The American Academy of Pediatrics (AAP) released its updated recommendations for childhood vaccines, reaffirming routine guidance for upwards of 18 diseases while also offering minor clarifications.

According to a report from CNN, more states and pediatricians are now choosing the AAP’s guidance over a revised federal schedule from the Centers for Disease Control and Prevention (CDC), which removed several routine vaccine recommendations for children.¹

CDC’s schedule also moved respiratory syncytial virus immunization to the high-risk group, despite the agency still recommending it for all infants under 8 months whose mother did not get vaccinated during pregnancy.²

“The science hasn’t changed,” said Dr. Claudia Hoyen, a pediatric infectious disease specialist and director of pediatric innovation at UH Rainbow Babies and Children’s Hospital in Cleveland. “We will continue to follow the science.”

The AAP’s 2026 schedule includes vaccines for respiratory syncytial virus (RSV) along with routine immunizations against hepatitis A and B, rotavirus, flu, and meningococcal disease. Twelve major medical and health care organizations have endorsed the guidance, including the American Medical Association, the National Medical Association, and the American Academy of Family Physicians.

“As there is a lot of confusion going on with the constant new recommendations coming out of federal government, it is important that we have a stable, trusted, evidence-based immunization schedule to follow and that’s the AAP schedule,” said Pia Pannaraj, M.D., M.P.H., a member of the AAP Committee on Infectious Diseases (COID) and a professor of pediatrics at the University of California San Diego.

How does the AAP schedule differ from the CDC schedule?

The CDC’s updated schedule, released in early January, removed routine recommendations for hepatitis A and B, Covid-19, rotavirus, flu, and meningococcal disease, and instead recommended them for high-risk groups or under shared clinical decision-making.¹ The agency also moved RSV immunization to the high-risk category, although the agency is expected to continue to recommend it for all infants under eight months whose mothers were not vaccinated during pregnancy.²

These updates build off of the agency’s previous vaccine schedule recommendations from October, recommending patients to go through a shared-decision making process with a healthcare professional prior to receiving a covid-19 vaccine.

“After an exhaustive review of the evidence, we are aligning the U.S. childhood vaccine schedule with international consensus while strengthening transparency and informed consent,” U.S. Health and Human Services Secretary Robert F. Kennedy Jr. said after the federal schedule update. “This decision protects children, respects families, and rebuilds trust in public health.”

AAP leaders have characterized the CDC changes as “dangerous and unnecessary” and are challenging them in court. “For now, unfortunately, we have to ignore everything about vaccines that is coming from our federal government,” said Dr. Sean O’Leary, chair of the AAP’s COID “Parents should trust their pediatrician, trust the professional societies like the American Academy of Pediatrics.”

Why are pediatricians choosing the AAP schedule?

According to a report from CNN, pediatricians across the country are saying that the federal schedule has caused confusion and also undermined parental confidence.¹

“We have families that come into our clinic that traditionally have been very accepting of vaccines and they want to know, ‘is this new recommendation, is this evidence-based, or do I need to think differently about these vaccines’ that they’ve accepted previously?” said Dr. Sarah Elizabeth DeRoo, a pediatrician at Children’s National in Washington, D.C.

“We’ve been giving messaging to our patients that we’re continuing to follow the recommended schedule by the American Academy of Pediatrics, which is an evidence-based schedule.”

Dr. Nina Alfieri, Continuity Clinic director with Lurie Children’s Pediatrics in Chicago, said the federal changes have amplified parental concern: “We always want families to feel welcome coming to clinic with their questions.” Dr. Adam Ratner, a pediatric infectious disease specialist at NYU, added, “We’ve had so many years of the CDC being a reliable source of information. It’s understandable why families are confused.”

What guidance does the AAP recommend?

The AAP continues to recommend two doses of the HPV vaccine starting at ages 9-12 years, while the CDC recommends one dose at 11-12 years.^2,3 “The evidence of two doses versus one is still under review,” said Dr. Pia Pannaraj, M.D., M.P.H., a member of the AAP Committee on Infectious Diseases and professor of pediatrics at the University of California San Diego. “Until then, the AAP continues to recommend two doses to ensure protection.”

For Covid vaccinations, the AAP recommends that all young children ages 6-23 months receive the vaccine, as well as older children in certain risk groups. “Young children under 2 years of age are at high risk just by age alone even if they don’t have any other underlying disease,” Dr. Pannaraj said. The agency is also advising that toddlers can receive either a measles, mumps, and rubella (MMR) vaccine plus a monovalent varicella vaccine or the combined MMRV vaccine for their first dose.² The CDC, in contrast, recommends giving these as two separate vaccines.³

Sources

1. Doctors are Ignoring New Federal Vaccine Recommendations CNN Health January 26, 2026 https://www.cnn.com/2026/01/26/health/vaccine-recommendations-cdc-aap
2. AAP’s 2026 immunization schedule keeps routine recommendations intact after overhaul of federal schedule AAP News January 26, 2026 https://publications.aap.org/aapnews/news/34141/AAP-s-2026-immunization-schedule-keeps-routine
3. Fact Sheet: CDC Childhood Immunization Recommendations U.S Department of Health and Human Services January 5, 2026 https://www.hhs.gov/press-room/fact-sheet-cdc-childhood-immunization-recommendations.html