The Centers for Disease Control and Prevention (CDC) recently published new guidance on the childhood immunization schedule. In this update, vaccines were categorized as recommended for all children, recommended for high-risk groups, or immunization based on shared clinical decision-making. In light of these changes, today's guidelines side-by-side compares the childhood immunization schedules from the CDC, American Academy of Family Physicians (AAFP), and the American Academy of Pediatrics (AAP).
Guidelines for Comparison
| Item | Birth Through Age 18 Immunization Schedule | Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger | CDC Childhood Immunization Schedule |
|---|---|---|---|
| Authoring Organization | American Academy of Family Physicians (AAFP) | American Academy of Pediatrics (AAP) | Centers for Disease Control and Prevention (CDC) |
| Publication Date | September 2025 | August 2025 | January 2026 |
| Links | Summary / Full Text | Summary / Full Text | Summary / Full Text |
Key Similarities
- All three organizations recommend the following immunizations for routine administration to all children:
- Diphtheria, tetanus, acellular pertussis (DTap)/Tetanus, diphtheria, acellular pertussis (Tdap)
- Haemophilus influenza type b (Hib)
- Pneumococcal conjugate
- Inactivated poliovirus
- Measles, mumps, rubella (MMR)
- Varicella
- Human papillomavirus (HPV)
- Respiratory syncytial virus (RSV) vaccination is recommended routinely for infants depending on maternal immunization status and for children in certain high-risk groups.
- Meningococcal B is recommended for high-risk groups and when appropriate based on shared decision-making.
Key Differences
- MMR
- In addition to routine vaccination beginning at 12 months of age, the AAFP and the AAP recommend certain high-risk groups initiate immunization earlier, between the ages of 6 and 12 months.
- The CDC recommends initiation of routine immunization at 12 months of age.
- Hepatitis B (HepB)
- Both the AAFP and AAP recommend routine HepB immunization beginning at birth.
- The CDC recommends Hep B for certain high risk groups like infants born to women who tested positive for hepatitis B or when appropriate based on shared decision-making in babies born to women who tested negative for hepatitis B.
- The CDC also suggests administering the initial dose of Hep B immunization no earlier than 2 months of age.
- Meningococcal ACWY
- The AAFP and AAP recommend routine immunization beginning at the age of 11-12 years and earlier initiation of immunization between 2 months and 10 years for certain high risk groups.
- The CDC recommends immunization for certain high risk groups and when appropriate based on shared decision-making.
- Hepatitis A (HepA)
- The AAFP and the AAP recommend routine immunization against Hepatitis A between 12 and 23 months of age and immunization between 6 and 9 months of age in certain high risk groups.
- The CDC recommends immunization between 6 months and 17 years of age in certain high risk groups and when appropriate based on shared decision-making.
- Rotavirus
- The AAFP and AAP recommend routine immunization against rotavirus.
- The CDC recommends that shared clinical decision-making be used to determine if rotavirus immunization should be administered.
- COVID-19
- The AAFP and AAP recommend routine immunization against COVID-19 in children ages 6-23 months, immunization in high-risk groups, and in those who desire protection from COVID-19 between the ages of 2 and 18 years.
- The CDC recommends the decision to immunize against COVID-19 be based on shared decision-making.
- Influenza
- The AAFP and AAP recommend routine influenza vaccination.
- The CDC recommends the decision to immunize against influenza be based on shared decision-making.
Comparison of Recommendations
| Immunization | AAFP | AAP | CDC |
|---|---|---|---|
| DTap < 7 years | Routine vaccination | Routine vaccination | Recommended for all children |
| Tdap ≥ 7 years | Routine vaccination | Routine vaccination | Recommended for all children |
| Hib | Routine vaccination | Routine vaccination | Recommended for all children |
| Pneumococcal conjugate (PCV15, PCV20) | Routine vaccination | Routine vaccination | Recommended for all children |
| Inactivated poliovirus ( IPV < 18 yrs) | Routine vaccination | Routine vaccination | Recommended for all children |
| MMR | Routine vaccination Recommended for certain high risk groups (6-12 mo) | Routine vaccination Recommended for certain high risk groups (6-12mo) | Recommended for all children (starting at age 12mo) |
| Varicella (VAR) | Routine vaccination | Routine vaccination | Recommended for all children |
| HPV | Routine vaccination | Routine vaccination | Recommended for all children |
| RSV-mAb | Routine vaccination depending on maternal vaccination status (birth-8mo) | Routine vaccination depending on maternal vaccination status (birth-8 mo) | Recommended for all children whose mother did not have the vaccine |
| RSV-mAb | Routine vaccination for certain high-risk groups (8-19mo) | Recommended for certain high risk groups (8-19 mo) | Recommended for high risk children |
| HepB | Routine vaccination | Routine vaccination | Recommended for certain high risk groups- infants born to women who tested positive for Hep B or whose status is unknown. Immunization based on shared clinical decision making— infants born to women who tested negative for Hep B, initial dose suggested no earlier than two months of age. |
| Meningococcal ACWY | Routine vaccination Recommended for certain high-risk groups | Routine vaccination Recommended for certain high risk groups | Recommended for certain high risk groups Immunization based on shared clinical decision making |
| Meningococcal B | Recommended for certain high-risk groups Recommended based on shared decision-making | Recommended for certain high risk groups Recommended based on shared decision making | Recommended for certain high risk groups Immunization based on shared clinical decision making |
| HepA | Routine vaccination Recommended for certain high-risk groups | Routine vaccination Recommended immunization for certain high-risk groups | Recommended for certain high risk groups Immunization based on shared clinical decision-making |
| Rotavirus (RV): RV1 (2 dose series), RV5 (3 dose series) | Routine vaccination | Routine vaccination | Immunization based on shared clinical decision-making |
| COVID-19 (1vCOV-mRNA, 1vCOV-aPS) | Routine vaccination Immunization for certain high risk groups and those whose parent or guardian desires their protection from COVID-10 | Routine vaccination Immunization for certain high risk groups and for those who desire protection | Immunization based on shared clinical decision-making |
| Influenza | Routine vaccination | Routine vaccination | Immunization based on shared clinical decision-making |
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