By Pia Pannaraj
A new school year. An approaching winter respiratory season. And lots of parents are confused by contradictory messages from various health authorities around childhood vaccinations. They are not alone. Health departments, clinics, pharmacies and even the Centers for Disease Control and Prevention are all scrambling to adapt to erratically changing directives.
It might seem hard to know who has the right answers. But for me, the answer is clear: Trust your pediatrician’s recommendation.
In all the confusion, the American Academy of Pediatrics has stepped up to create clear, reliable guidance for pediatricians and families. This is not new. The AAP, an organization that exists solely to attain optimal physical, mental, and social health and well-being for all infants, children, adolescents and young adults, has provided child health and immunization guidance for the last 95 years. These are the experts we need to trust — doctors and scientists — to provide health recommendations for our children.
The AAP released the updated pediatric immunization schedule in mid-August. One of the biggest changes is that healthy children ages 2 to 18 years no longer need a routine COVID-19 vaccination but can get one if desired. This reflects the experts’ recognition that COVID-19 is no longer a leading cause of childhood mortality in this age group as it was early in the pandemic. The strains have changed, and older children have built up a certain level of immunity now that COVID-19 has been around for over five years. Children at high risk of complications, however, should still be vaccinated.
On the other hand, all young children ages 6 to 23 months are at high risk even if they are healthy and should get the COVID-19 vaccine. Why? Infants and toddlers younger than 2 years continue to have the highest hospitalization rates among children. What is striking to me is that over half of those kids hospitalized are healthy children without any pre-existing medical conditions. That means that those kids had likely been playing energetically and enjoying their toddler life just before getting sick. Yet COVID-19 hit them hard enough to require a hospital admission for oxygen or even a breathing tube. Furthermore, death from COVID-19 among children is highest in this young age group. Healthy kids are not supposed to die. To die from a preventable disease is unthinkable.
Other professional medical associations also have stepped up to provide science-based COVID-19 recommendations. The American College of Obstetricians and Gynecologists reaffirmed their guidance for vaccinating individuals during pregnancy. This delivers two-for-one protection of both mom and baby, especially our youngest babies under 6 months old. The American Academy of Family Physicians recently released recommendations for all adults 18 years and older to get the COVID-19 vaccine.
Beyond COVID-19, the AAP Immunization schedule provides recommendations for all routine immunizations to keep our children and communities safe. Over the past year, I increasingly have been asked to train our young doctors on how to recognize vaccine preventable diseases that haven’t been seen in the United States in most of their lifetimes. Measles, for example, was declared eliminated in the United States in 2000 due to the success of vaccinations. However, due to dropping vaccination rates, U.S. measles cases have hit the highest level this year since elimination was declared.
We need to cut through all the misinformation and politics undermining children’s health. Vaccines have saved more than 150 million lives in the past 30 years alone. As a society, we forget what these preventable diseases can do to our children. It can be as simple as missing a few days of school, but it could also lead to brain inflammation, inability to breathe and death. Why take that chance? As a parent, I make a conscious choice to vaccinate and ensure that my children are not left vulnerable to serious and potentially deadly diseases. Fortunately, most Californians do the same and vaccinate their children.
In the midst of all the confusion, parents and patients now must advocate for themselves. But we are here to help. We are here for you. Ask your pediatricians to help you find the right answers for your child. We are all in this together for every child and for our community.
Pannaraj is a pediatric infectious diseases specialist at Rady Children’s Health in San Diego, a professor of pediatrics at UC San Diego and mother of three children.
This article was originally published September 19, 2025 in the San Diego Union Tribune.
