CDC and ACIP recommend vaccination of all people age 6 months through 64 years based on individual decision-making (also known as shared clinical decision-making), with an emphasis that the risk-benefit of vaccination is most favorable for individuals who are at an increased risk for severe COVID-19 disease and lowest for individuals who are not at an increased risk, according to the CDC list of COVID-19 risk factors. Refer to CDC’s interim clinical considerations for COVID-19 vaccination for the specific dosing schedule: www.cdc.gov/covid/hcp/vaccine-considerations/routine-guidance.html#cdc_clinical_guidance_recomm_key-table-1-2025–2026-covid-19-vaccination-schedule-november-4-2025.
The American Academy of Pediatrics (AAP) has issued separate COVID-19 vaccination recommendations for children during the 2025–26 season. Refer to the full statement for details of their recommendations: https://doi.org/10.1542/peds.2025-073924. In summary, AAP recommends age-appropriate COVID-19 vaccination of the following groups of children:
- All children age 6 months through 23 months
- Residents of long-term care facilities or other congregate settings
- Children who have never been vaccinated against COVID-19
- Infants and children with household contacts who are at high risk for severe COVID-19
- All children who are at risk of severe COVID-19 due to underlying conditions or treatments, including: chronic pulmonary disease, cardiovascular disease, gastrointestinal disorders, hepatic disease, hematologic disease, metabolic disorders, obesity, neurologic and neurodevelopmental conditions, immunosuppressive conditions, and rheumatologic or autoimmune disease
- Children 2 through 18 years not in the above categories whose parent or guardian desires their protection from COVID-19
Last reviewed:
November 16, 2025
This child should receive one dose recommended for his age at the time of the vaccination visit. At age 11 years, an age-appropriate single dose of either Comirnaty (Pfizer-BioNTech) or Spikevax (Moderna) mRNA vaccine is recommended. If the patient arrives in your clinic after turning 12 years old, the 2025–2026 Formula Nuvaxovid (Sanofi-Novavax) protein subunit vaccine and the mNexspike (Moderna) mRNA vaccine are also options.
Last reviewed:
November 16, 2025
CDC states that a person who moves to an older age group before completing the initial series recommended for the younger age group should follow the schedule for the older age group and receive the vaccine product and dosage for the older age group. In this case, the child should receive one dose of 2025–2026 Formula Spikevax (Moderna) at least 8 weeks after the most recent dose of COVID-19 vaccine.
An initial series of COVID-19 vaccine is recommended for children 6 months through 23 months of age. Children 24 months through 59 months of age are recommended to receive only one dose of 2025–2026 Formula Spikevax regardless of their COVID-19 vaccination history.
Last reviewed:
November 16, 2025
Moderately or severely immunocompromised children who transition from age 11 years to age 12 years during the initial vaccination series should complete the 3-dose series using the dosage for people ages 12 years and older for all doses received once they are age 12 years.
See www.cdc.gov/covid/hcp/vaccine-considerations/immunocompromised.html for additional details.
Last reviewed:
November 16, 2025
Both vaccines have been demonstrated to be safe, with side effects typical of those in older age groups. The most common local reaction in this age group is pain at the injection site; the most common systemic symptom in older children was fatigue and in younger children (6 through 23 months) irritability/crying and sleepiness were most common. Fever may occur after either vaccination. Febrile seizures can occur in infants and young children ages 6 months through 5 years as a result of any condition that causes a fever (most common with high fevers). Febrile seizures are uncommon after vaccination. Febrile seizures were rare after mRNA COVID-19 vaccine clinical trials in this age group, and CDC continues to monitor for this adverse event following vaccination in infants and young children.
No cases of myocarditis were reported during the clinical trials for either vaccine. To date, post-authorization surveillance has not detected an increased risk for myocarditis and pericarditis following mRNA COVID-19 vaccination in children ages 6 months–4 years (Pfizer-BioNTech) and ages 6 months–5 years (Moderna).
Last reviewed:
November 16, 2025
Last reviewed:
November 16, 2025
