Aligning vaccinations with the start of a new school year

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 sue the Health and Human Services department and Secretary Robert F. Kennedy Jr.4

Influenza

In July, the AAP released its updated influenza recommendations via a prepublication. To read these recommendations as reported, click here or view highlights below.

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

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:

  • Immunization for infants younger than 8 months who are born during or entering their first RSV season if the mother did not receive the vaccine during pregnancy, if the vaccination status is unknown, or if the infant was born less than 14 days after the pregnant mother received the vaccine.
  • Immunization for infants and children 8 months through 19 months of age at high risk of severe RSV disease and entering their second RSV season. High-risk infants include children with chronic lung disease or cystic fibrosis, those who are immunocompromised, and other groups.

For the full immunization schedule from the AAP, click here.

References

  1. The American Academy of Pediatrics releases its own evidence-based immunization schedule. Press release. AAP. August 19, 2025. Accessed August 19, 2025.
  2. AAP releases evidence-based immunization schedule; calls on payers to cover recommendations. AAP. Press release. August 19, 2025. Accessed August 19, 2025. https://publications.aap.org/aapnews/news/32835/AAP-releases-evidence-based-immunization-schedule?searchresult=1
  3. Fitch J. CDC: healthy children can receive COVID-19 vaccine via "shared clinical decision-making." Contemporary Pediatrics. June 2, 2025. Accessed August 19, 2025. https://www.contemporarypediatrics.com/view/cdc-healthy-children-can-receive-covid-19-vaccine-via-shared-clinical-decision-making-
  4. Fitch J. AAP, other medical societies sue HHS, Robert F. Kennedy Jr over vaccine practices. Contemporary Pediatrics. July 7, 2025. Accessed August 19, 2025. https://www.contemporarypediatrics.com/view/aap-other-medical-societies-sue-hhs-robert-f-kennedy-jr-over-vaccine-practices

Newsletter

Access practical, evidence-based guidance to support better care for our youngest patients. Join our email list for the latest clinical updates.

Recent Videos
Experts discuss importance of vaccination prior to school year
Lori Handy, MD: Vaccine-only visits can help ease back-to-school gaps | Image credit: CHOP
© 2025 MJH Life Sciences

All rights reserved.