February 21, 2024: Recommendations for childhood COVID-19 vaccination in Guatemala include using monovalent, bivalent, or updated monovalent vaccines authorized by the FDA, EMA, and listed under the WHO emergency use authorization. Both bivalent and monovalent XBB 1.5 vaccines can be used interchangeably for primary or booster schedules if there is eligibility for severe COVID-19 risk factors. Heterologous schedules can be employed to complete primary vaccination series or boosters if indicated. Children over 5 years with comorbidities are eligible for COVID-19 vaccine boosters six months after their last dose, and vaccination is recommended for children aged 6 months to 5 years with specified comorbidities. Comorbidities include severe primary or secondary immunodeficiency, cancer treatment, transplant recipients, congenital heart disease, chronic respiratory conditions, type 1 diabetes, neurological or neuromuscular chronic conditions, or significant complex health needs such as severe cerebral palsy or Down syndrome. Related vaccination schedules for children are provided.