What Parents Need to Know About the Updated Vaccine Schedule From the AAP

In the United States, two major organizations shape how vaccines are recommended and administered: the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP). Both rely on scientific evidence, but their roles and the scope of their recommendations differ significantly. This is important for parents to understand as they make decisions for their children.

In 2025, the AAP changed some of its guidelines for vaccines, which may leave some parents wondering what's best for their kids. We speak with a health expert to discuss the changes in the vaccine schedule and what it means for families.

What's the Difference Between the ACIP and the AAP?

The ACIP is a federal advisory committee that develops evidence-based recommendations for the entire U.S. civilian population. These recommendations are reviewed and approved by the Centers for Disease Control and Prevention's (CDC) Director, at which point they become official CDC policy. The CDC's immunization schedule, which guides national vaccine practices and public health programs, is based on these ACIP decisions.

The AAP, meanwhile, is a professional medical association representing more than  67,000 pediatricians. It creates its own set of recommendations, often closely aligned with but sometimes distinct from the CDC's guidelines. The AAP's vaccine schedule focuses specifically on children and adolescents, incorporating additional considerations that arise in pediatric care, such as vaccine timing, access, and outreach to under-immunized communities.

While ACIP recommendations carry the weight of federal policy, the AAP's guidance reflects the perspective of pediatric experts working directly with families and children. Occasionally, the AAP may take a stronger stance or issue different guidance to emphasize child-specific priorities. The key differences are:

• ACIP sets national vaccine policy after CDC approval
• AAP provides pediatric-focused recommendations from a professional medical standpoint
• ACIP serves the general population; AAP focuses on children and teens

Following the ACIP's latest updates, the AAP released its 2025 immunization schedule, reaffirming its evidence-based guidance and, in several areas, taking a distinct position from the CDC's recommendations. This underscores the organization's mission to protect child health and promote equitable vaccine access nationwide.

About the Vaccine Schedules

With the release of their 2025 immunization schedules for children and adolescents, both the CDC and the AAP have introduced important updates that reflect the evolving landscape of vaccine science and disease prevention. While the two organizations typically align, the AAP’s evidence-based schedule includes slight but notable differences from the CDC’s version. It emphasizes pediatric-specific concerns and recommendations tailored to clinical settings.

CDC Key Updates for 2025

COVID-19
Children 6 months and older are now recommended to receive the updated COVID-19 vaccine. Unlike previous years, vaccination decisions will be individualized, based on a child’s health status and discussions between families and healthcare providers, rather than a universal recommendation.

Chickenpox (Varicella)
Toddlers between 12 and 23 months should now receive the standalone varicella vaccine instead of the combined MMRV (measles, mumps, rubella, varicella) shot. This change is designed to reduce the small risk of febrile seizures associated with the combination vaccine.

RSV (Respiratory Syncytial Virus)
For the first time, the schedule includes a preventive option for RSV. Infants born during or entering their first RSV season who are not protected by maternal vaccination should receive a single dose of the monoclonal antibody nirsevimab (Clesrovimab) to help prevent severe illness.

Dengue
A new recommendation adds the DEN4CYD dengue vaccine for children ages 9–16 who live in areas where dengue is endemic and have tested positive for prior dengue infection.

Other Updates
The 2025 schedule also incorporates interim recommendations for the pneumococcal conjugate vaccine (PCV) and the hepatitis A and B vaccines. The influenza vaccine guidance is also expected to be updated for the 2025–2026 season.

How the AAP Schedule Differs

The AAP has also released its own evidence-based immunization schedule for 2025, which includes slight but notable differences from the CDC’s version.

The AAP 2025 Schedule

Focus on Respiratory Virus Protection
Emphasizes protection against respiratory viruses (COVID-19, influenza, and RSV) for all eligible children, aligning with the CDC’s list but maintaining a stronger recommendation for routine immunization in pediatric care.

Reaffirms Preventive RSV
The AAP reaffirms the use of preventive RSV antibodies (such as nirsevimab) for infants entering their first RSV season.

Prioritizes Equitable Vaccine Access
Highlights the importance of equitable vaccine access and outreach to reduce disparities in immunization rates among children and adolescents.

Both schedules serve as tools for pediatricians and families, with the AAP’s guidance reflecting its clinical perspective on children’s health and the CDC’s providing the national standard for vaccination practices.

What Does an Expert Say?

To better understand what is happening with vaccines, we turn to Erica Heartquist, the Public Health Communication Officer at the Oregon Health Authority (OHA). Heartquist says that the delay in federal approval temporarily disrupted the distribution process, particularly for COVID-19 vaccines.

“The ACIP recommendations for COVID-19 vaccines were finally signed by the acting CDC director, allowing states to begin receiving doses from the Vaccines For Children (VFC) program,” says Heartquist. “Influenza vaccine has been less disrupted, and Oregon Health Authority (OHA) is working with counties around Oregon to make sure each county has enough of both vaccines to vaccinate residents who want them,” according to Heartquist.

Many parents question whether there will be vaccine shortages. In a statement provided by Heartquist, Dr. Dean Sidelinger, Oregon's Health Officer and State Epidemiologist, said,  “If vaccine uptake trends in past seasons continue, we expect to have enough respiratory virus vaccines in Oregon to meet demand.” While Heartquist's focus is on Oregon, the story of states determining the guidance of the CDC and the AAP is similar across the country.

How Does Oregon Compare to Other States?

What is a little different is that Oregon is coordinating with California, Hawaii, and Washington under the Western States Scientific Safety Review Workgroup (WSSSRW) and Western Coalition for Health Access (WCHA) recommendations to interpret and implement the CDC's updated guidance.

The WCHA says recommendations draw on guidance from trusted national medical organizations, including the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians, and are built on a foundation of safety, efficacy, transparency, accessibility, and trust.

“We are referring our media colleagues to the WCHA recommendations that Oregon adopted along with California, Hawaii, and Washington,” Heartquist explains. 

Heartquist emphasized that any patient who requests a vaccine should receive one, provided there are no contraindications. However, this may not be the case nationwide, so patients should check with their own healthcare providers to understand what is available in their area.

What Parents Need to Know

The differences between the CDC and AAP schedules are subtle but meaningful. The CDC's schedule serves as the national public health standard, while the AAP's recommendations, though generally aligned, often go a step further to reflect what pediatricians see in their day-to-day practice. This includes delayed vaccination schedules, gaps in access, and the importance of communication between families and providers.

The most important step parents can take is to talk with their child's doctor or pediatric nurse about what's recommended and available in their community. Vaccine guidance can vary slightly depending on factors such as a child's age, health conditions, previous vaccinations, and even local disease trends. A trusted healthcare provider can explain these nuances, review your child's vaccination record, and ensure that no critical doses are missed.

Many local health departments, community clinics, and pharmacies also offer vaccination clinics to help families stay up to date. Staying informed, prepared, and proactive is the best way to keep your family healthy. Vaccines not only protect individual children but also create a stronger, safer community by reducing the spread of preventable diseases.

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