Key Takeaways:
- The AAP’s 2026 schedule continues to recommend routine immunization against 18 diseases.
- Respiratory syncytial virus (RSV) guidance was clarified, including the addition of clesrovimab and updated wording on timing by age and risk.
- Human papillomavirus (HPV) vaccination is recommended starting at ages 9–12 years.
- COVID-19 vaccination is universally recommended for children aged 6–23 months, with risk-based and elective recommendations for ages 2–17 years.
- The schedule has been endorsed by 12 major medical and health care organizations, including the American College of Obstetricians and Gynecologists (ACOG).
The American Academy of Pediatrics (AAP) has published its 2026 Recommended Childhood and Adolescent Immunization Schedule, continuing to advise routine vaccination to protect against 18 infectious diseases and formally separating its guidance from a revised federal schedule issued earlier this year. The AAP stated its recommendations remain grounded in long-standing scientific evidence and pediatric clinical practice in the United States.1
What’s new in the 2026 schedule
The AAP updates its immunization schedule annually to reflect current evidence and FDA-licensed vaccines. For 2026, the organization noted that most recommendations are unchanged from its August 2025 guidance, with targeted updates for clarity and alignment with AAP policy.
Notable changes included expanded RSV monoclonal antibody guidance, with clesrovimab added as an option, and revised language to clarify dosing during RSV season based on maternal vaccination status. Influenza vaccine listings were simplified into a single row, and the recommended age range for HPV vaccination was aligned with AAP policy to begin between 9 and 12 years.
“The evidence of 2 doses versus one is still under review,” said Pia Pannaraj, MD, MPH, a member of the AAP Committee on Infectious Diseases. “Until then, the AAP continues to recommend two doses to ensure protection.”3
COVID-19 recommendations were also updated, calling for universal vaccination of children aged 6 to 23 months, with risk-based recommendations for older children and an option for vaccination for those who desire protection.
Why the AAP diverged from CDC recommendations
For the first time in decades, the AAP is no longer endorsing the Centers for Disease Control and Prevention’s childhood and adolescent immunization schedule. According to the academy, recent federal changes departed from established evidence and did not follow the usual advisory process.2,3
“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 of this country,” said AAP President Andrew Racine, MD, PhD, FAAP. “Routine childhood immunizations are an important early step in the path to lifelong health. Every step you take alongside your child on that path is because you want them to grow up healthy and as a trusted partner on that journey, your pediatrician welcomes conversations about all your child’s health care, including immunizations.”2
AAP infectious disease experts emphasized that no new data support removing routine recommendations for vaccines such as hepatitis A and B, influenza, COVID-19, and meningococcal disease. “And nothing has changed. Therefore, we continue to recommend those vaccines,” said Pannaraj.3
Evidence, safety, and broad endorsement
The AAP said its recommendations are based on a structured evidence-to-recommendations framework, incorporating vaccine safety data, US disease epidemiology, and clinical outcomes. The 2026 schedule has been formally endorsed by 12 organizations, including the American College of Obstetricians and Gynecologists (ACOG), the American Medical Association, and the Infectious Diseases Society of America.2
ACOG President Steven J. Fleischman, MD, MBA, FACOG, said in a statement:
“ACOG is fully endorsing AAP’s Recommended Childhood and Adolescent Immunization Schedule as we recognize the urgent need for people to have access to reliable, evidence-based vaccination recommendations they can use to inform health care decisions for their families.”
AAP leaders continue to urge pediatricians to follow the AAP schedule and serve as trusted resources for families as debates over federal guidance continue.
“Our role as pediatricians is to cut through all that noise and understand what the science actually shows so that parents can make informed decisions with confidence alongside their pediatrician,” said Sean T. O’Leary, MD, MPH, FAAP.3
References:
- Sean T. O'Leary, Committee on Infectious Diseases; Recommended Childhood and Adolescent Immunization Schedule: United States, 2026: Policy Statement. Pediatrics 2026; 10.1542/peds.2025-075754
- American Academy of Pediatrics issues recommended childhood and adolescent immunization schedule for 2026. American Academy of Pediatrics. News release. January 26, 2026. Accessed January 26, 2026. https://www.aap.org/en/news-room/news-releases/aap/2025/american-academy-of-pediatric-issues-recommended-childhood-and-adolescent-immunization-schedule-for-2026/
- Jenco M. AAP’s 2026 immunization schedule keeps routine recommendations intact after overhaul of federal schedule. AAPNews. News release. January 26, 2026. Accessed January 26, 2026. https://publications.aap.org/aapnews/news/34141/AAP-s-2026-immunization-schedule-keeps-routine
