Uncertainty swirls around fall COVID-19 shots for kids

What used to be an autumn ritual for parents, making sure their school-aged children were up to date with vaccines, has been clouded with some uncertainty this year.

• In May, newly-appointed federal Health and Human Services Secretary Robert F. Kennedy, Jr., announced that most healthy children and pregnant women would no longer be eligible for routine COVID-19 vaccination. For decades, doctors, pharmacies and clinics throughout the United States have followed vaccine recommendations of the Centers for Disease Control and Prevention, which falls under Secretary Kennedy’s authority.
• On July 7, three national health organizations – the American Academy of Pediatrics (AAP), the American College of Physicians, and the American Public Health Association – sued Kennedy over his decision, which they called “arbitrary” and a violation of federal law, NPR reported.
• The American Academy of Family Physicians this month also recommended that adults 18 years and older receive the COVID vaccine, especially those over 65.
• On Aug. 19, the AAP put forth its own “evidence-based” vaccine schedule. In its announcement, AAP president, Sue Kressly, MD, said colleagues had told her it was important to take this step “given the confusing and contradictory recommendations coming from the federal government.”
• Recently, on Sept. 3, Florida State Surgeon General, Dr. Joseph Ladapo, and Gov. Ron Desantis, said they would make their state the first to end vaccine mandates.
• The following day, Massachusetts Gov. Maura Healey ordered health insurers to cover vaccinations recommended by the state Department of Public Health, not just those approved by the CDC. The state is developing those recommendations. In reaction to pharmacy chains Walgreens and CVS saying they might not offer vaccines that weren’t CDC-approved in Massachusetts and other states, state DPH commissioner, Dr. Robbie Goldstein, established an order permitting pharmacies to give COVID vaccinations to state residents ages 5 and older.

How various states handle the issue continues to evolve. It’s a confusing scenario, but Leif Norenberg, MD, a pediatrician with Briarpatch Pediatrics, in Sandwich, Yarmouth Port and Nantucket, said it hasn’t shaken the faith in vaccines of most parents he sees.

“The biggest confusion is about COVID, which is where the CDC and AAP vaccine schedules most differ,” he said. “I think mainstream Americans still feel vaccines are safe, and good.”

Dr. Norenberg said when talking to parents about vaccinations, he tells them there “aren’t really any cons, other than having a sore arm for a couple of days.

“If you have concerns, please talk to your PCP; we’re here to help.”

What National Pediatric Association Recommends

The AAP recommends children 6-23 months get vaccinated for COVID. Children 2-18 years in some risk groups should also get vaccinated, as well as any child whose parent wants them vaccinated. The risk groups include those who are immunocompromised, haven’t been previously vaccinated, or are in a household with a high risk from severe COVID. Immunocompromised children are defined as those being treated for cancer or organ transplant, taking immunosuppressant drugs, having an untreated or advanced HIV infection, or an immune system deficiency.

For other respiratory illnesses common in the fall, the AAP recommends:

• RSV vaccination, one dose for infants <8 months of age born during or entering their first RSV season, depending upon mother’s RSV vaccination status, and patients from 8 months through 19 months of age at high risk of severe RSV disease and entering their second RSV season.
• Influenza vaccination, from 6 months to 8 years, two doses the first year, then one dose annually, and 9 years and older, one dose annually.

The RSV, flu, and COVID vaccines aren’t perfect. You can still catch these illnesses if you get vaccinated, but they greatly reduce the chances of being hospitalized or dying. They also help protect older and immunocompromised people around you.

“We don’t want to see an older person with health issues die because a grandchild didn’t get vaccinated,” said Dr. Norenberg, who will attend the 2025 AAP National Conference & Exhibition in Denver, CO on Sept 26. This week, he joined pediatricians across the country who emailed their legislators urging them to work with colleagues on both sides of the aisle to call for postponement of Thursday’s CDC Advisory Committee on Immunization Practices (ACIP) until there is a clearer understanding of appropriate vaccine guidelines.

Although a case of the flu is typically an unpleasant inconvenience for most people, it can be fatal for some. According to the CDC, the estimated nationwide death toll from the last flu season from Oct. 1, 2024 to May 17, 2025 was between 27,000 and 130,000. Dr. Norenberg said he is still haunted by the death from flu of an otherwise healthy 15-year-old patient who didn’t get vaccinated for influenza.

“He got the flu, had various severe complications, and slowly died,” he said. “It was absolutely dreadful.”

As of Sept. 5, Dr. Norenberg’s office has received some flu vaccine, but no COVID vaccine. The federal stance has put uncertainty into COVID vaccine supply, availability and whether insurers will cover the cost to patients.

He lamented that some people question the value of immunizations.

“In the 1950s, when the polio vaccine came out, people were clamoring for it,” he said, because they had seen the terrible effects the virus could have. He contrasted that with the re-emergence of measles outbreaks among pockets of unvaccinated communities, today.

“We’re seeing measles, again, which is so preventable.  We’re going backwards, and that’s not what you expect in America.”