CDC Adds COVID-19 Vaccines to Child Immunization Schedule

child vaccinee

Westend61/Getty Images

Key Takeaways

  • The Centers for Disease Control and Prevention (CDC) updated its childhood immunization schedule to include COVID-19 vaccines.
  • The update comes after the CDC's Advisory Committee on Immunization Practices (ACIP) made the recommendation last fall.
  • The CDC can make vaccine schedule recommendations, but only the states can mandate them.

Every year, the Centers for Disease Control and Prevention (CDC) teams up with the American Academy of Pediatrics (AAP) and other organizations to update the recommended childhood immunization schedule. Now, for the first time, the COVID-19 vaccine appears on that table. This follows the recommendation from the CDC’s Advisory Committee on Immunization Practices (ACIP) in the fall of 2022.

The guidance from the CDC is ultimately the same as it has been—for everyone over the age of 6 months to receive their primary series of the COVID vaccine as well as boosters. The 2023 immunization schedule just solidifies that. It also points to the CDC's guidance on booster dose vaccination for when children should get their boosters. Essentially, when a new booster shot is approved, families should follow the CDC's recommendation for that particular vaccination.

Many parents may understandably be unsure about what this means. Will their child be required to get the COVID vaccine in order to attend school? Will COVID boosters be an annual requirement for kids? As the CDC notes, these are simply recommendations—only states have the power to mandate vaccines for school or otherwise.

Still, many questions still linger. We reached out to experts to help us unpack this news and to help us understand how child immunization schedules work and what the purpose is.

Why Are Childhood Vaccine Schedules Important?

The CDC’s job is to keep track of infectious diseases and make determinations about what vaccines are important for children to receive. “The current childhood vaccine schedule has been carefully crafted and extensively studied,” says Rebekah Diamond, MD, assistant professor of pediatrics at Columbia University, and author of the book Parent Like A Pediatrician.

Dr. Diamond emphasizes the vaccines the CDC recommends for children are the safest and most effective way to protect your child from serious illness. “We know vaccine uptake leads to happy, healthy children through data,” she describes. “As a pediatrician, I’ve also seen it firsthand—treating a devastating disease or even witnessing childhood death from vaccine-preventable disease.”

Childhood vaccination schedules are the guidepost for all providers to refer to when offering routine vaccinations.


The CDC’s vaccine schedule also provides guidance for states and institutions like schools, explains Nehali Patel, MD, an associate faculty member at the Infectious Disease Clinic at St. Jude Children’s Research Hospital. “Childhood vaccination schedules are the guidepost for all providers to refer to when offering routine vaccinations,” Dr. Patel describes. “They are also the main resource for parents and schools to see what is recommended for each age group and special circumstance.”

Additionally, Dr. Patel says these recommendations offer key guidelines regarding the number of vaccines in a series to offer, what ages children should start receiving these vaccines, how to space the vaccines out, and how to vaccinate children who have chronic conditions or are immunocompromised.

UPDATE: January 2023

The CDC says the number of vaccinated kindergarteners entering school continues to decline. During the 2021-22 school year, the number of covered kindergarteners declined to approximately 93% for state-required vaccinations. That's down 1% from the 2020-21 school year, and 2% from the year before. The percentages vary from state to state. Students vaccinated against MMR is 98% in New York but only 78% in Alaska. When it comes to the polio vaccine, almost 98% are vaccinated in Louisiana and Nebraska, but Alaska is at 77%.

Officials attribute the decline to COVID-related disruptions in the vaccine schedule. The CDC is concerned declining vaccination numbers could eventually impact the protection of students from these diseases.

How the COVID Vaccine Fits Into Immunization Schedules

The 2023 childhood immunization schedule only says COVID vaccines should be given starting at age 6 months, with boosters to follow. It does not get into details as specific as with other vaccines on the schedule. But caregivers should make sure to follow the CDC's guidelines for boosters, which could be different depending on your child's age and which vaccine they got for their primary series.

“The Pfizer vaccine will require three doses for first-time recipients who are under 5 years old,” Dr. Patel describes. “The Moderna will require 2 doses.” After that, she expects there will be seasonal COVID boosters, similar to the flu shot, updated yearly to target circulating COVID variants.

COVID Vaccinations Lag for Children

To date, COVID vaccination has lagged in children, especially young children. According to the Academy of American Pediatrics (AAP), as of October 26, 2022, 58% of 12-17 year olds have received two doses of a COVID vaccine, and 31% of 5-11 year-olds have received two doses. The vaccine uptake for 6 months to 4 years old is even lower—only 9% of kids in this age group have received even one COVID vaccine.

Katelyn Jetelina, PhD, an epidemiologist and founder of Your Local Epidemiologist, shares some thoughts on why this may be happening. “First, I think this has to do with the lagged clinical trials and honestly waiting too long,” she said. “So, many children were already infected by the time vaccinations were available that many parents don’t see the benefit.”

Additionally, compared to adults, children tend to fare better when it comes to COVID infections, which likely has led to a lack of urgency for parents, she says. “However, comparing children to adults is inherently flawed, as kids aren’t supposed to be hospitalized (or die),” Dr. Jetelina emphasizes. This type of messaging hasn’t reached parents with enough clarity, she says.

Finally, Dr. Jetelina thinks there are still quite a few hesitant parents and even hesitant pediatricians. There’s hope, though, she says. “Vaccine confidence takes time, and I think over time this gap will eventually close,” Dr. Jetelina describes. “Parents just want to do the best thing for their kids and it takes time to be convincing.”

Some Vaccines Required For Schools

Every state is different but all states in the U.S. require at least some of the CDC-recommended vaccines for school entry—and they have done so long before COVID vaccines came on the scene. According to the Pew Research Center, all states require vaccines against diphtheria, tetanus, pertussis, polio, chickenpox, measles, and rubella. Every state besides Iowa also requires the mumps vaccine. Some daycares and preschools require flu shots. Mandates for vaccines like hepatitis A and B also vary from state to state.

Not only do the CDC recommendations help schools decide what vaccines to require, but their recommendations have an important role to play when it comes to vaccine access for kids, Dr. Jetelina points out. CDC vaccine recommendations are added to the Vaccines for Children program, she says. When this happens, the federal government is required to pay for vaccines for children who don’t have health insurance.

“This is incredibly important for health equity in the United States,” Dr. Jetelina commented.

What This Means For You

The CDC has officially added COVID vaccines to its child immunization schedule. The recommendation follows the CDC's advice that everyone over the age of 6 months gets vaccinated against COVID. Each individual state will decide what to do with this information in terms of mandating vaccines. Everyone has unique concerns when it comes to COVID vaccines for children.  If you have any further questions about vaccinating your child against COVID, please touch base with their pediatrician or healthcare provider.

12 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention (CDC). Child and Adolescent Immunization Schedule By Age.

  2. Centers for Disease Control and Prevention. Requirements & Laws.

  3. Centers for Disease Control and Prevention. ACIP Immunization Schedule Vote.

  4. Centers for Disease Control and Prevention. Recommended Vaccinations for Infants and Children, Parent-Friendly Version.

  5. Smith LE, Amlôt R, Weinman J, Yiend J, Rubin GJ. A systematic review of factors affecting vaccine uptake in young childrenVaccine. 2017;35(45):6059-6069. doi:10.1016/j.vaccine.2017.09.046

  6. Seither R, Calhoun K, Yusuf OB, et al. Vaccination Coverage with Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2021–22 School Year. MMWR Morb Mortal Wkly Rep 2023;72:26–32. DOI:

  7. Centers for Disease Control and Prevention. Stay Up to Date with COVID-19 Vaccines Including Boosters.

  8. American Academy of Pediatrics. Summary of data publicly reported by the Centers for Disease Control and Prevention.

  9. American Academy of Pediatrics. Children and COVID-19: State-Level Data Report.

  10. Woodruff RC, Campbell AP, Taylor CA, et al. Risk Factors for Severe COVID-19 in Children. Pediatrics. 2022;149(9):e2021053418. doi:10.1542/peds.2021-053418

  11. DeSilver D. States have mandated vaccinations since long before COVID-19. Pew Research Center.

  12. Centers for Disease Control and Prevention. Vaccines for Children Program (VFC).

By Wendy Wisner
Wendy Wisner is a lactation consultant and writer covering maternal/child health, parenting, general health and wellness, and mental health. She has worked with breastfeeding parents for over a decade, and is a mom to two boys.