The Centers for Disease Control and Prevention will no longer advise that healthy children receive routine Covid shots, a significant departure from its previous approach of suggesting annual shots for everyone age 6 months and older.
Health Secretary Robert F. Kennedy Jr. announced the change on X on Tuesday, citing a lack of data to support shots for healthy children. The move echoes Mr. Kennedy’s longstanding skepticism about the need to vaccinate children against the virus, and comes less than a week after the Food and Drug Administration said it may require additional testing before allowing Covid shots to be used for younger, healthy Americans. Mr. Kennedy, who as health secretary oversees both the C.D.C. and the F.D.A., has repeatedly said that children are at almost no risk from Covid.
It’s true that for many children, a case of Covid will be inconsequential. They might have a runny nose, a cough or other mild symptoms, if any at all, and bounce back within a few days. But some children do become seriously ill and, in rare cases, die from their infections. And data shows that over one million U.S. children have developed long Covid.
That discrepancy is at the root of a continuing debate among medical researchers about just how much of a risk Covid poses to children, and whether they should receive annual vaccines against it.
Many agree that the original course of vaccination offered significant protection against serious illness in children. Data from the Centers for Disease Control and Prevention shows that two or more doses of Covid vaccines were 40 percent effective at preventing emergency room visits and hospitalizations among children under the age of 5. The agency has for years recommended Covid vaccines for everyone 6 months or older, and the American Academy of Pediatrics also recommends vaccinating children and adolescents.
But the question of whether children need annual vaccines to protect against the latest circulating variants is more contentious. Children might not benefit as much as adults would from a yearly shot because their immune systems can remember vaccinations for much longer, said Dr. Michael Mina, a former professor of epidemiology at the Harvard T.H. Chan School of Public Health who has extensively studied Covid. Another argument against annual shots is that most children in the United States now have some degree of protection from previous infections or vaccinations.
Those in favor of annual vaccines for children stress that protection from vaccines or infections wanes over time, especially as new variants emerge, and so they can benefit from another dose. And emerging evidence shows that vaccination may protect against long Covid — although that is far from settled science.
“We know that Covid’s still out there — we can prevent it, and the vaccine has got no appreciable side effects,” said Dr. Chris Forrest, a professor of pediatrics at Children’s Hospital of Philadelphia. “So I think it’s a totally positive value proposition.”
This added protection may be especially important for children with underlying conditions, and for those who live with relatives who are older or at high risk of severe illness.
“The more comorbid illnesses the child has, the quicker I would be in general to consider Covid vaccination,” said Dr. Aaron Glatt, the chair of the department of medicine at Mount Sinai South Nassau in Oceanside, N.Y. “And the reverse would be true. A perfectly healthy 3-year old, he doesn’t have any medical problems, he’s had Covid once or twice — I’m not sure that there’s any scientific data to support vaccination.”
But, he added, “it doesn’t mean that it would be wrong or dangerous to give it.”
Ultimately, doctors said, the question comes down to how families make sense of the risk to their children. Here’s what the data shows.
How mild is Covid usually for children?
It is difficult to get good data on what share of pediatric cases are mild, but doctors say most children develop few symptoms.
Some of the best information on children we have is from 2020, before children had built up widespread immunity from vaccination or infections. A review of studies from that year found that around 4 percent of children with Covid worldwide developed severe symptoms, which can include difficulty breathing, high fever and chest pain.
How likely is it that children will be hospitalized with or die from Covid?
Children who have Covid are generally at a low risk for hospitalization. About 234,000 children in the United States were hospitalized with infections between September 2020 and April 2024. Though the virus has led to milder disease over time, children and teenagers still accounted for about 4 percent of hospitalizations related to Covid between October 2024 and March 2025.
The risk is higher for babies younger than 6 months. From October 2022 to April 2024, young infants were more likely to be hospitalized than any other age group apart from adults 75 and older.
Pediatric Covid deaths are very rare. Provisional data from the C.D.C. shows over 1800 children in the United States have died from Covid. Unicef has said that more than 17,400 children and adolescents under 20 years old around the globe have died from Covid.
Are only children with underlying health conditions falling seriously ill?
In an April appearance on Fox News, Mr. Kennedy said that some children with “very profound morbidities may have a slight risk” from Covid, but that “most kids don’t.”
But C.D.C. data from July 2023 to March 2024 found that half of children who were hospitalized because of Covid had no underlying medical conditions.
It is true that underlying health conditions like obesity, diabetes, heart disease and chronic lung diseases raise the risk of hospitalization. Children with these and other conditions will still be able to be vaccinated.
But the increase in risk isn’t small. Research has shown that young people with at least one underlying condition are 28 percent more likely than those with no underlying conditions to end up in critical care with Covid, and are 125 percent more likely to die from it. The more underlying conditions a child has, the greater the risk.
On a recent episode of “Dr. Phil Primetime,” Mr. Kennedy claimed that people who died from Covid “were so sick that they were basically hanging from a cliff, and Covid came along and stamped on their fingers and dropped them off.”
Doctors noted that just because children had underlying conditions did not mean they were in extremely poor health before they were infected.
“That’s totally a not correct assessment, that it was only children who otherwise were going to die, and it just took them out,” said Dr. Sarah Long, a professor of pediatrics at Drexel University College of Medicine who has advised the C.D.C. and F.D.A.
And despite Mr. Kennedy’s claim during an event last year that there isn’t “a single healthy kid who died from Covid,” even children without pre-existing health issues have become seriously sick or, in rare cases, have died. A review of data on 183 pediatric Covid deaths from 2020 to 2022 found that 32 percent of children who died did not have another medical condition.
Does vaccinating pregnant women protect infants?
Mr. Kennedy also announced on Tuesday that the C.D.C. will no longer recommend healthy pregnant women be vaccinated against Covid. Pregnant women are at a far higher risk of severe disease from Covid.
Vaccinating pregnant women also reduces the risk that their infants will be hospitalized from Covid. Babies under six months are at higher risk of hospitalization from Covid, in part because their immune systems are so fragile, and they are not able to be vaccinated.
What about the risk of myocarditis?
Mr. Kennedy has claimed that Covid vaccines have “huge associations” with types of heart inflammation, called myocarditis or pericarditis. The shots have been linked to this issue in rare cases, particularly among adolescent boys. Most instances of myocarditis associated with vaccines have been mild. One analysis of nearly four million people who received booster shots found 28 instances of probable or confirmed myocarditis, all of which resolved quickly.
Covid-19 vaccinescarry note the minor risk of heart inflammation to young men on their warning labels. Last month, the F.D.A. told Pfizer and Moderna to broaden that warning to include boys between the ages 16 and 25, citing data that showed about 38 cases of heart inflammation per million doses among this age group.
Research has consistently shown that the virus itself is far more likely to cause this inflammation. One review found that the risk of myocarditis after infection was more than seven times greater than the risk after vaccination.
What’s the risk of long Covid?
Estimates of long Covid among children vary widely. But even at the lower end, studies show that around 1 percent of children in the United States, or roughly one million children, have ever had long Covid, broadly defined as symptoms that persist or emerge at least three months after an infection. These include many children who had mild or asymptomatic infections.
The condition commonly causes children to experience fatigue, dizziness, shortness of breath and trouble concentrating and sleeping.
“We see kids that are having huge impacts on their everyday activities — they can no longer go to school because they’re having such profound fatigue or other symptoms,” said Dr. Laura Malone, the director of the Pediatric Post-Covid-19 Rehabilitation Clinic at the Kennedy Krieger Institute. “These kids are not able to play sports or go to their school dances,” she added.
Dani Blum is a health reporter for The Times.
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