Bashar Hasan, MD
For the first time in decades, the CDC and AAP have published separate childhood immunization schedules. This resource explains the differences and provides a clear overview of the AAP-recommended schedule for clinical education.
On January 5, 2026, the CDC reduced routine childhood vaccine recommendations from 17 diseases to 11, moving several vaccines to "high-risk only" or "shared clinical decision-making" (SCDM) categories. The AAP maintained all prior routine recommendations. Below is a vaccine-by-vaccine comparison.
| Vaccine | CDC 2026 | AAP 2026 | Status |
|---|---|---|---|
| Hepatitis B | High-risk + SCDM Birth dose only for HBsAg+ / unknown-status mothers. For HBsAg− mothers: shared decision-making; first dose no earlier than 2 months. | Routine — All Children Universal birth dose for all newborns. Standard 3-dose series at birth, 1 month, and 6 months regardless of maternal status. | Diverge |
| Hepatitis A | High-risk + SCDM High-risk only (e.g., international travel to endemic areas). Shared decision-making for routine use in other children. | Routine — All Children Universal 2-dose series for all children starting at 12–23 months. | Diverge |
| Rotavirus | SCDM Only No longer universally recommended. Available through shared clinical decision-making. | Routine — All Infants RV1 (2-dose) or RV5 (3-dose) series beginning at 2 months for all infants. | Diverge |
| Influenza | SCDM Only No longer universally recommended. Available through shared clinical decision-making. | Routine — Annual Annual vaccination for all children ≥6 months. Two doses the first year for those receiving influenza vaccine for the first time. | Diverge |
| COVID-19 | SCDM Only No longer universally recommended. Available through shared clinical decision-making. | Routine — Annual Routine for all eligible children ≥6 months of age. | Diverge |
| RSV (mAb) | High-risk 1 dose for infants whose mother did not receive RSV vaccine during pregnancy. 2nd dose for high-risk infants only (e.g., chronic lung disease). | Routine — All Infants Recommended for all infants in their first RSV season. Additional doses for high-risk children in subsequent seasons. | Diverge |
| Meningococcal ACWY | High-risk + SCDM Routine adolescent doses (11–12 yr and 16 yr booster) moved to shared decision-making. High-risk groups only for infant/child series. | Routine — All Adolescents Routine 1st dose at 11–12 years with booster at 16 years. High-risk infant/child series also recommended. | Diverge |
| HPV | Routine — 1 Dose Recommended for all children, but reduced to 1 dose only (no FDA-approved 1-dose regimen exists). | Routine — 2 or 3 Doses 2-dose series if initiated at ages 9–14; 3-dose series if started at ≥15 years. | Partial |
| Meningococcal B | High-risk + SCDM High-risk groups + SCDM for adolescents 16–23 yr. | High-risk + SCDM High-risk groups + SCDM for adolescents 16–23 yr (preferred 16–18). | Aligned |
| Vaccines recommended as routine by both schedules | |||
| DTaP / Tdap | 5-dose DTaP series (2, 4, 6, 15–18 mo, 4–6 yr) + Tdap booster at 11–12 yr | Aligned | |
| Hib | 3- or 4-dose series depending on product used | Aligned | |
| PCV (Pneumococcal) | 4-dose series at 2, 4, 6, and 12–15 months (PCV15 or PCV20) | Aligned | |
| IPV (Polio) | 4-dose series at 2, 4, 6–18 months, and 4–6 years | Aligned | |
| MMR | 2-dose series at 12–15 months and 4–6 years | Aligned | |
| Varicella | 2-dose series at 12–15 months and 4–6 years | Aligned | |
The AAP schedule groups vaccines by the age at which each dose should be given. All vaccines below are recommended as routine for every child unless otherwise noted. This view is organized by age group for quick clinical reference.
Combination vaccines: Vaxelis (DTaP-IPV-HepB-Hib) can be given at 2, 4, and 6 months, reducing the number of injections per visit. At 4 months, HepB is not separately scheduled, but the extra dose delivered through Vaxelis is safe and acceptable. It cannot be used for the 12–15 month booster — its Hib component is not sufficiently immunogenic as a booster dose; use a different Hib-containing vaccine instead.
Test your understanding of the AAP 2026 recommended schedule. Select an answer for each question, then check your results.