How do AAP’s 2026–27 COVID-19 vaccination recommendations differ from CDC’s clinical considerations?

AAP routinely recommends vaccination for all children age 6 through 23 months. For ages 2 through 18 years, AAP recommends vaccination for children at increased risk of severe COVID-19, residents of congregate settings, children who have never been vaccinated, and those with high-risk household contacts. AAP recommends offering vaccination to other children whose parent or guardian desires protection. CDC uses shared clinical decision-making for children age 6 months through 17 years without moderate or severe immunocompromise; CDC recommends vaccination for all adults starting at age 18.

Both AAP and CDC recommend vaccination for children with moderate or severe immunocompromise. AAP’s 2026 schedule explicitly permits additional doses based on shared clinical decision-making at least 2 months after the last dose. AAP lists a 2-month minimum for post-initial-series doses in immunocompromised adolescents, including mNexspike; CDC lists 3 months for mNexspike and allows case-by-case dosing outside its intervals. For immunocompetent adolescents receiving mNexspike, AAP specifies at least 12 weeks after the last dose; CDC specifies 3 months (although in either case, a dose of mNexspike administered at least 2 months after the most recent dose should be considered valid and not repeated). See https://doi.org/10.1542/peds.2026-079045, www.aap.org/ImmunizationSchedule, and www.cdc.gov/covid/hcp/vaccine-considerations/routine-guidance.html.