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Baby vaccine schedule, explained (AAP and CDC, 2026)

The short answer

Checked 11 November 2026. US vaccine policy is changing. We’ll update this page when it does.

  • For babies, the AAP and CDC schedules match on almost every vaccine right now. In March 2026, a federal court paused the CDC’s January 2026 schedule changes, so the CDC’s 2025 schedule is still the one in effect [1][2].
  • The main difference in force is COVID-19 for babies 6 to 23 months. The AAP recommends it for all of them. The CDC leaves it to a shared decision between you and your doctor, unless your child is immunocompromised [3][4].
  • Insurance still covers the vaccines on the CDC schedule with no cost-sharing (no copay, coinsurance or deductible) under most plans [2]. Insurers have pledged to keep covering them through the end of 2027 [5][6].
  • Late is better than never. A missed dose doesn’t mean starting over [3].
  • Some vaccines in pregnancy protect your baby from birth: whooping cough (Tdap) and RSV [7][8].

The schedule, birth to 2

This is the AAP’s 2026 schedule [3]. Where the CDC schedule in effect says something different, the last column says so. Your pediatrician may combine some shots, which can change the number of doses a little [3].

Vaccine Protects against Doses (AAP 2026) CDC in effect
RSV antibody (nirsevimab or clesrovimab) RSV, the leading cause of hospital stays for babies in the US [8] 1 dose before or during a baby’s first RSV season, unless the birthing parent had the RSV vaccine at least 14 days before birth. Babies born October to March get it within a week of birth [3] Same, but the CDC schedule lists nirsevimab only [2]. Both also give one dose of nirsevimab before the second RSV season (age 8 to 19 months) to some high-risk children. The AAP’s list of who qualifies is broader [2][3]
Hepatitis B A liver infection Birth (within 24 hours, if medically stable), 1 to 2 months, 6 to 18 months [3] Same [2]
Rotavirus A severe diarrhea virus 2 and 4 months, or 2, 4 and 6 months, depending on the brand. Must start before 15 weeks of age [3] Same [2]
DTaP Diphtheria, tetanus, whooping cough 2, 4, 6 and 15 to 18 months [3] Same [2]
Hib A cause of meningitis 2, 4 and 6 months (or 2 and 4, by brand), then 12 to 15 months [3] Same [2]
Pneumococcal (PCV) Pneumonia, meningitis, blood infections 2, 4, 6 and 12 to 15 months [3] Same [2]
Polio (IPV) Polio 2 months, 4 months, 6 to 18 months [3] Same [2]
Flu Influenza Every year from 6 months. 2 doses, 4 weeks apart, the first time [3] Same [2][9]
COVID-19 COVID-19 Routine for all babies 6 to 23 months [3] Shared decision with your doctor, unless immunocompromised [4]
MMR Measles, mumps, rubella 12 to 15 months [3] Same [2]
Chickenpox (varicella) Chickenpox 12 to 15 months. The AAP has no preference between separate shots and the combined MMRV shot [3] Recommends separate MMR and chickenpox shots for the first dose, though the combined shot may be used if parents prefer [2]. The combined first dose carries a rare extra chance of a fever-related seizure 1 to 2 weeks later [3]
Hepatitis A A liver infection 2 doses between 12 and 23 months, 6 months apart [3] Same [2]

Second doses of MMR and chickenpox, and more DTaP and polio doses, come at 4 to 6 years [3].

What changed in 2026, and what’s in effect

US vaccine recommendations have been through a lot of change. Here is the state of it as of 11 November 2026:

  • January 2026: the CDC published a new childhood schedule. It moved several vaccines, including rotavirus, flu, hepatitis A and hepatitis B, from “recommended for all children” to “shared decision-making” or “high-risk only” [1][2].
  • March 2026: in a case brought by the AAP and others, a federal court paused (stayed) that schedule, the appointments of 13 members of the CDC’s vaccine advisory committee, and that committee’s votes, including its December 2025 vote on the hepatitis B birth dose [1].
  • Since then: the government appealed only the part about the committee appointments. Its brief to the appeals court says “the pre-January 5 immunization schedule remains in effect” [10]. The appeal was argued in October 2026, with no decision yet [10].
  • Still in effect: a separate May 2025 change. The CDC no longer routinely recommends COVID-19 vaccines for healthy children, or in pregnancy. The court didn’t block that change [1][4].
  • What may come next: executive orders in May and August 2026 back the January categories as federal policy, and the CDC is taking nominations for members of its vaccine advisory committee until 31 December 2026 [11][12]. The CDC schedule could change again in 2027.

If this feels confusing, you’re not alone. Your pediatrician is the right person to talk it through with.

What insurance covers

  • The law: most private health plans must cover vaccines recommended by the CDC’s advisory committee, with no cost-sharing [2]. Because the January 2026 changes are paused, that still means the 2025 schedule [2].
  • The pledge: the insurers’ trade group, AHIP, has pledged that its members will keep covering these vaccines with no cost-sharing through the end of 2027 [5][6]. It’s a voluntary promise, not a law.
  • The administration: a May 2026 executive order says every vaccine on the schedule, in any category, “should continue to be covered without cost sharing,” including by Medicaid, CHIP and the Vaccines for Children program [11].
  • Vaccines for Children (VFC) gives free vaccines to children 18 and under who are uninsured, eligible for Medicaid, or American Indian or Alaska Native. Children whose insurance doesn’t cover vaccines can also get them free at community health centers and rural health clinics [2][13]. VFC coverage wasn’t changed by the January schedule [2].
  • Some states go further. As of August 2026, 15 states base insurers’ required vaccine coverage on something other than the current federal advisory committee. Ten of them point to medical groups such as the AAP [14].

Before a visit, you can call your plan and ask: “Is this vaccine covered with no cost-sharing for my child?”

In pregnancy: vaccines that protect your baby

Vaccine When Why
Tdap (whooping cough) Every pregnancy, between 27 and 36 weeks, ideally early in that window [7][15] Your antibodies pass to your baby before birth, protecting them before they can have their own shots [16]
RSV (Abrysvo) Once, at 32 to 36 weeks, in RSV season. The CDC says September to January. ACOG and the AAP say September 1 to March 1 for 2026–27 [3][8][17] It protects your baby from birth. If you have it at least 14 days before birth, your baby usually doesn’t need the antibody shot [3]
Flu Any time in pregnancy, in flu season [9][15] Protects you, and your baby in their first months
COVID-19 ACOG recommends it in any trimester. The CDC has no recommendation for pregnancy since May 2025 [15][18] Ask your provider

For people around your baby

The CDC recommends that parents, siblings, grandparents, babysitters and other caregivers be up to date on whooping cough vaccines, and get a flu vaccine each season. Anyone who needs either should get it at least 2 weeks before meeting the baby, because that’s how long protection takes to build [16]. Adults who’ve already had a Tdap booster don’t need another one for this [16]. More in visitors and family boundaries.

Late or missed doses

A vaccine series doesn’t need to be restarted, however long it’s been between doses [3]. Your pediatrician will catch your baby up at the next visit. The exception is rotavirus: it can’t be started on or after 15 weeks of age, and the last dose must be given by 8 months [3].

After the shots

Common and usually mild: soreness or swelling where the shot went in, for 3 to 5 days (up to 7 after DTaP); fever, usually starting within 24 hours and lasting 1 to 2 days; and fussiness [19][20]. A mild rash can show up 6 to 12 days after MMR, or 1 to 4 weeks after chickenpox vaccine [20].

What helps: a cool, damp cloth on the spot, extra feeds (only breast milk or formula under 6 months), and cuddles [19][20]. Ask your pediatrician about a pain reliever and the dose for your baby’s weight. Never give aspirin [19].

Call 911 for trouble breathing or swallowing, a baby who is very weak or not moving, or can’t be woken [20].

Go to the ER now if your baby is hard to wake up [20].

Get seen now for any fever in a baby under 12 weeks old (don’t give fever medicine before they’re seen), a fever over 104°F (40°C), crying nonstop for more than 3 hours, vomiting or severe crying after the rotavirus vaccine, or a baby who looks or acts very sick [20].

Call within 24 hours if a fever lasts more than 3 days or comes back after a day without one, or if redness around the shot is getting bigger and more painful after 3 days [20]. Call any time something worries you [19].

Two safety systems, in one line each

  • VAERS, run by the CDC and FDA, collects reports of health problems after vaccination, from anyone. It’s an early warning system, and a report doesn’t mean the vaccine caused the problem [21].
  • The Vaccine Injury Compensation Program (VICP) is a no-fault way to seek compensation for an injury from most childhood vaccines. COVID-19 vaccine claims go through a separate program [3].

Sources

  1. US District Court, D. Massachusetts, American Academy of Pediatrics v. Kennedy, No. 1:25-cv-11916-BEM, Memorandum and Order (16 March 2026). courthousenews.com
  2. Congressional Research Service, “The 2026 Childhood Immunization Schedule” (R48982, 11 June 2026), and CDC, “Child and Adolescent Immunization Schedule Notes” (2025). congress.gov · cdc.gov
  3. American Academy of Pediatrics, “Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2026” (updated 2 September 2026). aap.org
  4. CDC, “Overview of COVID-19 Vaccines and Vaccination” (updated 23 September 2026). cdc.gov
  5. CIDRAP Vaccine Integrity Project, “Federal Vaccine Action Timeline” (AHIP coverage pledge extended through 2027, 27 May 2026). cidrap.umn.edu
  6. AHIP, “AHIP Statement on Vaccine Coverage” (published 16 September 2025, updated May 2026). ahip.org
  7. CDC, “Pertussis Vaccine Recommendations.” cdc.gov
  8. CDC, “RSV Immunization: Protecting Infants.” cdc.gov
  9. CDC, “Who Needs a Flu Vaccine.” cdc.gov
  10. US Department of Justice, Brief for Federal Defendants-Appellants, AAP v. Kennedy, 1st Cir. No. 26-1503 (18 June 2026), and The Hill, “Appeals court wrestles with block of RFK Jr.’s vaccine panel appointments” (6 October 2026). courthousenews.com · thehill.com
  11. Executive Order 14407 (29 May 2026) and Executive Order 14420 (10 August 2026), Federal Register. federalregister.gov · federalregister.gov
  12. CDC, “Solicitation of Nominations for Appointment to the Advisory Committee on Immunization Practices” (30 October 2026). federalregister.gov
  13. CDC, “Vaccines for Children (VFC) Program Eligibility” (27 August 2026). cdc.gov
  14. KFF, “State Requirements for Private Insurance Coverage of Vaccines” (as of 3 August 2026). kff.org
  15. American College of Obstetricians and Gynecologists, “2026 Maternal Immunization Schedule” (10 June 2026), and CDC, “Vaccination Guidelines for Pregnancy.” cmss.org · cdc.gov
  16. CDC, “Vaccines for Family and Caregivers.” cdc.gov
  17. American Academy of Family Physicians, “Respiratory syncytial virus: 2026-27 recommendations.” aafp.org
  18. STAT, “OB-GYN association, deviating from CDC guidance, issues its own vaccine recommendations” (10 June 2026). statnews.com
  19. CDC, “Before, During, and After Shots.” cdc.gov
  20. HealthyChildren.org (AAP), “Immunization Reactions” symptom checker. healthychildren.org
  21. Vaccine Adverse Event Reporting System (CDC and FDA), “About VAERS.” vaers.hhs.gov

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