The Centers for Disease Control and Prevention (CDC) has released the 2025 immunization schedules. The most significant updates are related to COVID-19, meningococcal B and Haemophilus influenzae type b vaccines.
The schedules incorporate policies approved over the past year and tweaks to improve clarity and readability. They have been endorsed by the AAP, which has published a policy statement detailing the updates.
“Both immunization schedules … are designed to be a guide for health care providers to ensure individuals get all the vaccines they need when they need them,” Sybil Cineas, M.D., FACP, FAAP, chair of CDC’s Advisory Committee on Immunization Practices (ACIP) immunization schedule work group, said during a recent ACIP meeting.
The 2025 child and adolescent immunization schedules include the following updates.
- COVID-19: The vaccine formula has been updated for 2024-’25. All individuals ages 6 month and older should receive at least one dose of the 2024-’25 vaccine and additional COVID vaccine doses are recommended for children and adolescents who are immunocompromised. Updated notes state all doses should be from the same manufacturer for healthy children ages 6 months through 4 years and immunocompromised children and adolescents receiving their initial vaccine series.
- Dengue: The schedule clarifies the vaccine is recommended only for certain populations in the age group.
- Diphtheria, tetanus and acellular pertussis (DTaP): A note addresses the use of Td vaccine in children under 7 years with a contraindication to the pertussis component of DTaP.
- Haemophilus influenzae type b (Hib): Vaxelis is one of two preferred vaccines to protect American Indian/Alaska Native infants from Hib. The other preferred vaccine is PedvaxHIB.
- Inactivated poliovirus: Clarifies an earlier recommendation that catch-up vaccination is recommended for 18-year-olds who are known or suspected to be unvaccinated or incompletely unvaccinated.
- Influenza: Vaccines for 2024-’25 are trivalent. High-dose inactivated and adjuvanted inactivated influenza vaccines are acceptable options for 18-year-old solid organ transplant recipients who are receiving immunosuppressive medications with no preference over other age-appropriate inactivated or recombinant influenza vaccines.
- Measles, mumps, rubella: A new note indicates children 12 months and older vaccinated with one dose should get a second dose at least four weeks after the first if they are going to travel internationally.
- Measles, mumps, rubella, varicella: The vaccine is contraindicated in HIV-infected people.
- Meningococcal B: Bexsero dosing has been changed to a two-dose series for healthy adolescents and a three-dose series for those at increased risk of disease. Patients who need rapid protection (such as during an outbreak) can choose a three-dose series.
- Respiratory syncytial virus (RSV): Updated notes clarify that for infants born in October through March, the ideal timing of nirsevimab administration is during the birth hospitalization. In addition, infants born to people who received an RSV vaccine during a previous pregnancy should receive nirsevimab.
As the CDC updates policies throughout the year, addenda will be added to the online schedules.
The updated schedules come as reports show troubling trends in childhood vaccination. A recent CDC report showed kindergarten vaccination rates decreased last school year, as exemptions from school vaccine requirements reached another record high. Another CDC study showed vaccine coverage for children by 2 years of age was lower for those born during the COVID-19 pandemic than in previous years.
CDC experts have said the declining rates leave more children at risk for preventable illnesses. There have been 23,544 pertussis cases this year, which is five times more than this time last year, according to CDC data. The count is the highest since 2014.
There also have been 277 cases of measles reported this year, the highest since 2019, according to CDC data. About 41% of the cases this year have been in children under 5 years, and 89% of all patients were unvaccinated or had an unknown vaccination status.
Resources
- AAP Red Book Online page with immunization schedules for children and adolescents
- AAP policy Recommended Childhood and Adolescent Immunization Schedule: United States, 2025
- AAP immunization resources
- CDC’s Let’s RISE vaccine initiative
- Information for parents from HealthyChildren.org on recommended childhood immunizations
