COVID-19 vaccines for kids are mired in uncertainty amid conflicting federal guidance

It's August, and parents and caregivers are frantically preparing their kids for a new school year by buying supplies, filling out forms and meeting teachers. This year, many parents also face a question that's more complicated than usual: Should my child get an updated COVID-19 vaccine, and will I even have that choice? For some, that decision may have already been made by chaotic federal policy, just as COVID-19 cases are rising nationwide.

As a pediatrician and researcher who studies vaccine delivery and health policy, I am hearing uncertainty from both parents and health care providers. If that describes you, you are not alone. A poll published Aug. 1, 2025, by the health policy organization KFF found half of parents are unsure whether federal health agencies are recommending COVID-19 vaccines for healthy children this fall.

The process that normally provides clear, consistent recommendations and ensures availability for vaccines before respiratory virus season has been upended, and this year's COVID-19 vaccine guidance for children is a prime example.

How the process typically works

For over two decades, there was a predictable, well-coordinated process to ensure recommended seasonal vaccines, such as the flu shot, were available for anyone who wanted them by early fall. In recent years, COVID-19 vaccines have been incorporated into this same annual cycle.

Beginning in February, the Food and Drug Administration, including its independent committee of experts, reviewed data and approved the optimal formulation. After FDA approval, the Advisory Committee on Immunization Practices, or ACIP, an independent panel of experts that advises the Centers for Disease Control and Prevention, reviewed the evidence in public meetings and issued clear recommendations.

The U.S. has long followed an established set of steps lining up vaccines for any given year.

Manufacturers then scaled up production; insurers confirmed coverage, which is tied to the advisory committee's recommendations; and doses were distributed nationwide so vaccines would be available in clinics and pharmacies before the leaves started turning. This usual series of steps ensured that guidance incorporated input from scientists, epidemiologists, public health experts, clinicians, manufacturers, insurers and consumers. It also fostered trust among health care providers and, in turn, provided parents with clarity and confidence when making decisions.

Related: 'These decisions were completely reckless': Funding cuts to mRNA vaccines will make America more vulnerable to pandemics

What's different this year

Since Robert F. Kennedy Jr. took over as secretary of Health and Human Services in February 2025, that usual, tightly choreographed dance has become a chaotic scramble marked by uncertainty and a lack of transparency. Decisions about vaccine guidance have been made through internal channels without the same level of public discussion, review of the evidence or broad stakeholder input.

In May 2025, Kennedy and FDA leadership bypassed the agency's independent review committee and announced that some COVID-19 vaccines would be approved only for children with high-risk conditions. One formulation has yet to be FDA-approved for children at all. The secretary first announced updated recommendations for children on X, stating COVID-19 vaccines would no longer be recommended for healthy children. Shortly after, the CDC posted guidelines that differed from that announcement and said healthy children "may" receive them. Meanwhile, the Advisory Committee on Immunization Practices was disbanded by Kennedy and replaced with a smaller, hand-picked panel that operates with less transparency and has yet to weigh in on COVID-19 vaccines for children.

Public messaging has added to the confusion. Statements from newly appointed federal health leaders have questioned the safety of COVID-19 vaccines and the long-standing processes for ensuring their safety. Funding for mRNA technology, which supports several COVID-19 vaccines and is being explored for use against other diseases and even some cancers, has been cut. And many of the claims used to justify these actions have been challenged by experts as inaccurate or misleading.

What this means for parents

For parents, the result is uncertainty about whether their children should be vaccinated, when and where the vaccines will be available, whether insurance will cover them, or whether their choice has effectively been made for them by newly appointed health leaders operating outside the guardrails of the normal vetting process. This uncertainty comes at a time when the uptake of COVID-19 vaccines in children is already lower than that of other routine vaccines.

Currently, CDC guidelines say healthy children six months and older "may" receive a COVID-19 vaccine based on shared decision-making with their health care provider. The CDC recommends that children who are moderately or severely immunocompromised receive it. These guidelines differ from FDA approvals and Kennedy's guidelines announced on X, and they have not been reviewed or voted on in an advisory committee on immunization practices meeting.

Parents can start by talking with their child's pediatrician about benefits and potential risks, confirming eligibility and checking on insurance coverage. Pediatricians welcome parents' questions and work tirelessly to provide answers grounded in the best available evidence so families can make truly informed decisions about their child's health.

In some cases, unfortunately, even if parents want the vaccine and their pediatrician agrees, they may not be able to get it due to any number of factors, including local supply shortages, lack of insurance coverage, policies that prevent administration by pharmacists and other health providers without clear federal guidance, or an unwillingness of providers to give it "off-label," meaning in a way that differs from the FDA's official approval. For those parents, their decision has been made for them.

Reducing risks in other ways

Whether or not a child receives an updated COVID-19 vaccine, parents can still take steps to reduce illness, including keeping children home when sick, teaching them cough-and-sneeze hygiene and encouraging frequent hand-washing. The CDC provides national and state data on seasonal respiratory illnesses, including COVID-19, while local public health websites often offer community-level information.

Parents should also remember that the COVID-19 vaccine is not the only thing to consider before school starts. Routine immunizations such as those for measles, mumps and rubella, known as the MMR vaccine; diphtheria, tetanus and pertussis, called DTaP; and influenza are essential for keeping kids healthy and in school. These are widely available for now. This is particularly important, as this year the United States has experienced the highest number of measles cases in decades.

Uncertainty surrounding COVID-19 vaccine recommendations, and potentially other vaccines, may worsen in the coming weeks and months. It is possible parents will continue to see shifting guidance, conflicting statements from federal agencies and reduced access to vaccines in their communities.

In this chaotic environment, parents can look to trusted sources such as their pediatrician or organizations such as the American Academy of Pediatrics, which will continue to provide independent, evidence-based vaccine guidance.

This edited article is republished from The Conversation under a Creative Commons license. Read the original article.