May 30, 2025 – On May 29, the CDC revised its COVID-19 vaccine recommendations for children, shifting from a universal recommendation to a "shared clinical decision-making" approach, leaving the decision to families and their health care providers. This update followed an announcement earlier this week by Health and Human Services Secretary Robert F. Kennedy Jr. that the agency would stop recommending COVID vaccines for healthy children.
What does all of this mean for your child? We asked Paul A. Offit, MD, director of the Vaccine Education Center and a pediatric infectious disease specialist at Children’s Hospital of Philadelphia, for guidance.
Q: Are kids still getting sick from COVID?
A: Yes. Young children, particularly those between 6 months and 5 years old, are more vulnerable because any COVID antibodies passed from the mother during pregnancy typically fade by 6 months of age, said Offit. That’s why vaccination was previously recommended starting at 6 months.
Today, vaccination rates among children remain low, leaving many about as vulnerable to COVID-19 as they were early in the pandemic. "If you look at the number of children who are dying now at less than 5 years of age, it’s just about the same as before we had a vaccine because they're not vaccinated," he said. "The pandemic is over, but the virus isn't finished with us yet, and won't be, probably for decades, if not centuries."
Q: Are healthy kids safe from COVID?
A: Not necessarily. While severe illness is less common in kids than in adults, healthy children can be hospitalized or die from COVID. "Over the past year, 150 children have died from COVID," said Offit. Of those pediatric deaths, 40% were in kids with no other conditions. Among children and adolescents hospitalized with COVID and eligible to receive the shot, the vast majority – 95% – had not received the most recent COVID vaccination, CDC data shows.
Q: My child has received multiple COVID shots. Are yearly boosters necessary?
A: That’s a conversation to have with their doctor, Offit said. "The goal of the vaccine is to keep people from being hospitalized or going to the ICU or dying if you've been appropriately vaccinated."
Here’s what that means for a child who is fully vaccinated (which typically means two shots, depending on the vaccine maker):
- If the child has risk factors for severe illness – such as obesity, asthma, or diseases of the heart and blood vessels – then your doctor may recommend yearly boosters.
- If your child has no risk factors, a booster is "low risk, low reward," Offit said. "You buy yourself four to six months of protection against mild to moderate infection." Moderate infection means the child would have symptoms and need to stay home from school for a few days but not need a hospital stay.
Q: What about side effects? Are the risks worth the benefits for kids?
A: "The mRNA vaccines are remarkably safe," said Offit. The most common side effects, like headache, fever, and fatigue, tend to be mild and brief.
One of the most publicized adverse reactions to the COVID shot is myocarditis, or heart inflammation. It’s rare, happening in 1 to 4 out of every 100,000 people, and occurs most often in 16- to 29-year-old males, usually within four days of the second dose. Typically, it clears up on its own without long-term complications, he said. "These days, you don't see that side effect nearly as much as you did before," said Offit, perhaps because young men’s immune systems are less naive to the virus, compared to when the vaccine first came out. Developing myocarditis from a COVID infection, however, is more common and more dangerous, said Offit. Research suggests that those who develop myocarditis from the vaccine, versus from COVID and other causes, may be less likely to have complications.
Q: Can kids get long COVID, and would vaccination help?
A: Yes, and yes. New research published in JAMA Pediatrics found that 14% of infants and toddlers infected with COVID got long COVID, defined as an illness lasting three or more months after infection and marked by symptoms like trouble sleeping, fussiness, a poor appetite, a stuffy nose, and coughing. About 15% of preschool-age children developed long COVID with symptoms like a dry cough, daytime sleepiness, and low energy. Older kids can get long COVID, too.
"You don't have to be in a high-risk group when you get COVID to suffer long COVID," said Offit. Vaccines help reduce the risk of long COVID in kids by about 42%.
Q: Will health insurance still cover COVID vaccines for all kids?
Yes, it appears that they will. The CDC’s revised recommendations are what they call "shared clinical decision-making," which means health insurers will still be required to cover the COVID shots for children.
Q: What’s the bottom line?
"It's an easy decision," said Offit. "You should vaccinate your child against COVID." Once your child has had the primary series of shots, ask your doctor whether they recommend boosters.
