Yes, the COVID-19 vaccine is listed on the CDC’s recommended childhood immunization schedule. It appears on both the birth-to-15-months and 18-months-to-18-years portions of the schedule. However, it carries an important distinction: the recommendation is based on individual decision-making (what the CDC calls “shared clinical decision-making”), and no state requires it for school entry.
What “On the Schedule” Actually Means
Being on the CDC’s childhood immunization schedule does not automatically mean a vaccine is required for school. The schedule is a set of recommendations developed by the Advisory Committee on Immunization Practices (ACIP), which advises the CDC. States and local jurisdictions, not the federal government, decide which vaccines children must have to attend school or daycare. Many states use the ACIP recommendations as a starting point when writing their own requirements, but they are not bound by them.
As of now, no state requires the COVID-19 vaccine for school entry. That makes it different from vaccines like MMR or polio, which are mandated in all 50 states with varying exemption policies.
How the Recommendation Works
ACIP unanimously recommended that COVID-19 vaccination be determined through individual decision-making for everyone six months and older. In practice, this means the vaccine is available and recommended as an option, but it’s framed as a conversation between families and their healthcare providers rather than a blanket directive. ACIP noted that the risk-benefit balance is most favorable for people at increased risk of severe COVID-19 and less pronounced for those who are not.
Recommended Doses by Age
The 2025–2026 guidance breaks down differently depending on a child’s age and vaccination history.
Children aged 6 to 23 months who have never been vaccinated need two doses of Moderna, spaced 4 to 8 weeks apart. Kids who started a series but didn’t finish it need one or two doses depending on what they’ve already received. Those who completed an earlier series need just one updated dose, given at least 8 weeks after their last shot.
For children aged 2 to 4, the schedule simplifies: one dose of Moderna whether or not they’ve been vaccinated before (with at least 8 weeks after any previous dose). Children 5 to 11 can receive either Moderna or Pfizer-BioNTech, again as a single dose. Starting at age 12, Novavax becomes an additional option alongside Moderna and Pfizer-BioNTech.
How Well It Works in Children
A CDC study covering August 2024 through September 2025 measured how well the updated vaccines protected children against COVID-19 serious enough to send them to an emergency department or urgent care. Among children aged 9 months to 4 years, vaccine effectiveness was 76% during the first six months after vaccination. For kids and teens aged 5 to 17, effectiveness was lower at 56% over the same period. Hospitalization-specific numbers weren’t available because COVID-related hospital visits in children were too infrequent during the study period to produce reliable estimates.
Myocarditis Risk: Vaccine vs. Infection
One of the most common safety concerns parents raise is myocarditis, an inflammation of the heart muscle. A large study published in The BMJ compared the risk in children and young people after vaccination versus after COVID-19 infection itself. Over a six-month period, COVID-19 infection led to roughly 2.24 extra cases of myocarditis or pericarditis per 100,000 children, while vaccination led to about 0.85 extra cases per 100,000. Both risks were small in absolute terms, but infection carried about 2.5 times the risk.
The timing also differed. After vaccination, the slightly elevated risk appeared within the first four weeks and then returned to baseline. After infection, the spike in risk was concentrated in the first week and was more pronounced, with roughly a 3.5-fold increase compared to uninfected children.
Cost and Access
The Vaccines for Children (VFC) program covers COVID-19 vaccines at no cost for children under 19 who are uninsured, enrolled in Medicaid, or are American Indian or Alaska Native. Underinsured children also qualify. Providers participating in VFC cannot charge for vaccines supplied through the program. For children with private insurance, the vaccine is typically covered without a copay, though specifics vary by plan.