David Higgins, University of Colorado Anschutz Medical Campus

For 30 years, vaccine recommendations from the Centers for Disease Control and Prevention have aligned closely with those from the American Academy of Pediatrics, or AAP. But on Aug. 19, 2025, the AAP published new vaccine recommendations that diverge from those of the CDC.

The pediatrician association’s move comes on the heels of unprecedented changes made earlier this year by Robert F. Kennedy Jr., as head of the Department of Health and Human Services, in how the government approves and issues guidance on vaccines.

The biggest difference is in the AAP’s guidance around COVID-19 vaccines for children. This new guidance comes as COVID-19 cases are once again rising across the U.S. and many parents and providers are confused by unclear guidance from federal health authorities about whether children should be vaccinated.

In a Q&A with The Conversation U.S., David Higgins, a pediatrician, preventive medicine physician and vaccine delivery researcher from the University of Colorado Anschutz Medical Campus, explains the new guidance and what it means for parents. Higgins is also a member of the American Academy of Pediatrics.

What are the AAP’s new vaccine recommendations?

The AAP recommends that all children 6 to 23 months old receive a complete COVID-19 vaccine series, consistent with recommendations for this age group in previous years.

For children and adolescents ages 2 to 18, the AAP now advises a single dose if they are at higher risk, a change from previous years, when vaccination was recommended for all in this age group. Children at higher risk include those who have certain chronic medical conditions, who live in long-term care or group settings, who have never been vaccinated, or who live with family members at high risk.

The AAP also recommends that COVID-19 vaccines remain available for any child or adolescent whose parent wants them to be protected, regardless of risk status. In all cases, the most updated version of the vaccine should be used.

How do these recommendations differ from CDC guidance?

The difference is substantial. The CDC currently advises what it calls “shared clinical decision-making” for children ages 6 months to 17 years who are not moderately or severely immunocompromised. This means the decision is left up to individual discussions between families and their health care providers, but the vaccine is not treated as a routine recommendation. These current guidelines were made after Kennedy bypassed the agency’s normal independent review process.

That framework can be confusing for families and difficult for providers to implement. By contrast, the AAP recommendations identify the ages and conditions where the risk is highest while also supporting vaccine availability for any families who want it.

Why are they diverging?

The AAP has been publishing vaccine guidance since the 1930s, long before the CDC or the Advisory Committee on Immunization Practices, an independent panel of experts that advises the CDC, existed.

Since 1995, the two groups have generally issued essentially identical vaccine guidance. But this year, the federal government dismissed the advisory committee’s panel of independent scientists and immunization experts, raising questions about the credibility of CDC guidance. At the same time, misinformation about vaccines continues to spread.

In response, the AAP decided to publish independent recommendations based on its own review of the latest evidence. That review showed that although the risks for healthy older children have declined compared with the early years of the pandemic, young children and those with specific conditions remain especially vulnerable. Additionally, a review of evidence by an independent expert group called the Vaccine Integrity Project, also released on Aug. 19, 2025, confirmed that there are no new safety concerns and no decline in the effectiveness of COVID-19 vaccines.

COVID-19 continues to cause hospitalizations and deaths in children and remains a leading cause of serious respiratory illness.

Will parents be able to follow these recommendations?

This is still unclear. The AAP recommendations do not automatically guarantee insurance coverage.

By law, insurance plans and the federal Vaccines for Children program, which provides vaccines for eligible children who might not otherwise be vaccinated due to cost or lack of insurance, are tied to Advisory Committee on Immunization Practices recommendations. Unless insurers and policymakers act to align with the AAP recommendations, there is a risk that parents would be forced to pay the costs out of pocket.

Vaccine supply may also be an issue. Currently, only two COVID-19 vaccines are available for children under 12. Moderna’s vaccine is approved only for children with at least one high-risk condition, while Pfizer’s authorization for younger children may not be renewed. If that happens, any remaining Pfizer doses for this age group may be unusable, leaving a shortfall in available vaccines for children.

Finally, implementation may differ depending on the type of provider. Some vaccine providers, such as pharmacists, operate under policies tied strictly to CDC recommendations, which may make it harder to follow AAP’s schedule unless rules are updated.

What happens next?

Parents and providers are likely to face continued confusion, just as COVID-19 cases rise as children return to school. Much will depend on whether the Advisory Committee on Immunization Practices updates its own recommendations at its upcoming meeting, expected in September, and whether pediatric COVID-19 vaccines remain available.

Until then, parents can speak with their pediatricians to understand the best protection for their children.

David Higgins, Assistant Professor of Pediatrics, University of Colorado Anschutz Medical Campus

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Deryn Davidson, Colorado State University

If you’ve spent any time in the gardening corners of social media lately, you’ve likely come across a trend called “chaos gardening.”

The name alone is eye-catching – equal parts fun, rebellious and slightly alarming. Picture someone tossing random seeds into bare soil, watering once or twice, and ending up with a backyard jungle of blooms. No rows, no color coordination, no spacing charts. Just sprinkle and hope for the best.

As a sustainable landscape specialist at Colorado State University Extension, I think a lot about how to help people make designed landscapes more sustainable. Occasionally, a new trend like this one crops up claiming to be the silver bullet of gardening – supposedly it saves water, saves the bees and requires no maintenance.

But what is chaos gardening, really? And does it work? As with most viral trends, the answer is: sometimes.

What chaos gardening is and isn’t

At its core, chaos gardening is the practice of mixing a wide variety of seeds, often including leftover packets, wildflower mixes, or cut flower favorites, and scattering them over a planting area with minimal planning.

The goal is to create a dense, colorful garden that surprises you with its variety. For many, it’s a low-pressure, joyful way to experiment.

But chaos gardening isn’t the same as ecological restoration, pollinator meadow planting or native prairie establishment. Unlike chaos gardening, all of these techniques rely on careful species selection, site prep and long-term management.

Chaos gardening is a bit like making soup from everything in your pantry – it might be delicious, but there are no guarantees.

Chaos gardening’s appeal

One reason chaos gardening may be catching on is because it sidesteps the rules of garden design. A traditional landscape design approach is effective and appropriate for many settings, but it is a time investment and can feel intimidating. Design elements and principles, and matching color schemes, don’t fit everyone’s style or skill set.

Even the apparently relaxed layers of blooms and informal charm of an English cottage garden actually result from careful planning. Chaos gardening, by contrast, lets go of control. It offers a playful, forgiving entry point into growing things. In a way, chaos gardening is an antidote to the pressure of perfection, especially the kind found in highly curated, formal landscapes.

There’s also the allure of ease. People want gardening to be simple. If chaos gardening brings more people into the joy and mess of growing things, I consider that a win in itself. Broader research has found that emotional connection and accessibility are major motivators for gardening, often more than environmental impact.

When does chaos gardening work?

The best outcomes from chaos gardening happen when the chaos has a few guardrails:

• Choose plants with similar needs. Most successful chaos gardens rely on sun-loving annuals that grow quickly and bloom prolifically, like zinnias, cosmos, marigolds, snapdragons and sunflowers. These are also excellent cut flowers to use in bouquets, which makes them doubly rewarding.

• Consider your region. A chaos garden that thrives in Colorado might flop in North Carolina. It is beneficial to select seed mixes or individual varieties suited to your area since factors like soil type and growing season length matter. Different plants have unique needs beyond just sun and water; soil pH, cold hardiness and other conditions can make a big difference.

• Think about pollinators. Mixing in nectar- and pollen-rich flowers native to North America, such as black-eyed Susans, bee balm or coneflowers, provides valuable resources for native bees, butterflies, moths and other local pollinators. These species benefit even more if you plan your garden with phenology – that is, nature’s calendar – in mind. By maintaining blooms from early spring through late fall, you ensure a steady food supply throughout the growing season. Plus, a diverse plant palette supports greater pollinator abundance and diversity.

• Prep your site. Even “chaos” needs a little order. Removing weeds, loosening the top layer of soil and watering regularly, especially during germination when seeds are sprouting, will dramatically improve your results. Successful seed germination requires direct seed-to-soil contact and consistent moisture; if seeds begin to grow and then dry out, many species will not survive.

When does chaos gardening not work?

There are a few key pitfalls to chaos gardening that often get left out of the online hype:

• Wrong plant, wrong place. If your mix includes shade-loving plants and your garden is in full sun, or drought-tolerant plants whose seeds end up in a soggy low spot, they’ll struggle to grow.

• Invasive species and misidentified natives. Some wildflower mixes, especially inexpensive or mass-market ones, claim to be native but actually contain non-native species that can spread beyond your garden and become invasive. While many non-natives are harmless, some spread quickly and disrupt natural ecosystems. Check seed labels carefully and choose regionally appropriate native or adapted species whenever possible.

• Soil, sun and water still matter. Gardening is always a dialogue with place. Even if you’re embracing chaos, taking notes, observing how light moves through your space, and understanding your soil type will help you know your site better, and choose appropriate plants.

• Maintenance is still a thing. Despite the “toss and walk away” aesthetic, chaos gardens still require care. Watering, weeding and eventually cutting back or removing spent annuals are all part of the cycle.

Beyond the hashtag

Beneath the chaos gardening memes, there’s something real happening: a growing interest in a freer, more intuitive way of gardening. And that’s worth paying attention to.

Once someone has success with a zinnia or cosmos, they may be inspired to try more gardening. They might start noticing which flowers the bees are visiting in their garden. They may discover native plants and pay attention to the soil they are tending, seeing how both are part of a larger, living system. A chaotic beginning can become something deeper.

Chaos gardening might not replace the structured borders of a manicured garden or a carefully curated pollinator patch, but it might get someone new into the garden. It might lower the stakes, invite experimentation and help people see beauty in abundance rather than control.

If that’s the entry point someone needs, then let the chaos begin.

Deryn Davidson, Sustainable Landscape State Specialist, Extension, Colorado State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.