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The American Academy of Pediatrics (AAP) published its official immunization schedule for children and adolescents from birth through age 18 on August 19, 2025. The document, included in the AAP Red Book Online, incorporates new recommendations on influenza, respiratory syncytial virus (RSV), and COVID-19 vaccines.
The calendar, titled “Recommended Childhood and Adolescent Immunization Schedule: United States, 2025”, distances itself from recent guidelines from the CDC's Advisory Committee on Immunization Practices (ACIP), which is now under fire for including members with a history of spreading misinformation about vaccines.
“The AAP will continue to provide science-based recommendations for the health of children and adolescents,” said President Susan J. Kressly, MD.
Main changes in the calendar
The new schedule covers immunization against 18 diseases and includes key updates:
- RSV: vaccines and passive immunizations for infants and risk groups.
- Influenza: annual application from 6 months of age.
- COVID-19: priority vaccination for young children and risk-specific recommendations.
- Meningococcus: incorporation of pentavalent vaccine.
- HPV: adjustment in the age of onset.
- Hepatitis: elimination of a discontinued vaccine.
The AAP urged all insurers to cover all vaccines included in the schedule.
RSV: protection from birth
RSV is the leading cause of hospitalization in infants under one year of age. The AAP recommends immunizing:
- Infants under 8 months of age who did not receive prenatal protection.
- Children aged 8 to 19 months at high risk (chronic lung disease, immunosuppression, cystic fibrosis).
The monoclonal antibodies nirsevimab and clesrovimab are recommended, while palivizumab is no longer recommended.
Influenza: mandatory annual vaccination
The AAP reiterated that all children 6 months and older should receive the flu vaccine every season. In the last campaign (2024-2025), the CDC reported 267 pediatric deaths from influenza, nearly half of which were in children without pre-existing risk conditions.
“Getting a flu vaccine prevents serious complications and allows children to continue their daily activities,” explained Kristina Bryant, MD.
COVID-19: Focus on the most vulnerable
The AAP recommends COVID-19 vaccination for:
- All children from 6 to 23 months (most vulnerable group).
- Children and adolescents aged 2 to 18 years at risk of severe illness, without prior immunization, or with high-risk contacts.
Dr. Sean O'Leary, chair of the AAP Committee on Infectious Diseases, stressed:
“Vaccines are safe for all age groups and remain essential to prevent hospitalizations in young children and those with chronic illnesses.”
Information for parents
In addition to the technical calendar, the AAP announced the publication of a family-friendly version on HealthyChildren.org to support community understanding and acceptance of vaccination.
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