Both the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) conduct periodic reviews of immunization data and publish updated child and adolescent immunization schedules. Usually, the recommendations of both of these organizations are aligned. However, this year the AAP and CDC immunization schedules differ in a few areas.
In this side-by-side comparison, we compare the latest childhood and adolescent immunization schedules from the AAP and the CDC. We highlight the differences in immunization recommendations for the COVID-19, influenza, and HPV vaccines. Overview and full-text links for each of the guidelines are listed below for your reference.
Guidelines for Comparison
| Item | Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States 2025 | Child and Adolescent Immunization Schedule by Age (Addendum updated August 7, 2025) United States 2025 |
|---|---|---|
| Authoring Organization | American Academy of Pediatrics (AAP) | Centers for Disease Control and Prevention (CDC) |
| Publication Date | August 2025 | August 2025 |
| Links | Overview / Full Text | Overview / Full Text |
Key Takeaways
The CDC and AAP immunization schedules had differences in the recommendations for three vaccines: COVID-19, Influenza, and HPV.
COVID-19:
- The CDC does not recommend routine COVID-19 vaccination for non-immunocompromised children. Instead they recommend a shared, decision-making approach.
- In contrast, the AAP recommends routine COVID-19 immunization for all children ages 6-23 months and for patients in high risk groups who are between 2 and 18 years of age. For patients not considered to be in a high risk group they recommend immunization if the parent/guardian wants protection from COVID-19.
Influenza
- Minimum age for use of the recombinant influenza virus vaccine (RIV3) is 18 years according to the CDC, and 9 years according to the AAP.
HPV
- The CDC states that while the HPV vaccine can be given as early as 9 years, it’s routinely recommended between the ages of 11 and 12. The AAP gives a wider window for the provider, child, and parent/guardian to decide when the right time is to start the vaccine series; between the ages of 9 and 12 years.
Comparisons of Recommendations
| Immunization | AAP | CDC |
|---|---|---|
| COVID-19 | Routine vaccination: Everyone age 6–23 months. All vaccine doses should be from the same manufacturer. Unvaccinated (i.e., never received any COVID-19 vaccine doses): • 2 doses Moderna 0, 4–8 weeks • 3 doses Pfizer-BioNTech at 0, 3–8, and at least 8 weeks after dose 2 Incomplete initial vaccination series: • 1 dose Moderna: complete initial series with 1 dose 4–8 weeks after most recent dose • 1 dose Pfizer-BioNTech: complete initial series with 2 doses 8 weeks apart (administer dose 1 3–8 weeks after most recent dose) • 2 doses Pfizer-BioNTech: complete initial series with 1 dose at least 8 weeks after the most recent dose Completed initial vaccination series: • 1 dose Moderna or Pfizer-BioNTech at least 8 weeks after the most recent dose Special situations Age 2–18 years in the following risk groups: • Persons at high risk of severe COVID-19 • Residents of long-term care facilities or other congregate settings • Persons who have never been vaccinated against COVID-19 • Persons whose household contacts are at high risk for severe COVID-19 Ages 2–11 years: • 1 dose of Moderna Spikevax or Pfizer-BioNTech regardless of previous vaccination status at least 8 weeks after the most recent dose Ages 12–18 years: • 1 dose of Moderna Spikevax, Pfizer-BioNTech Comirnaty, or Novavax Nuvaxovid regardless of previous vaccination status at least 8 weeks after the most recent dose • 1 dose of Moderna mNEXSPIKE for people who have previously received a COVID-19 vaccine. This dose should be administered at least 12 weeks after the last dose was received Children 2 through 18 years of age not included in the risk groups above whose parent or guardian desires their protection from COVID-19 should be offered a single dose of age-appropriate COVID-19 vaccine. | Recommends shared clinical decision making for ages 6 months - 17 years who are NOT moderately or severely immunocompromised. Shared clinical decision-making vaccinations are individually based and informed by a decision process between the health care provider and the patient or parent/guardian. Where the parent presents with a desire for their child to be vaccinated, children 6 months and older may receive COVID-19 vaccination, informed by the clinical judgment of a healthcare provider and personal preference and circumstances. All vaccine doses should be from the same manufacturer. Age 6 months–4 years: Unvaccinated: • 2 doses 2024–25 Moderna at 0, 4–8 weeks • 3 doses 2024–25 Pfizer-BioNTech at 0, 3–8, and at least 8 weeks after dose 2 Incomplete initial vaccination series before 2024–25 vaccine with: • 1 dose Moderna: complete initial series with 1 dose 2024–25 Moderna 4–8 weeks after most recent dose • 1 dose Pfizer-BioNTech: complete initial series with 2 doses 2024–25 Pfizer-BioNTech 8 weeks apart (administer dose 1 3–8 weeks after most recent dose). • 2 doses Pfizer-BioNTech: complete initial series with 1 dose 2024–25 Pfizer-BioNTech at least 8 weeks after the most recent dose. Completed initial vaccination series before 2024–25 vaccine with: • 2 or more doses Moderna: 1 dose 2024–25 Moderna at least 8 weeks after the most recent dose. • 3 or more doses Pfizer-BioNTech: 1 dose 2024–25 Pfizer-BioNTech at least 8 weeks after the most recent dose. Age 5–11 years: Unvaccinated: • 1 dose 2024–25 Moderna or Pfizer-BioNTech Previously vaccinated before 2024–25 vaccine with 1 or more doses Moderna or Pfizer-BioNTech: • 1 dose 2024–25 Moderna or Pfizer-BioNTech at least 8 weeks after the most recent dose. Age 12–17 years: Unvaccinated: • 1 dose 2024–25 Moderna or Pfizer-BioNTech • 2 doses 2024–25 Novavax at 0, 3–8 weeks Previously vaccinated before 2024–25 vaccine with: • 1 or more doses Moderna or Pfizer-BioNTech; 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech at least 8 weeks after the most recent dose. • 1 dose Novavax; 1 dose 2024–25 Novavax 3–8 weeks after the most recent dose. If more than 8 weeks after the most recent dose, administer 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech. • 2 or more doses Novavax; 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech at least 8 weeks after the most recent dose. Routine vaccination recommended for: Age 18 years who are NOT moderately or severely immunocompromised Unvaccinated: • 1 dose 2024–25 Moderna or Pfizer-BioNTech • 2 doses 2024–25 Novavax at 0, 3–8 weeks Previously vaccinated before 2024–25 vaccine with: 1 or more doses Moderna or Pfizer-BioNTech: • 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech at least 8 weeks after the most recent dose. 1 dose Novavax: • 1 dose 2024–25 Novavax 3–8 weeks after the most recent dose. If more than 8 weeks after the most recent dose, administer 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech. 2 or more doses Novavax: • 1 dose 2024–25 Moderna or Novavax or Pfizer-BioNTech at least 8 weeks after the most recent dose. |
| Influenza | Influenza vaccine minimum ages: IIV3 6 months, LAIV3 2 years, RIV3 9 years Use any influenza vaccine appropriate for age and health status annually Routine Vaccination: Age 6 months–8 years who have received fewer than 2 influenza vaccine doses before July 1, 2025, or whose influenza vaccination history is unknown: • 2 doses, separated by at least 4 weeks. Administer dose 2 even if the child turns 9 years between receipt of dose 1 and dose 2. Age 6 months–8 years who have received at least 2 influenza vaccine doses before July 1, 2025: • 1 dose Age 9 years or older: • 1 dose Age 18 years solid organ transplant recipients receiving immunosuppressive medications: • High-dose inactivated (HD-IIV3) and adjuvanted inactivated (aIIV3) influenza vaccines are acceptable options. No preference over other age-appropriate IIV3 or RIV3. | Influenza vaccine minimum ages: IIV3 6 months, LAIV3 2 years, RIV3 18 years. Use any influenza vaccine appropriate for age and health status annually Age 6 months–8 years who have received fewer than 2 influenza vaccine doses before July 1, 2024, or whose influenza vaccination history is unknown: • 2 doses, separated by at least 4 weeks. Administer dose 2 even if the child turns 9 years between receipt of dose 1 and dose 2. Age 6 months–8 years who have received at least 2 influenza vaccine doses before July 1, 2024: • 1 dose Age 9 years or older: • 1 dose Age 18 years solid organ transplant recipients receiving immunosuppressive medications: • High-dose inactivated (HD-IIV3) and adjuvanted inactivated (aIIV3) influenza vaccines are acceptable options. No preference over other age-appropriate IIV3 or RIV3. |
| HPV | The AAP recommends starting the series between the ages of 9 and 12 years, at an age the pediatric health care professional deems optimal for acceptance and completion of the vaccination series. Catch-up HPV vaccination recommended for all persons through age 18 years if not adequately vaccinated. 2- or 3-dose series depending on age at initial vaccination: Age 9–14 years at initial vaccination: • 2-dose series at 0,6–12 months (minimum interval: 5 months; repeat dose if administered too soon) Age 15 years or older at initial vaccination: • 3-dose series at 0, 1–2 months, 6 months (minimum intervals: dose 1 to dose 2 = 4 weeks; dose 2 to dose 3 = 12 weeks; dose 1 to dose 3 = 5 months; repeat dose if administered too soon). | HPV vaccination routinely recommended at age 11–12 years (can start at age 9 years) and catch-up HPV vaccination recommended for all persons through age 18 years if not adequately vaccinated. 2- or 3-dose series depending on age at initial vaccination: Age 9 –14 years at initial vaccination: • 2-dose series at 0, 6–12 months (minimum interval: 5 months; repeat dose if administered too soon) Age 15 years or older at initial vaccination: • 3-dose series at 0, 1–2 months, 6 months (minimum intervals: dose 1 to dose 2 = 4 weeks; dose 2 to dose 3 = 12 weeks; dose 1 to dose 3 = 5 months; repeat dose if administered too soon). |
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