Contemporary Pediatrics week in review: August 31-September 4, 2026

Review some of the top stories from the Contemporary Pediatrics website over the last week, and catch up on anything you may have missed.

Thank you for visiting the Contemporary Pediatrics® website. Take a look at some of our top stories from last week (Monday, August 31 to Friday, September 4, 2026) and click each link to read and watch anything you may have missed.

1.) FDA approves zilganersen (Zanvastro) as first treatment for Alexander disease

The FDA has approved zilganersen (Zanvastro), an antisense oligonucleotide, as the first therapy for Alexander disease, an ultra-rare and often fatal neurological disorder that previously had no treatment beyond supportive care. The approval covers patients from infancy through adulthood and is based on a randomized, controlled trial of 49 pediatric and adult patients that showed a statistically significant gait-speed improvement in patients 5 and older and better motor function in children aged 2 to 4, alongside a reduction in a plasma biomarker linked to the disease.

Evidence in children younger than 2 relied on pharmacokinetic modeling and safety data from a small open-label substudy rather than a controlled efficacy comparison, since the disease's rarity made a dedicated trial in infants infeasible. Common side effects included vomiting, back pain, and post-lumbar puncture syndrome, and the FDA is advising monitoring for aseptic meningitis, which has been reported with the intrathecal therapy.

2.) AAP recommends 2026-2027 COVID-19 vaccine for all infants 6 to 23 months and at-risk older children

The American Academy of Pediatrics has updated its COVID-19 vaccine guidance for the coming season, calling for universal vaccination of infants and children 6 through 23 months old regardless of risk factors, and a risk-based single dose for most children ages 2 through 18. The recommendation for younger children is driven by data showing infants under 6 months had a cumulative hospitalization rate that outpaced adults in their late 60s and early 70s during the 2024-2025 season, even as overall pediatric COVID-19 hospitalizations continued a multiyear decline.

For school-age children and adolescents, the AAP is targeting those with high-risk conditions, in congregate care settings, or living with a high-risk household contact, noting that roughly three-quarters of hospitalized children in that age range had at least one qualifying condition. Despite that risk concentration, fewer than 4% of vaccine-eligible children hospitalized for COVID-19 were up to date on their shots, pointing to a persistent uptake gap the AAP hopes the updated policy will help close.

3.) AAP expands RSV immunization recommendations for high-risk children

The AAP has broadened its RSV immunization guidance for the 2026-2027 season, expanding the high-risk criteria that qualify children aged 8 through 19 months entering their second RSV season for monoclonal antibody protection. Newly included groups are children born before 32 weeks' gestation, those with hemodynamically significant congenital heart disease, certain chromosomal differences including Down syndrome, and American Indian or Alaska Native children, among others. The policy continues to recommend immunization for essentially all infants younger than 8 months in their first season.

Nirsevimab remains the only product indicated for eligible children in their second season, while nirsevimab and clesrovimab are both recommended options for infants under 8 months. The AAP is advising administration between October 1 and March 31 in most of the continental US, alongside routine childhood vaccines, and notes that a prior RSV infection does not remove the recommendation since reinfection can occur within the same season.

4.) HPV vaccination coverage stalls for fourth straight year as rural-urban gap persists, CDC finds

New CDC survey data show HPV vaccination coverage among US adolescents has been flat since 2021, with 77.7% of teens having received at least one dose and 63.4% up to date with the full series in 2025 — both essentially unchanged from the prior year and well short of the Healthy People 2030 target of 80% series completion. That plateau stands in contrast to Tdap and meningococcal vaccine coverage, which held near 90% despite modest year-over-year declines that researchers partly attribute to survey methodology.

The report also found a 12-percentage-point gap in HPV coverage between adolescents in rural versus urban areas that persisted across income levels, a disparity the authors link to the absence of HPV vaccination mandates for school entry in most states. State-level coverage varied widely, from under 50% to more than 94% for at least one dose, underscoring how uneven access and policy can shape uptake of a vaccine proven to prevent HPV-related cancers.

5.) PCOS to PMOS: A long-awaited change

A global consensus report published in The Lancet in May 2026 has renamed polycystic ovarian syndrome (PCOS) to polyendocrine metabolic ovarian syndrome (PMOS), a shift discussed this week by Heather Appelbaum, MD, Melanie Cree, MD, PhD, and Michelle M. Maresca, MD, in a special report video series. Cree, who helped shape the renaming process, said the new name better reflects the condition's lifelong metabolic risks rather than framing it primarily as a reproductive issue, citing trial data showing nearly half of affected women develop cardiometabolic disease by age 40 compared with a much smaller share who face infertility.

The panel noted that adolescent diagnosis has never relied on ovarian ultrasound, making the word "polycystic" a common source of confusion for families, and outlined a three-year transition timeline with updated ICD-10 and WHO classifications expected by early 2027. The experts also welcomed the renewed attention the change brings to the condition's mental health dimension alongside its endocrine and metabolic features.