The American Academy of Pediatrics Committee on Infectious Diseases released its 2025 recommended immunization schedule for children and adolescents.

In a prepublication document in Pediatrics, seven medical organizations approved the schedule, including the U.S. Centers for Disease Control and Prevention (CDC), American Academy of Family Physicians, American College of Obstetricians and Gynecologists, American College of Nurse-Midwives, American Academy of Physician Associates, and National Association of Pediatric Nurse Practitioners.

Changes to the schedule included a change from quadrivalent to trivalent influenza vaccines and the addition of cell-culture inactivated influenza vaccine (ccIIV3). For solid organ transplant recipients aged 18 years, the schedule specified either adjuvanted inactivated influenza vaccine (aIIV3) or high-dose inactivated influenza vaccine (HD-IIV3).

The COVID-19 vaccination guidance changed to one or more doses of the 2024 to 2025 vaccine. The schedule added guidance for additional doses for moderately or severely immunocompromised patients.

For respiratory syncytial virus (RSV) prevention, the schedule specified nirsevimab administration within 1 week of birth for infants born between October and March, with administration during birth hospitalization when possible. The guidelines stated that infants born to individuals who received the RSV vaccine during previous pregnancies should receive nirsevimab.

The Meningococcal B vaccination schedule changed to a two-dose Bexsero series at 0 and 6 months for patients aged 16 to 23 years, based on shared decision-making. For patients aged ≥ 10 years at increased risk, the schedule listed a three-dose series at 0, 1 to 2, and 6 months.

Other changes included:

• A new contraindication for MMRV in human immunodeficiency virus–infected patients
• Additional Hib guidance for immunoglobulin deficiency and complement disorders
• Updates to polio catch-up vaccination for incomplete vaccination at age 18
• Removal of Heplisav B from the pregnancy contraindication list
• New MMR vaccination requirements for international travel
• A statement of no current recommendation for pneumococcal vaccination during pregnancy, citing limited data.

The schedule contained three sections:

• Table 1: Birth to 18 years recommendations
• Table 2: Catch-up schedule for ages 4 months to 18 years
• Table 3: Medical indication–based recommendations.

The American Academy of Pediatrics and CDC websites published the complete schedules, including parent-friendly versions. The prepublication document noted that final revisions might occur before the final version.

Health care providers received instructions to report adverse events to the Vaccine Adverse Event Reporting System through www.vaers.hhs.gov or 800-822-7967.

The CDC's Advisory Committee on Immunization Practices website provided additional vaccine recommendations, including those for high-risk conditions. Future updates will appear in the schedule's Addendum on the CDC website.