Pediatricians’ group breaks with CDC, still urging COVID-19 shots for young children

LOS ANGELES - For the first time in 30 years, the American Academy of Pediatrics is breaking from federal vaccine guidance — urging COVID-19 shots for young children despite scaled-back recommendations from the Centers for Disease Control and Prevention.

The pediatricians’ group announced Tuesday it will continue recommending COVID-19 vaccines for children ages 6 months to 2 years, and for older children at risk of severe illness. The move marks a significant departure from new federal guidance shaped by Health Secretary Robert F. Kennedy Jr., which no longer recommends the shots for healthy children.

"This is going to be somewhat confusing," said Dr. James Campbell, vice chair of the AAP’s infectious diseases committee. "But our opinion is we need to make the right choices for children to protect them."

Why the AAP is keeping COVID-19 vaccine recommendations

The AAP said young children face higher risks of hospitalization and severe illness from COVID-19, making vaccination critical for ages 6 months to 2 years.

The group also recommended shots for older children with chronic conditions such as asthma and other lung diseases. Vaccination for healthy older children should be left to parental choice, the AAP added.

Campbell, an infectious diseases expert at the University of Maryland, said the decision reflects science and decades of pediatric guidance, not politics.

What we know:

The AAP’s announcement has created one of the sharpest divides in vaccine guidance in decades. Here are the major points the organization is standing by:

• The AAP is strongly recommending COVID-19 vaccination for children under 2.
• Older children with chronic medical conditions are also advised to get vaccinated.
• Federal guidance, issued under Kennedy, says healthy children no longer "should" get the shots.

What we don't know:

Despite the strong stance from pediatricians, uncertainty lingers about how federal policy will evolve and whether other groups will follow. Key questions remain:

• Kennedy’s newly appointed vaccine advisory panel has not yet voted on formal COVID-19 shot recommendations.
• It remains unclear whether other major medical groups will follow the AAP’s stance or align with the CDC.

The backstory:

Since 1995, the AAP has largely aligned its vaccine guidance with CDC recommendations. Small differences have surfaced before — such as the AAP encouraging HPV shots at age 9 compared to the CDC’s focus on ages 11 and 12 — but experts say this marks the first major rift in three decades.

The break comes after Kennedy dismissed the CDC’s existing 17-member vaccine panel and replaced it with a smaller group that includes vaccine skeptics. His panel excluded the AAP and other major medical organizations from shaping recommendations.

The other side:

Federal officials criticized the AAP’s move. In a statement, Health and Human Services spokesperson Andrew Nixon accused the group of "undermining national immunization policymaking with baseless political attacks."

He also suggested the group’s recommendations were influenced by vaccine manufacturers, pointing to donations made to the AAP’s Friends of Children Fund. The fund supports projects on health equity, injury prevention and other initiatives.

What they're saying:

Campbell said the split was unavoidable.

"In 30 years, this is the first time the recommendations have differed in a significant or substantial way," he said.

What's next:

The new federal vaccine panel has yet to issue a formal recommendation on COVID-19 shots. The group has voted to continue endorsing flu shots but only those packaged as single doses without thimerosal, a preservative.

The AAP countered that there is no evidence of harm from thimerosal and urged doctors to use any licensed flu vaccine appropriate for patients.