For 30 years, vaccine suggestions from the Facilities for Illness Management and Prevention have aligned intently with these from the American Academy of Pediatrics, or AAP. However on Aug. 19, 2025, the AAP revealed new vaccine suggestions that diverge from these of the CDC.
The pediatrician affiliation’s transfer comes on the heels of unprecedented modifications made earlier this yr by Robert F. Kennedy Jr., as head of the Division of Well being and Human Companies, in how the federal government approves and points steerage on vaccines.
The most important distinction is within the AAP’s steerage round COVID-19 vaccines for youngsters. This new steerage comes as COVID-19 instances are as soon as once more rising throughout the U.S. and lots of mother and father and suppliers are confused by unclear steerage from federal well being authorities about whether or not youngsters ought to be vaccinated.
In a Q&A with The Dialog U.S., David Higgins, a pediatrician, preventive drugs doctor and vaccine supply researcher from the College of Colorado Anschutz Medical Campus, explains the brand new steerage and what it means for fogeys. Higgins can be a member of the American Academy of Pediatrics.
Pediatrician and preventive drugs specialist David Higgins explains the steerage on this video.
What are the AAP’s new vaccine suggestions?
The AAP recommends that each one youngsters 6 to 23 months outdated obtain an entire COVID-19 vaccine sequence, in line with suggestions for this age group in earlier years.
For youngsters and adolescents ages 2 to 18, the AAP now advises a single dose if they’re at increased danger, a change from earlier years, when vaccination was really helpful for all on this age group. Youngsters at increased danger embrace those that have sure persistent medical situations, who reside in long-term care or group settings, who’ve by no means been vaccinated, or who reside with relations at excessive danger.
The AAP additionally recommends that COVID-19 vaccines stay out there for any little one or adolescent whose mother or father desires them to be protected, no matter danger standing. In all instances, probably the most up to date model of the vaccine ought to be used.
How do these suggestions differ from CDC steerage?
The distinction is substantial. The CDC at the moment advises what it calls “shared clinical decision-making” for youngsters ages 6 months to 17 years who will not be reasonably or severely immunocompromised. This implies the choice is left as much as particular person discussions between households and their well being care suppliers, however the vaccine is just not handled as a routine suggestion. These present tips have been made after Kennedy bypassed the company’s regular unbiased assessment course of.
That framework could be complicated for households and troublesome for suppliers to implement. In contrast, the AAP suggestions establish the ages and situations the place the danger is highest whereas additionally supporting vaccine availability for any households who need it.
It’s not clear whether or not households will have the ability to entry routine COVID-19 vaccines for youngsters this fall.
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Why are they diverging?
The AAP has been publishing vaccine steerage because the Thirties, lengthy earlier than the CDC or the Advisory Committee on Immunization Practices, an unbiased panel of consultants that advises the CDC, existed.
Since 1995, the 2 teams have typically issued primarily an identical vaccine steerage. However this yr, the federal authorities dismissed the advisory committee’s panel of unbiased scientists and immunization consultants, elevating questions concerning the credibility of CDC steerage. On the similar time, misinformation about vaccines continues to unfold.
In response, the AAP determined to publish unbiased suggestions based mostly by itself assessment of the most recent proof. That assessment confirmed that though the dangers for wholesome older youngsters have declined in contrast with the early years of the pandemic, younger youngsters and people with particular situations stay particularly susceptible. Moreover, a assessment of proof by an unbiased knowledgeable group referred to as the Vaccine Integrity Challenge, additionally launched on Aug. 19, 2025, confirmed that there are not any new security issues and no decline within the effectiveness of COVID-19 vaccines.
COVID-19 continues to trigger hospitalizations and deaths in youngsters and stays a number one trigger of great respiratory sickness.
Will mother and father have the ability to comply with these suggestions?
That is nonetheless unclear. The AAP suggestions don’t routinely assure insurance coverage protection.
By regulation, insurance coverage and the federal Vaccines for Youngsters program, which supplies vaccines for eligible youngsters who won’t in any other case be vaccinated as a consequence of price or lack of insurance coverage, are tied to Advisory Committee on Immunization Practices suggestions. Except insurers and policymakers act to align with the AAP suggestions, there’s a danger that oldsters could be compelled to pay the prices out of pocket.
Vaccine provide might also be a problem. Presently, solely two COVID-19 vaccines can be found for youngsters beneath 12. Moderna’s vaccine is accepted just for youngsters with no less than one high-risk situation, whereas Pfizer’s authorization for youthful youngsters is probably not renewed. If that occurs, any remaining Pfizer doses for this age group could also be unusable, leaving a shortfall in out there vaccines for youngsters.
Lastly, implementation could differ relying on the kind of supplier. Some vaccine suppliers, comparable to pharmacists, function beneath insurance policies tied strictly to CDC suggestions, which can make it tougher to comply with AAP’s schedule until guidelines are up to date.
What occurs subsequent?
Mother and father and suppliers are more likely to face continued confusion, simply as COVID-19 instances rise as youngsters return to high school. A lot will rely upon whether or not the Advisory Committee on Immunization Practices updates its personal suggestions at its upcoming assembly, anticipated in September, and whether or not pediatric COVID-19 vaccines stay out there.
Till then, mother and father can communicate with their pediatricians to grasp the most effective safety for his or her youngsters.
