Now that the ’25-’26 school year is underway, parents are facing conflicting messages about COVID-19 vaccinations for children. Changes under Health and Human Services Secretary Robert F. Kennedy Jr. have moved pediatric COVID vaccines to a “shared clinical decision-making” model, while the American Academy of Pediatrics (AAP) continues to strongly recommend vaccination for children 6 to 23 months and older high-risk children.
At the same time, children still need their regular school vaccines, making decisions confusing for families.
In late August, the FDA approved three COVID-19 vaccines—Pfizer-BioNTech’s Comirnaty, Moderna’s Spikevax and Mnexspike and Novavax’s Nuvaxovid—for adults 65 and older and younger individuals with at least one high-risk condition. Approval letters require multiple post-marketing studies, including trials in adults 50 to 64 without high-risk conditions and investigations of post-COVID-19 vaccination syndrome.
HHS Secretary Kennedy announced the approvals without clarifying availability, although, according to a federal notice posted Thursday, the Advisory Committee on Immunization Practices (ACIP) will meet Sept. 18 and 19 to discuss and potentially vote on recommendations for vaccines against COVID-19, hepatitis B and measles.
Experts say ongoing research is crucial to assess safety, immune response and long-term outcomes, especially as families navigate back-to-school vaccination decisions.
David Dodd, CEO of GeoVax, a clinical-stage vaccine developer, notes the confusion this creates for parents.
“Parents should start by locking in the ‘must-have’ school vaccines—MMR, Tdap, polio, etc.—those requirements are set by states and haven’t changed,” he said. “Then add flu for everyone six months and older and RSV protection for infants. For COVID-19, recognize the current split: CDC/HHS have moved children 6 months–17 years to a shared clinical decision-making model with your clinician, while the AAP actively recommends vaccination for all children 6–23 months and for older high-risk kids.”
Dodd stated that mixed messages can affect trust in vaccines overall.
“When one federal body narrows access or shifts to ‘talk to your doctor’ while pediatric leaders still recommend for some ages, families may infer that ‘the experts don’t agree,’ which risks spillover doubt about routine immunizations that keep measles, whooping cough, and other school-spread infections in check,” he said.
From a vaccine-developer perspective, clear and transparent communication is critical.
“It’s critically important that we explain the ‘why’ behind each recommendation, acknowledge uncertainty without minimizing risk, and provide parents a simple, sequential plan—school-required vaccines to flu/RSV to COVID shared decision,” Dodd said. “We need to be explicit about what’s federal policy versus pediatric clinical advice, and flag access issues. Most of all, clarity about scope and rationale—plus clear next steps—is necessary to build confidence even when experts disagree.”
In addition, states are stepping in to fill the gaps left by federal shifts.
Democratic governors such as JB Pritzker in Illinois, Kathy Hochul in New York and Maura Healey in Massachusetts are ensuring vaccine access, from stockpiling doses to requiring insurers to cover state-recommended shots regardless of federal guidance. Regional coalitions are also forming on the West Coast and Northeast to issue immunization guidance, safeguard public health labs, track diseases and coordinate emergency preparedness, underscoring the patchwork parents must navigate when planning back-to-school vaccines.
Dodd also warned of the risks if parents delay or skip vaccinations.
“Immediate outbreaks of routine-preventable diseases in schools, like measles or pertussis, can sideline kids for weeks,” he said. “For COVID-19 specifically, skipped or delayed shots in high-risk children raise the odds of severe illness and missed school days—exactly what families want to avoid in the fall.”
Private-sector vaccine leaders can help steady confidence when guidance diverges, Dodd added.
“Focus on evidence first and remain apolitical: publish plain-language summaries that map the AAP versus CDC positions, coordinate with clinicians so families get fast, consistent answers, and support access pathways where coverage is uncertain,” he said. “Reinforce stable pillars—state-required vaccines, annual flu, and infant RSV protection—so families can act even while COVID recommendations evolve.”
With federal and professional guidance at odds, and states creating their own pathways, parents should work closely with pediatricians to ensure children receive timely immunizations while navigating a landscape of evolving COVID-19 recommendations.