The American Academy of Pediatrics issued new immunisation guidance on 19 August that for the first time in three decades diverges substantially from federal recommendations. The group “strongly recommends” COVID-19 vaccination for children aged six to 23 months and advises shots for older children at parental discretion or when underlying conditions raise risk. AAP president Dr. Susan J. Kressly said the advice reflects “decades of peer-reviewed science” demonstrating the benefit of early protection against severe disease. The CDC, operating under Health Secretary Robert F. Kennedy Jr., currently does not recommend COVID-19 vaccination for healthy children of any age, instead leaving the decision to families in consultation with physicians. Federal officials responded sharply. HHS communications director Andrew Nixon accused the paediatric society of allowing “financial influence” from vaccine manufacturers, while Kennedy posted that the AAP was “angry” because the CDC had removed what he called corporate sway over its advisory process. AAP leaders countered that the organisation maintains conflict-of-interest safeguards and invited the administration to discuss restoring its seat on federal vaccine panels. The policy clash comes amid a broader restructuring of the nation’s public-health apparatus. On 22 August, the CDC confirmed roughly 600 job cuts—part of a previously announced plan by HHS to eliminate about 2,400 positions at the agency and 10,000 across HHS. The American Federation of Government Employees said many of the affected staff worked in violence-prevention and infectious-disease units and had only recently returned to CDC headquarters after an 8 August shooting at the Atlanta campus. HHS maintains the reductions will save an estimated $1.8 billion annually and refocus resources on chronic-disease prevention. Public-health experts warn the simultaneous staff reductions and split vaccine messaging risk confusing parents and weakening outbreak preparedness. Dr. James Campbell, a University of Maryland infectious-disease specialist who serves on the AAP committee that drafted the guidance, said infants remain at comparatively high risk for hospitalisation from COVID-19 and that clear, consistent communication is critical ahead of the autumn respiratory-virus season.