Pediatrics

AAP releases COVID-19 vaccination recommendations for children and adolescents

August 20, 2025

The American Academy of Pediatrics (AAP) issued updated guidance for COVID-19 vaccination in children, diverging from recent CDC policy changes. These recommendations are based on current epidemiologic data, vaccine safety and effectiveness, and risk stratification across pediatric age groups.

Recommendations

Infants and children 6 through 23 months of age are at high risk for severe COVID-19. AAP recommends all infants and children in this age group who don’t have contraindications* receive 2025-2026 COVID-19 vaccine, as follows:

• Those who are previously unvaccinated should receive an initial vaccine series.
• Those who are previously vaccinated but did not complete their initial vaccine series should complete their initial vaccine series.
• Those who are previously vaccinated and completed their initial series should receive a single dose. This dose should be administered at least 8 weeks after the last dose was received.
• Those with a previous asymptomatic infection or symptomatic disease caused by SARS-CoV-2 should also receive COVID-19 vaccination.

Children 6 months through 18 years of age who are moderately or severely immunocompromised require 2 or more doses of age-appropriate 2025-2026 COVID-19 vaccine depending on previous vaccination status. Refer to the AAP Recommended Child and Adolescent Immunization Schedule for dosing recommendations.

AAP recommends a single dose of age-appropriate 2025-2026 COVID-19 vaccine for all children and adolescents 2 through 18 years of age in the following risk groups regardless of prior COVID-19 vaccination status:

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

Children 2 through 18 years of age not included in the risk groups above whose parent or guardian desires their protection from COVID-19 should be offered a single dose of age-appropriate 2025-2026 COVID-19 vaccine. This dose should be administered at least 8 weeks after the last dose was received.

Any available COVID-19 vaccine appropriate by age and health status that is approved by the FDA through a biologics license application or authorized through emergency use authorization can be used. The most updated version of the COVID-19 vaccine that is available should be used.

*COVID-19 vaccine contraindication includes a history of severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a component of the COVID-19 vaccine.

Source:

Committee on Infectious Diseases. (2025, August 19). Pediatrics. Recommendations for COVID-19 Vaccines in Infants, Children, and Adolescents: Policy Statement. https://pubmed.ncbi.nlm.nih.gov/40826495/