Evidence points to benefits for expanded groups of high-risk children as they enter their second season of RSV
ITASCA, IL—New guidance from the American Academy of Pediatrics expands the categories of high-risk children eligible for immunization against respiratory syncytial virus (RSV), a leading cause of hospitalization among young children.
The AAP continues to recommend RSV immunization for all infants under 8 months of age born during or entering their first RSV season, unless the infant has documented protection from vaccination of their pregnant parent. The AAP expands the high-risk criteria for administration of RSV immunization in infants and children ages 8 months-19 months entering their second RSV season, as well, according to AAP.
“The evidence is clear: these products work very well to prevent RSV and keep infants out of the hospital,” said Sean T. O’Leary, MD, MPH, FAAP, who chairs the RSV immunization subgroup of the AAP Committee on Infectious Diseases. “We’re already seeing real-world impact.”
The policy statement, “Recommendations for the Prevention of RSV Disease in Infants and Children,” will be published in the November 2026 Pediatrics (published online at 6 a.m. CT Sept. 2). The AAP will also publish a policy statement, “Recommendations for COVID-19 Vaccines in Infants, Children, and Adolescents, 2026-2027” on the same day.
All policy statements are written by medical experts, reflect the latest evidence in the field, and undergo several rounds of peer review before being approved by the AAP Board of Directors. and published in Pediatrics.
Respiratory syncytial virus spreads easily through the air and through physical contact, and infects the nose, throat, and lungs. While it causes mild, cold-like symptoms in most people, it is common and can lead to severe lung infections like bronchiolitis or pneumonia in babies. It has been the leading cause of infant hospitalization in the United States and causes about 50,000 to 80,000 hospitalizations each year in children under 5 years, according to Centers for Disease Control and Prevention data.
The AAP’s updated second season recommendations are for children ages 8 through 19 months who are at high risk for severe disease. These include:
Nirsevimab and the RSVPreF vaccine for pregnant people became available in the 2023-’24 season. Another product, Clesrovimab, was licensed last summer.
The AAP also released its guidance on COVID-19 with a policy statement and technical report published online at 6 a.m. CT Sept. 2 and in the November 2026 Pediatrics. The AAP recommends all infants and children 6 through 23 months of age receive 2026–2027 COVID-19 vaccine. The AAP recommends a single dose of age-appropriate 2026–2027 COVID-19 vaccine for all children and adolescents 2 through 18 years of age at increased risk of severe disease, regardless of prior COVID-19 vaccination status.
The vaccine should also be available to those ages 2-18 who are not considered at increased risk but whose parent or guardian desires their protection from COVID-19. Any available COVID-19 vaccine appropriate by age and health status can be administered and the most updated version of the COVID-19 vaccine that is available should be used.
The RSV and COVID-19 policies complete the AAP recommendations for the fall respiratory virus season. AAP recently published guidance on influenza prevention with a policy statement Recommendations for Prevention and Control of Influenza in Children, 2026–2027 and technical report.
The updated 2026 immunization schedule also expands the age indication for the meningococcal ACWY conjugate vaccine MenQuadfi for children as young as 6 weeks, down from 2 years. The Food and Drug Administration approved lowering the age following clinical trials and the AAP Committee on Infectious Diseases voted to update its recommendation after reviewing the data.
“Talk with your pediatrician if you have any questions,” Dr. O’Leary said.
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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.