{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T12:03:21Z","timestamp":1792411401787,"version":"4.4.0"},"reference-count":97,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:p>Immunocompromised pediatric patients, including hematopoietic cell and solid organ transplant recipients, those undergoing chemotherapy for malignancy, and those receiving biologic response modifiers for autoimmune or inflammatory conditions, are at risk for severe disease from vaccine-preventable respiratory viral infections such as influenza, SARS-CoV-2 (COVID-19), and respiratory syncytial virus (RSV). These children face higher rates of hospitalization, intensive care admissions, and mortality, reflecting contributions from an immature immune system, absence of immunologic memory, and\/or increased environmental exposures. Immunization recommendations for immunocompromised children are largely extrapolated from studies conducted among healthy children and\/or immunocompromised adults due to a paucity of primary data on immunological responses and vaccine efficacy in immunocompromised children. Trends in vaccine hesitancy in the general population, ongoing transmission of respiratory viral infections in the community, and suboptimal vaccination rates among immunocompromised children and their household contacts further compound the risk for this vulnerable population. As the number of children with immunocompromising conditions expands, it is imperative that primary care practitioners and subspecialists who care for immunocompromised children ensure appropriate immunizations are provided to these patients and their household and community contacts. We will review available data supporting the current guidelines regarding vaccine dosing, scheduling, and formulations to prevent influenza, COVID-19, and RSV infections in immunocompromised children. Furthermore, we highlight key knowledge gaps and areas of current investigation aimed at improving respiratory viral vaccine immunogenicity and optimize protection.<\/jats:p>","DOI":"10.1542\/peds.2026-075971","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:02:55Z","timestamp":1784764975000},"source":"Crossref","is-referenced-by-count":1,"title":["Influenza, COVID-19, and RSV Vaccinations for Immunocompromised Children and Household Contacts"],"prefix":"10.1542","volume":"158","author":[{"given":"Carol M.","family":"Kao","sequence":"first","affiliation":[{"name":"1Division of Infectious Diseases, Department of Pediatrics, St. Louis Children\u2019s Hospital, Washington University in St. Louis, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Bahakel","sequence":"additional","affiliation":[{"name":"2Division of Infectious Diseases, Department of Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor A.","family":"Heald-Sargent","sequence":"additional","affiliation":[{"name":"3Division of Infectious Diseases, Department of Pediatrics, Ann and Robert H. Lurie Children\u2019s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy D.","family":"Minniear","sequence":"additional","affiliation":[{"name":"4Division of Infectious Diseases, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria A.","family":"Statler","sequence":"additional","affiliation":[{"name":"5Division of Infectious Diseases, Department of Pediatrics, Norton Children\u2019s Hospital, University of Louisville School of Medicine, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanya J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"6Pediatric Transplant & Immunocompromised Host Infectious Diseases Program, Pediatric Infectious Diseases, Columbia University Irving Medical Center and New York-Presbyterian, Morgan Stanley Children\u2019s Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn E.","family":"Weakley","sequence":"additional","affiliation":[{"name":"5Division of Infectious Diseases, Department of Pediatrics, Norton Children\u2019s Hospital, University of Louisville School of Medicine, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Cao","sequence":"additional","affiliation":[{"name":"7Department of Infectious Diseases, Shanghai Children\u2019s Medical Center, National Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica I.","family":"Ardura","sequence":"additional","affiliation":[{"name":"8Division of Infectious Diseases, Host Defense Program, Department of Pediatrics, Nationwide Children\u2019s Hospital, The Ohio State University College of Medicine, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Danziger-Isakov","sequence":"additional","affiliation":[{"name":"2Division of Infectious Diseases, Department of Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Foca","sequence":"additional","affiliation":[{"name":"9Division of Infectious Diseases, Department of Pediatrics, Children\u2019s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betsy C.","family":"Herold","sequence":"additional","affiliation":[{"name":"9Division of Infectious Diseases, Department of Pediatrics, Children\u2019s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New 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