CDC Opens Orders for COVID-19 Vaccines in Vaccines for Children

The CDC released its clinical guidance and opened ordering for COVID-19 vaccines to state Vaccines for Children (VFC) programs, nearly a month after the FDA approved the 2026-2027 vaccines.¹

Millions of children who are uninsured, from low-income families, or American Indian or Alaska Native typically can get free vaccines through the program. The move follows a delay in federal action, and availability will be highly variable in each state.¹

Ordering Opens, But Availability Varies

How quickly children can get vaccinated depends in part on how long states take to implement ordering systems, whether initial supplies are limited, and how quickly states distribute the vaccines to clinicians. The CDC's guidance on who should get vaccinated also differs in some cases from guidance issued by the American Academy of Pediatrics (AAP) and from FDA labels.¹

Before the CDC acted, Health and Human Services (HHS) press secretary Grace Davis Jamison said the CDC was finalizing decisions about availability in the VFC program. "HHS and CDC have a responsibility to ensure responsible stewardship of taxpayer resources and that vaccines procured through federally funded programs are appropriate for the populations those programs serve," Jamison said via email to AAP.²

AAP President Andrew D. Racine, MD, PhD, FAAP, said the administration had promised that changes to the federal vaccine process would not interfere with families' ability to access recommended vaccines, "yet that is exactly what is occurring."¹

"Children cannot benefit from vaccines that are delayed or out of reach, and policymakers should be focused on removing obstacles, not creating new ones," Racine said.¹

This is the second consecutive year of delayed access to COVID-19 vaccines for children in VFC because of upheaval among federal health officials. Typically, the CDC's Advisory Committee on Immunization Practices (ACIP) makes recommendations about who should receive COVID-19 vaccines, and the CDC director signs off. However, a federal judge found that ACIP members likely were unlawfully appointed. They have not been replaced, and the group has not met since December 2025.¹

The AAP recommends COVID-19 vaccination for all children aged 6 to 23 months without a contraindication and for high-risk children aged 2 to 18 years. The vaccine also should be available for any child whose parent desires protection from COVID-19.¹

The CDC data cited by AAP News show the cumulative COVID-19 hospitalization rate among infants aged 6 to 11 months during the 2025-2026 season was on par with that of adults aged 65 to 74 years. About 42% of children aged 6 to 23 months hospitalized for COVID-19 from October 2022 to April 2024 had an underlying condition.¹

Flu Vaccine Deliveries Lag in Some States

Flu vaccines for VFC patients also are being delayed or are in short supply in some states, even though the program is carrying them and ordering is open. The reasons for the delays are unclear. The AAP recommends flu vaccination for all children aged 6 months and older.²

Jason Yaun, MD, FAAP, a pediatrician in Memphis, Tennessee, has a clinic with a high number of VFC patients that received VFC flu vaccines about 2 weeks later than usual and is among those receiving only small quantities. The delay has meant turning people away and rescheduling appointments booked in early September.²

Small and unpredictable deliveries also make it difficult to hold large vaccination events, and delays could make it hard for some children, especially those who need 2 doses, to be fully immunized by the end of October.²

"I am concerned many of these families may not have the ability to come back," Yaun said to AAP, "whether that's time off work or missing school or transportation or the resources to get back to see us."²

Pharmacy Expert Says Cost Can Keep Families From Vaccination

Gretchen Garofoli, PharmD, BCACP, CTTS, FAPhA, clinical professor at the West Virginia University School of Pharmacy, said that if VFC did not cover COVID-19 vaccines and certain influenza vaccines for pediatric patients, children in the program would likely not receive them.

"When vaccines move to an out-of-pocket cost or if a patient does not have health insurance, there will be people who choose not to be vaccinated either because they no longer can afford the vaccine(s) or because they decide it is not worth paying for as an out-of-pocket expense," Garofoli said. She said research shows patients opt not to be vaccinated when they must pay out of pocket.

Lower vaccination rates carry community-level consequences, she said. "If vaccination rates drop, we will likely see more disease spread in communities and higher rates in those communities with lower vaccination rates," Garofoli said.

She added that she was uncertain whether a coverage gap would increase hesitancy about other vaccines. "It is important for us to keep providing education and answering questions that patients may have regarding vaccines in an empathetic manner," she said.

Garofoli said she would encourage policymakers to keep covering these vaccines, noting that vaccine-preventable illness leads to missed school and work days and compounds problems for people who already have lower incomes.

"This is a public health issue and protecting the public needs to remain at the center of these discussions and decisions that are made," she said.

She also recommended that everyone serve as a resource for patients in their community. "There are groups that can assist with health care–related costs for those who are under or uninsured, so make sure you are aware of those resources so that you can connect patients in need with them," Garofoli said.

REFERENCES

1. Jenco M. CDC opens ordering for COVID vaccines in VFC program after delay. AAP News. September 24, 2026. Accessed September 28, 2026. https://publications.aap.org/aapnews/news/36232/CDC-opens-ordering-for-COVID-vaccines-in-VFC

2. Jenco M. COVID vaccines for children in federal program delayed. AAP News. September 18, 2026. Accessed September 28, 2026. https://publications.aap.org/aapnews/news/36144/COVID-vaccines-for-children-in-federal-program