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It’s August, and parents and caregivers are frantically preparing their kids for a new school year by buying supplies, filling out forms and meeting teachers. This year, many parents also face a question that’s more complicated than usual: Should my child get an updated COVID-19 vaccine, and will I even have that choice? For some, that decision may have already been made by chaotic federal policy, just as COVID-19 cases are rising nationwide.

As a pediatrician and researcher who studies vaccine delivery and health policy, I am hearing uncertainty from both parents and health care providers. If that describes you, you are not alone. A poll published Aug. 1, 2025, by the health policy organization KFF found half of parents are unsure whether federal health agencies are recommending COVID-19 vaccines for healthy children this fall.

The process that normally provides clear, consistent recommendations and ensures availability for vaccines before respiratory virus season has been upended, and this year’s COVID-19 vaccine guidance for children is a prime example.

For over two decades, there was a predictable, well-coordinated process to ensure recommended seasonal vaccines, such as the flu shot, were available for anyone who wanted them by early fall. In recent years, COVID-19 vaccines have been incorporated into this same annual cycle.

Beginning in February, the Food and Drug Administration, including its independent committee of experts, reviewed data and approved the optimal formulation. After FDA approval, the Advisory Committee on Immunization Practices, or ACIP, an independent panel of experts that advises the Centers for Disease Control and Prevention, reviewed the evidence in public meetings and issued clear recommendations.

Manufacturers then scaled up production; insurers confirmed coverage, which is tied to the advisory committee’s recommendations; and doses were distributed nationwide so vaccines would be available in clinics and pharmacies before the leaves started turning. This usual series of steps ensured that guidance incorporated input from scientists, epidemiologists, public health experts, clinicians, manufacturers, insurers and consumers. It also fostered trust among health care providers and,........

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