09 Jun 2025 COVID-19 Vaccination Policy Update for VFC Providers
On May 29, 2025, the CDC updated the routine Child and Adolescent Immunization Schedule. All moderately and severely immunocompromised children should receive the COVID-19 vaccine. All other children may receive the COVID-19 vaccine based on shared decision-making between the patient/parent and the pediatrician, combining the patient’s/parent’s decision with the pediatrician’s clinical judgement and recommendation.
Children at high risk for severe COVID-19 and hospitalization include those with the underlying medical conditions listed in the table below and those 4 years of age and younger who have not received the primary series. Infants less than one year of age experience the highest hospitalization rates.
COVID-19 vaccines are available for ordering through the VFC program.
| CDC 2025 List of Underlying Medical Conditions That Increase a Person’s Risk of Severe COVID-19 |
|---|
| Asthma |
|
Cancer Hematologic malignancies |
| Cerebrovascular disease |
|
Chronic kidney disease* People receiving dialysis |
|
Chronic lung diseases limited to the following: Bronchiectasis COPD (chronic obstructive pulmonary disease) Interstitial lung disease Pulmonary embolism Pulmonary hypertension |
|
Chronic liver diseases limited to the following: Cirrhosis Non-alcoholic fatty liver disease Alcoholic liver disease Autoimmune hepatitis |
| Cystic fibrosis |
| Diabetes mellitus, type 1 |
| Diabetes mellitus, type 2* |
| Gestational diabetes |
| Disabilities‡, including Down syndrome |
| Heart conditions (such as heart failure, coronary artery disease, or cardiomyopathies) |
| HIV (Human immunodeficiency virus) |
|
Mental health conditions limited to the following: Mood disorders, including depression Schizophrenia spectrum disorders |
| Neurologic conditions limited to dementia‡ and Parkinson’s Disease |
| Obesity (BMI ≥ 30 or ≥ 95th percentile in children) |
| Physical inactivity |
| Pregnancy and recent pregnancy |
| Primary immunodeficiencies |
| Smoking, current and former |
| Solid-organ or blood stem-cell transplantation |
| Tuberculosis |
| Use of corticosteroids or other immunosuppressive medications |
* Indicates presence of evidence for pregnant and non-pregnant people
‡ Underlying conditions for which there is evidence in pediatric patients
Next Steps
VFC providers should evaluate their populations to identify patients with underlying medical conditions that put them at greater risk for severe COVID-19 disease and hospitalization. Pediatricians can help parents conduct risk assessments to support their decision making.
Continue to use a shared decision-making model, including with parents of children that do not fulfill high risk criteria.
VFC sites can then order COVID-19 vaccine based on their estimates of eligible patients.
As your patient’s medical home, your practice is the best place for eligible children to receive their COVID-19 vaccination. Receiving a vaccine recommendation from the pediatrician has been shown to increase uptake.
We will continue to offer updates on evolving CDC and HHS guidance, as well as opportunities to ensure equitable immunization access. Please note that the Advisory Committee on Immunization Practices (ACIP) is meeting on June 25-27, 2025, and that guidance may change based on the committee’s updated recommendations. If you have any questions, please reach out at vaccines@phila.gov. As always, we value your continued partnership in keeping Philadelphia residents healthy.