The American Academy of Pediatrics on Aug. 19 released its annual immunization schedule recommending that all children aged six to 23 months receive a Covid-19 vaccine, regardless of previous infection or shots, and that children two and older be immunised if they have underlying conditions that heighten the risk of severe disease. The guidance marks the first substantive break with federal vaccine policy in three decades; since 1995 the 65,000-member physicians’ group has largely mirrored recommendations issued by the Centers for Disease Control and Prevention. The CDC, now overseen by Health and Human Services Secretary Robert F. Kennedy Jr., shifted in May to a “shared clinical decision-making” model that stops short of advising Covid shots for healthy children of any age. AAP President Dr. Susan J. Kressly said infants and toddlers remain the paediatric population most likely to experience serious outcomes from the virus and “deserve clear, evidence-based protection.” HHS spokesperson Andrew Nixon criticised the academy for “undermining national immunisation policymaking,” alleging the group is influenced by pharmaceutical donors. The AAP denied any conflict of interest and said its schedule is rooted in peer-reviewed data. Because insurers typically defer to the CDC’s Advisory Committee on Immunization Practices—whose 17 original members were dismissed by Kennedy in June—the divergence could complicate reimbursement for families that follow the academy’s advice. Paediatricians now face the task of reconciling conflicting guidance for parents at a time when public confidence in vaccines is already strained. The split underscores growing tension between professional medical organisations and a federal health apparatus that has reoriented vaccine policy since the change in administration.