The American Academy of Pediatrics (AAP) has ignited a fierce national debate by recommending that all infants and toddlers aged 6 months to 23 months receive a COVID-19 vaccine, a move that stands in sharp contrast to the latest guidance from the Centers for Disease Control and Prevention (CDC) and Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. The AAP, a leading voice in pediatric health since the 1930s, included this recommendation in its annual childhood immunization schedule released on August 19, 2025, which also covers flu and RSV vaccines for those under 18.
This split in vaccine guidance comes at a time when the U.S. is grappling with misinformation and growing skepticism toward childhood immunizations. According to ABC News, the AAP’s decision marks a rare divergence from federal health authorities, who have traditionally set the tone for immunization policy. The CDC, following Kennedy’s announcement in May that it would no longer recommend COVID-19 shots for healthy children, shifted to a "shared clinical decision making" approach—leaving the choice to parents and their doctors rather than issuing a blanket recommendation.
Dr. Susan J. Kressly, president of the AAP, explained the group’s reasoning in an interview with ABC News: "The academy has been making pediatric immunization recommendations since the 1930s, that has not changed. But what has changed is that this year, we're doing it in the environment of misinformation, which makes it more important than ever that we provide clear and confident guidance, because the majority of American families really depend on us for this guidance."
The AAP’s recommendation is rooted in data showing that young children—especially those under two—are at the highest risk of severe COVID-19 outcomes. As Dr. Kressly put it, "We know that this age group, that's the highest risk for severe disease. And so we want to make sure that those children who are at highest risk and did not live through the pandemic—they were not exposed to COVID viruses during the pandemic—we want to make sure that they are protected as best as possible." The group’s broader guidance for the coming respiratory virus season also includes advice on flu and RSV shots, reinforcing the importance of routine immunizations for all children.
But the AAP’s stance has drawn sharp criticism from federal officials. HHS communications director Andrew Nixon, in a statement to ABC News and The Hill, accused the AAP of undermining national immunization policymaking: "The American people deserve confidence that medical recommendations are based solely on science and public health. We call on the AAP to strengthen conflict-of-interest safeguards and keep its publications free from financial influence, ensuring every recommendation reflects only the best interests of America’s children. Instead, the AAP is undermining national immunization policymaking with baseless political attacks. Secretary Kennedy has stood firm in his commitment to science, transparency, and restoring public trust. By bypassing the CDC’s advisory process and freelancing its own recommendations, while smearing those who demand accountability, the AAP is putting commercial interests ahead of public health and politics above America’s children."
This war of words is just one aspect of a broader conflict that has been simmering since Kennedy took office. In May, Kennedy announced—via a video posted on X—that the CDC would no longer recommend routine COVID-19 shots for healthy children, citing a lack of clinical data to justify annual vaccinations. He also removed the COVID-19 vaccine from recommendations for pregnant women. The CDC, however, did not fully adopt Kennedy’s position; instead, it left the decision to families and their healthcare providers. As noted by TNND, only 13% of eligible children are currently up to date on their COVID-19 vaccines, according to CDC estimates.
The AAP and other medical organizations have pushed back forcefully against Kennedy’s approach. In a written statement, Dr. Kressly reaffirmed the group’s commitment to science: "The AAP will continue to provide recommendations for immunizations that are rooted in science and are in the best interest of the health of infants, children and adolescents. Pediatricians know how important routine childhood immunizations are in keeping children, families and their communities healthy and thriving." The association cited the continued impact of COVID-19 on children—including hospitalizations and deaths—as a key reason for its recommendation. Dr. Shane O’Leary, another AAP spokesperson, told TNND, "We extensively reviewed the most recently available data about COVID-19 risks in kids, as well as the safety and effectiveness of available COVID-19 vaccines. It's clear they are very safe for all populations. Among the reasons we decided to move to a risk-based recommendation for healthy older children is the fact that the hospitalization rate for young children and children with underlying medical conditions remains high, in line with rates for many of the other vaccine-preventable diseases for which we vaccinate."
For children aged 2 to 18, the AAP recommends shared decision making—encouraging parents who desire the protection of the vaccine for their children to consult with their clinicians. The Food and Drug Administration (FDA), meanwhile, has not approved Moderna’s COVID-19 vaccine for use in healthy young children, only for those with health conditions that put them at increased risk of severe illness, according to The Hill.
The rift between the AAP and federal authorities has been exacerbated by Kennedy’s overhaul of the CDC’s Advisory Committee on Immunization Practices (ACIP). In June 2025, Kennedy dismissed all previous members and replaced them with eight new appointees, some of whom have a history of spreading vaccine misinformation. The AAP, along with other top medical organizations, refused to participate in the reconstituted panel’s first meeting, calling it "illegitimate." According to The Hill, the ACIP has yet to vote on COVID-19 shot recommendations, throwing the traditional system for vaccine policy into uncertainty.
The stakes of this policy dispute extend beyond the doctor’s office. Insurance companies and government programs like the Vaccines for Children (VFC) program typically rely on ACIP recommendations to determine coverage. As ABC News reported, if certain vaccines are not endorsed by ACIP, families may face out-of-pocket costs, and shots might not be covered for vulnerable children. Dr. Kressly stressed the need for continued access: "We need to work with our like-minded policy makers who understand the importance of keeping VFC vaccines available in every community for those children who depend on them. At the same time, there are children in this country whose vaccines are paid for through commercial insurance, and we are having continuing conversations with major payers to make sure that those can be vaccines are available as well. Vaccination is part of high-quality preventive care, and we are confident that we can work with the payers to make sure that translated into policy."
The controversy has drawn in voices from across the medical field. Dr. S. Wesley Long, medical director of microbiology at Houston Methodist, told TNND, "Everybody should probably talk to their doctor to try to determine what makes the most sense for them. And then, having said that, the vaccine is still the best way to protect yourself against severe infection, severe outcomes and death." Dr. David Hill, chair of the American Lung Association board of directors, emphasized that the typical process for vaccine decisions involves consulting a panel of experts before making changes to the immunization schedule.
As the debate continues, the AAP is urging insurers to cover all vaccines included in its immunization schedule and pledges to work with partners at every level to ensure access for all children. The outcome of this high-stakes policy clash will shape not only the nation’s COVID-19 response but also the future of childhood immunization in America.
