What Changed in the 2025 U.S. Immunization Schedule for Children and Adolescents

This page describes the 2025 schedule. Check CDC's current immunization schedules before acting on it.

At its October 2024 meeting, the Advisory Committee on Immunization Practices (ACIP) approved the Recommended Immunization Schedule for Child and Adolescent Ages 18 Years or Younger, United States, 2025. The schedule gathers ACIP's current vaccine recommendations for young people in one place for clinicians and public health workers. Besides CDC, it was approved by the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Nurse-Midwives, the American Academy of Physician Associates and the National Association of Pediatric Nurse Practitioners.

The schedule has a cover page, three tables, notes, an appendix and an addendum, which records any new ACIP recommendations made before the next yearly update. Clinicians are urged to use all the parts together for each patient. ACIP recommendations do not create mandates.

How recommendations are made

ACIP bases each recommendation on in-depth reviews of the disease's epidemiology and effects on society; the vaccine's efficacy, effectiveness and safety; the quality of the evidence; how feasible the program would be; its effect on health equity; and economic analyses. Clinical trials for each vaccine are run alongside the routine childhood schedule. CDC and the Food and Drug Administration (FDA) keep monitoring routinely recommended vaccines for safety through several surveillance systems, safety studies and literature review.

The main changes

• New or updated recommendations for COVID-19, Haemophilus influenzae type b (Hib), influenza and meningococcal serogroup B vaccines.
• Flu vaccine formulation: every section now lists trivalent rather than quadrivalent influenza vaccines, matching the products FDA approved for the 2024–25 season.
• Clarified recommendations for dengue vaccine, DTaP, polio (IPV), MMR, MMRV, pneumococcal vaccines, the RSV monoclonal antibody, RSV vaccines and varicella vaccine.

Changes by vaccine

COVID-19. Table 1 now reads "1 or more doses of 2024–2025 vaccine." In Table 3, for children with immune compromise or with HIV and low CD4 counts, the bar now signals that extra doses are recommended. The notes set out 2024–2025 vaccine recommendations by age and vaccination history, separately for the general population and for moderately or severely immunocompromised children.

Dengue. For ages 9–16, the table now shows vaccination as recommended for certain high-risk groups or populations.

Influenza. Table wording now matches the adult schedule ("1 or 2 doses annually" or "1 dose annually"). Solid organ transplant recipients aged 18 who take immunosuppressive medicines may receive high-dose (HD-IIV3) or adjuvanted (aIIV3) trivalent inactivated vaccine, with no preference over other suitable trivalent inactivated or recombinant vaccines.

Polio (IPV). Age 18 is now marked for catch-up vaccination.

DTaP. The notes summarize when to use tetanus and diphtheria vaccine (Td) for children under 7 who cannot receive the pertussis component.

Hib. Vaxelis was added as a second preferred option for primary doses in American Indian and Alaska Native infants, and early component complement inhibitor use was added as a reason to vaccinate when age-appropriate.

Hepatitis B. Heplisav-B was removed from the wording about vaccines not recommended in pregnancy, and the note on its pregnancy registry, no longer active, was removed.

MMR and MMRV. The international travel recommendation was reworded by age group and vaccination history. The appendix now states that MMRV is contraindicated in people with HIV infection of any severity, and the varicella row was renamed "Varicella/MMRV."

Meningococcal B. The notes add the new Bexsero schedule: for healthy people aged 16–23, 2 doses 6 months apart, based on shared clinical decision-making; for children and adolescents 10 and older at higher risk, 3 doses at 0, 1–2 and 6 months.

Pneumococcal. Because data are limited, there is no recommendation for pneumococcal conjugate vaccines or the 23-valent polysaccharide vaccine during pregnancy.

RSV monoclonal antibody. Infants born from October through March should receive it within 1 week of birth, ideally before leaving the hospital. Infants whose mothers received RSV vaccine in an earlier pregnancy should still receive nirsevimab. For infants born from April through September, the best time to give it is October–November.

RSV vaccine in pregnancy. Additional doses are not recommended in later pregnancies.

Table 2, the catch-up schedule, did not change. Throughout the notes, wording was aligned with the adult schedule as far as possible; every vaccine in the child tables except dengue, DTaP, rotavirus, MMRV and nirsevimab also appears in the adult schedule.

The schedule is on CDC's immunization schedules page, and ACIP's full recommendations for each vaccine are on its vaccine-specific recommendations page.

Sources

• Issa AN, Wodi AP, Moser CA, Cineas S. "Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger — United States, 2025." MMWR 2025;74(2).