New U.S. guidelines on COVID-19 vaccines for kids shouldn’t impact Canada, expert says

Syringes with Pfizer COVID-19 vaccine shots for children aged 6 months to 4 years old at a University of Washington Medical Center clinic in Seattle, on June 21, 2022. (Ted S. Warren / AP)

Contradicting recommendations in the U.S. on vaccinating young children shouldn’t have an impact on vaccination trends in Canada, according to one expert.

This week, the American Academy of Pediatrics (AAP) released recommendations for children receiving the COVID-19 vaccines, which opposed those made by the U.S. for Centers for Disease Control and Prevention (CDC).

Currently, the CDC only suggests “parents of children ages 6 months to 17 years should discuss the benefits of vaccination with a healthcare provider.” Meanwhile, the AAP recommends that all children aged between six months through 23 months get a COVID-19 vaccine, unless they have known allergies to the vaccine or its ingredients. It also endorses a single dose of the vaccine for children aged two through 18 years if they are at high risk of COVID-19.

“It differs from recent recommendations of the Advisory Committee on Immunization Practices of the CDC, which was overhauled this year and replaced with individuals who have a history of spreading vaccine misinformation,” the AAP said in a news release.

However, one Canadian pediatrician says the situation in the U.S. shouldn’t influence how the vaccine is rolled out to children in Canada.

Dr. Karina Top is a professor of pediatrics at the University of Alberta, as well as a pediatric infectious disease specialist at Edmonton’s Stollery Children’s Hospital. She says when the vaccine first became available in 2021, both the U.S. and Canada strongly recommended it for children 12 years and older, then extended that to children between five to 11 and to children under five.

In January 2025, the Public Health Agency of Canada (PHAC) published guidance from the National Advisory Committee on Immunization (NACI), which included a “systematic consideration of programmatic factors” that curated “evidence-based recommendations” for publicly funded vaccine programs in provinces and territories across the country, the PHAC’s website said.

Currently, the NACI strongly recommends vaccination for both previously vaccinated and unvaccinated children six months or older considered to be at a higher risk for COVID-19, such as those who were immunocompromised or those with chronic lung diseases, PHAC said in a statement to CTVNews.ca Friday.

However, for other children, the recommendation was that vaccination may be considered with the advice of a health-care provider, but it wasn’t universally recommended.

“That recommendation may be similar to the U.S. recommendation now that it may be shared decision making,” Top said in an interview with CTVNews.ca on Tuesday.

Top says now that most children have had the virus, or been vaccinated, COVID-19 isn’t as severe in youth who are otherwise healthy, as it is older adults. It’s also not as severe in children as influenza can be. The yearly flu shot is more broadly recommended for people six months and older.

“We haven’t recommended (the COVID-19 vaccine) as strongly (as the flu shot),” she said.

At this time, PHAC recommends one dose per year for most previously vaccinated children and individuals. However, previously vaccinated children or individuals who are at an increased risk of severe illness due to compromised immune systems and similar conditions should get two vaccine doses in a year, a spokesperson said.

For unvaccinated children between the ages of six months and under five years, the health agency recommends two doses of the latest vaccines with an eight-week interval between doses, with an added dose with a shorter interval of four to eight weeks for those who are immunocompromised.

Unvaccinated children over five years old are recommended one dose of the most recent vaccine available, PHAC said. Children with compromised immunity due to underlying conditions are required to take two doses with a potential third dose for those who are new recipients of a stem cell transplant or CAR-T therapy.

Top said that the recent changes in U.S. CDC recommendations brings it closer in line with recommendations in Canada, the U.K. and Australia, which have also not universally recommended the vaccine. The issue in the U.S., she says, is the way in which that change was made.

“It didn’t follow the typical process (that) the U.S. generally followed to make its vaccine recommendations,” she said, adding that the changes to recommendations were made without consulting the U.S. Advisory Committed on Immunization Practices.

In June, U.S. Health Secretary Robert F. Kennedy Jr. appointed eight new vaccine policy advisers to replace the panel that he had previously fired. These include critics of both the COVID-19 vaccine and pandemic lockdowns.

Top says in the last few years, fewer of her young patients are getting the COVID-19 vaccine and it’s seen as less of a priority.

“Even for children that are considered at high risk, we’re definitely seeing a lower uptake of COVID-19 vaccine than we would like,” she said.

Top recommends the vaccine for children who are at higher risk of complication from COVID-19, including those with compromised immune systems, those who rely on breathing apparatuses, have neurologic conditions like chronic lung disease or weakened immune systems.

“Parents of children who have chronic health conditions should talk to their healthcare provider about whether their child could benefit from the COVID-19 vaccine and how to receive it,” Top says.

With files from CTV News’ Kendra Mangione