The American Academy of Pediatrics on Tuesday released its annual childhood immunization schedule recommending that all children aged six to 23 months receive a Covid-19 vaccine and that older children be inoculated if they are at high risk of severe disease or live with vulnerable individuals. The guidance, which also covers RSV and flu shots, is the academy’s first substantial departure from federal vaccine policy in three decades. The advice conflicts with current federal recommendations issued under Health Secretary Robert F. Kennedy Jr., whose department in May dropped routine Covid vaccination for healthy children and shifted the decision to a “shared clinical” model. Dr. Susan J. Kressly, the academy’s president, said the group’s recommendations are “rooted in science and in the best interest of infants, children and adolescents,” while an HHS spokesperson accused the AAP of undermining national immunization policymaking. The divergence could complicate insurance coverage: many payers and the federally funded Vaccines for Children program typically follow guidance from the CDC’s Advisory Committee on Immunization Practices, which has yet to vote on Covid shots for kids. Pediatricians now face the task of explaining conflicting advice to parents as public confidence in childhood vaccinations remains fragile.