What pediatricians should know about the 2026-27 AAP vaccine schedule

The Advisory Committee on Immunization Practices (ACIP) was effectively in limbo and not meeting, leaving no new federal changes to the pediatric immunization schedule, according to Sean T. O'Leary, MD, MPH. In its absence, the American Academy of Pediatrics (AAP) led development of the schedule for children and adolescents in collaboration with other professional societies.

"And unfortunately, we're at a place we can't trust what's coming out of our federal government around vaccines," O'Leary told Contemporary Pediatrics during an interview at the AAP 2026 National Conference & Exhibition in San Diego, California.

Changes to the AAP schedule for the current season were limited. The AAP released its influenza recommendations in August and continued to recommend vaccination for all children aged 6 months and older. COVID-19 vaccine recommendations, released September 2, were also unchanged: routine vaccination for all children aged 6 to 23 months, risk-based vaccination thereafter, and vaccination for anyone who wanted to receive it.

First-season respiratory syncytial virus (RSV) recommendations were likewise unchanged. The AAP continued to recommend either nirsevimab or clesrovimab for all infants younger than 8 months entering their first RSV season, provided the infant's mother had not received the maternal RSV vaccine 14 days or more before delivery.¹ The notable update involved second-season indications, with the AAP increasing the number of conditions that qualified a child for RSV immunization in a second season.¹

The process behind these recommendations also shifted substantially. Previously, professional societies coordinated closely with the Centers for Disease Control and Prevention (CDC) and ACIP to produce a single harmonized schedule.

"We've had to switch from a situation where AAP and other professional societies worked extraordinarily closely with CDC, with ACIP, to make sure we had a harmonized schedule that was in the best interest of American children and adolescents," said O’Leary, a pediatric infectious disease specialist at the University of Colorado School of Medicine and the immunization schedule editor for the AAP.

With that relationship essentially severed, the stated goal was to return ACIP and the CDC to a position in which their immunization recommendations could be trusted. A lawsuit addressing that question was moving through the courts, according to O'Leary.

In the interim, responsibility for recommendations was divided among professional societies, with support from organizations such as the Vaccine Integrity Project.² The AAP led recommendations for children and adolescents, the American Academy of Family Physicians led adult recommendations, the Infectious Diseases Society of America led recommendations for immunocompromised children and adults, and the American College of Obstetricians and Gynecologists led maternal vaccination recommendations. The American Medical Association served in a coordinating and convening role, and the American College of Physicians and other societies were also involved.²

For the pediatric schedule specifically, the AAP drew input from other professional societies that care for children, including the Pediatric Infectious Diseases Society and the National Association of Pediatric Nurse Practitioners.

References

1. American Academy of Pediatrics Committee on Infectious Diseases. Recommendations for the prevention of RSV disease in infants and children: policy statement. Pediatrics. Published online September 2, 2026. Accessed October 3, 2026. https://doi.org/10.1542/peds.2026-079047

2. O'Reilly KB. Doctors united on respiratory virus vaccine recommendations. American Medical Association. September 2, 2026. Accessed October 3, 2026. https://www.ama-assn.org/public-health/prevention-wellness/doctors-united-respiratory-virus-vaccine-recommendations