COVID-19 Vaccine Officially on Childhood Immunization Schedule

The CDC updates its recommended vaccine schedule every year.

Medically reviewed by Monika Goyal, M.D.

If you're keeping a close eye on what vaccines your child needs, this year, for the first time, you'll now see the COVID-19 vaccine on the recommended list of childhood immunizations. The Centers for Disease Control and Prevention (CDC) has officially added it to the schedule for people of all ages, particularly children. In the fall of 2022, the Advisory Committee on Immunization Practices (ACIP) voted to recommend the CDC add the COVID vaccine. Now it's official. This comes on the heels of President Joe Biden announcing the end of the national COVID emergency declaration on May 11, 2023.

For 2024, the guidance remains largely the same: COVID vaccination should begin at age 6 months—or any time thereafter. The 2024 immunization suggests children ages 6 months to 4 years should begin with the latest updated two-dose series of the Moderna vaccine or a three-dose series of the Pfizer-BioNTech vaccine. Between the ages of 5 and 11 years old, both unvaccinated and vaccinated children should receive one dose of the updated vaccine formula.

How Vaccines Get On The Vaccine Schedule

The schedule of immunizations your child's pediatrician uses to help keep your child healthy is updated annually. The process includes collaboration between the Food and Drug Administration, which licenses all vaccines, and five different governing boards of trusted experts representing different areas of medicine and public health. That includes the CDC and the American Academy of Pediatrics (AAP).

In response to the COVID pandemic, researchers worked at breathtaking speeds to create an effective COVID vaccine. At the time of publishing, more than 81% of Americans have had at least one dose of the vaccine. Now that the vaccine is added to the regular immunization schedule, doctors and parents will have more face-to-face opportunities to talk about the benefits of the vaccine.

"This effort reinforces my support of vaccinating all eligible people, including children, against COVID," says Matthew Harris, MD, a pediatric emergency medicine physician and medical director of the COVID-19 vaccination program at Cohen Children's Medical Center in New Hyde Park, NY. "The American Academy of Pediatrics has come out very strongly in favor of vaccinating all eligible children, regardless of prior history of COVID."

Related: Everything Parents Need to Know About the COVID-19 Vaccines

Will COVID Vaccines Be Mandated by Schools?

Following a vaccination schedule can feel confusing, considering that there are vaccines for 25 different diseases. That said, not all vaccines listed by the CDC are required for kids to enroll in public school.

Parents should note that adding the COVID vaccine to the childhood immunization schedule does not mean it will be mandated for students before enrolling in public schools. Those types of mandates happen solely at the state and local levels. As NBC News pointed out, the CDC added the HPV vaccine to the immunization schedule; however, only a handful of states have required it for students who matriculate in public schools.

Related: Will the COVID-19 Vaccine Be Mandatory for Kids?

"Moving Covid-19 to the recommended immunization schedule does not impact what vaccines are required for school entrance if any," says Nirav Shah, MD, director of the Maine Center for Disease Control and Prevention, said at the 2022 ACIP meeting where experts voted to add the vaccine to the schedule. "Local control matters. And we honor that the decision around school entrance for vaccines rests where it did before, which is with the state level, the county level, and at the municipal level if it exists at all."

Others agree that the CDC guidelines are unlikely to create COVID vaccine mandates in public education. "I think it is unlikely to ever be a mandate for public schools," says Dr. Harris. "There are a very select group of vaccine-preventable illnesses that pose such a tremendous risk to the population and that most states chose to make those vaccines mandatory."

Dr. Harris says that unless there is a dramatic change in the COVID virus, he does not foresee the vaccine becoming mandated. However, it will be highly encouraged. "My hope is that this recommendation will generate more conversations between vaccine-hesitant parents and their pediatricians, and maybe those conversations will help parents feel at ease as they become more likely to open to vaccination," said Dr. Harris. "COVID, while thought to be benign in most children, has killed over a thousand children in the last three years; it's made hundreds of thousands of children sick. So I hope this reinvigorates really important family and provider conversations."

Again, vaccine mandates happen at a state and local level, so check your state or local community to learn how they impact you and your family.

Why Is This COVID Vaccine Recommendation Significant?

The updated immunization schedule including the COVID vaccine and boosters will help insurance providers that usually cover the cost of vaccines listed on the CDC-recommended vaccine schedule. This distinction is significant as the federal government is winding down and ending its publicly funded program to offer free COVID vaccines to kids and adults.

During the 2022 ACIP committee vote, members voted to add the COVID vaccine to the Vaccines for Children Program (VFC), a nationalized public health program that offers free vaccines to kids who are eligible for or covered by Medicaid. Adding the COVID vaccine to the VFC will give greater access to uninsured or underinsured children, which will help inevitably boost COVID vaccination rates.

Related: Vaccine Schedule for Babies and Toddlers: A Cheat Sheet for Parents

Should My Child Get the COVID Vaccine?

The COVID vaccine is safe and available for anyone over the age of 6 months. While the vaccine won't 100% prevent anyone from getting the virus, it lowers the risk of spread and the risk of developing severe disease requiring hospitalization. Still, some parents wonder if their children should get it. For those still on the fence, Dr. Harris points out that the environment where kids spend their days automatically puts them at a higher risk of getting sick.

"Children spend most of the day in a mass setting," Dr. Harris says. "They are in school, they are in camp, they are in social teams, and their ability to participate in other behaviors that minimize risks of infections is limited by the fact that we put them in a condition that they are in amongst lots of other kids who can potentially transmit a virus. I'm a parent of three kids, and they've gotten sick a dozen times because other kids come to school sick."

Some parents worry that giving too many vaccines in a short window can overwhelm a child's natural immune system. However, current data does not support that claim. The AAP notes kids are constantly exposed to germs, called antigens, and in a typical day, might be fighting off between 2,000 and 6,000 antigens. The AAP also says a child fights off under 150 antigens in the entire vaccine schedule combined. In short, kids' immune systems are not overwhelmed by vaccines, and it is safe to add the COVID vaccine to the current recommended vaccine schedule.

Children as young as 6 months can receive either the Pfizer-BioNTech or Moderna vaccines. They recommend that all children receive the vaccine even if they have already been infected with COVID. When it comes to boosters, there are different recommendations depending on whether your child has had the Pfizer or Moderna primary series. You can always check the CDC's website or with your child's pediatrician for the most up-to-date guidance on booster shots.

To learn more about up-to-date data on COVID-19, and the science and safety of vaccines, including the COVID-19 vaccine, visit the CDC website.

Related: COVID-19 Vaccines and Myocarditis: What Parents Need to Know About the Potential Link

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