This week the U.S. Food and Drug Administration (FDA) approved the first monoclonal antibody shot to protect young children against respiratory syncytial virus (RSV). While rates have now fallen, the three respiratory viruses (RSV, influenza, and COVID-19) surged among children last winter. Routine vaccinations, including the COVID-19 and flu shot, and the new RSV injection can provide important protection for children as they head back to school and into the winter season this year. This issue brief examines the most recent trends in children’s routine vaccinations, including COVID-19, and explores what to watch as children head back to school this year.