As children return to school, doctors are urging Americans to prepare for another respiratory virus season involving influenza, COVID-19 and RSV. With federal guidance limited this year, major medical organizations have stepped forward with their own recommendations on who should be vaccinated and when. The guidance covers seasonal flu shots, updated COVID-19 vaccines and RSV protection for older adults, pregnant people, infants and other higher-risk groups.
Medical Groups Fill the Gap in Federal Vaccine Guidance
The Centers for Disease Control and Prevention has not issued new recommendations for RSV immunization or COVID-19 vaccines for the 2026-27 season. Its latest COVID-19 approach shifted away from a broad recommendation and toward discussions between patients and healthcare providers. The agency did update its clinical guidance for seasonal flu vaccination this week, saying recommendations from the July 2025 immunization schedule remain in effect for the 2026-27 season. That update does not address the first mRNA-based flu vaccine, which the Food and Drug Administration approved last month for older adults. In response to the limited federal guidance, the American Medical Association and the University of Minnesota's Vaccine Integrity Project conducted independent reviews of the available flu, COVID-19 and RSV vaccines. Several medical organizations then used those reviews to develop recommendations for the coming respiratory virus season.
Why Doctors Say the Guidance Matters
Dr. Bruce Gellin, board chair of the Vaccine Integrity Project and a professor of medicine at Georgetown University, said the United States has historically relied on a federal process involving the CDC and its Advisory Committee on Immunization Practices to evaluate vaccine evidence and translate it into public recommendations. He said the need for evidence-based guidance has not disappeared simply because that federal process has changed. Influenza, SARS-CoV-2 and RSV are expected to circulate again during the fall and winter, leaving doctors and families to make vaccination decisions without the same level of federal direction. The new recommendations were released by groups including the American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists and the Infectious Diseases Society of America.
RSV Protection: Who Should Get Vaccinated?
RSV immunization is recommended for several groups, including older adults, pregnant people and infants. Adults 75 and older should receive one dose, as should people ages 50 and older who have certain high-risk conditions. RSV vaccination is not an annual shot, so people who have already received the recommended dose generally do not need another one this season. Pregnant people are advised to receive the RSV vaccine during the third trimester, between 32 and 36 weeks of pregnancy. For infants younger than 8 months, protection generally comes through an RSV monoclonal antibody unless the mother received an RSV vaccine during pregnancy. Infants whose maternal vaccination status is unknown should also receive the antibody. Certain children between 8 and 19 months who face a higher risk of severe RSV disease are also recommended to receive the monoclonal antibody. Adults with weakened immune systems are another group for whom a single RSV vaccine dose is recommended.
When Should RSV Protection Be Given?
For older adults, RSV vaccination is generally recommended in late summer or early fall. The timing for vaccination during pregnancy has changed this year. The American College of Obstetricians and Gynecologists now recommends the maternal RSV vaccine from September 1 through March 1, extending the previous window. Doctors said the change reflects a later RSV season and concern that the disease season has become more severe. For infants, RSV monoclonal antibody protection is generally given around the virus season, from October through March.
Flu Shots Remain an Annual Priority
Everyone 6 months and older is advised to receive a flu vaccine every year. Doctors say flu vaccination can reduce the risk of needing medical care because of influenza by roughly 30% to 60%. Adults 65 and older are advised to receive an enhanced flu vaccine when available. Options include high-dose, adjuvanted and recombinant vaccines. Doctors also stress that people should not postpone vaccination simply because their preferred enhanced formulation is unavailable. The 2026-27 season also brings a new option for adults 50 and older: the first mRNA-based flu vaccine. Pregnant people are also advised to receive a flu vaccine, although the nasal spray version should be avoided during pregnancy. Inactivated or recombinant flu vaccines can be used during pregnancy, and vaccination can provide some immunity to the baby.
October Is the Ideal Time for a Flu Shot
Doctors recommend getting the flu vaccine in October because protection gradually decreases as the season continues. Some healthcare providers use the phrase "flu before boo" as a simple reminder to get vaccinated before Halloween. The goal is to build protection before influenza activity becomes widespread while avoiding vaccination so early that immunity has significantly weakened later in the season.
Updated COVID-19 Vaccines Are Available
The new recommendations call for updated COVID-19 vaccination for adults, with particular emphasis on older people and those at increased risk of severe disease. Adults over 19 are recommended to receive an updated COVID-19 vaccine. People 65 and older should receive a second updated dose six months after their first dose during the season to help maintain protection as immunity decreases. Updated COVID-19 vaccination is also recommended for infants between 6 months and 23 months, children in certain high-risk groups and children whose families request vaccination. For people who are immunocompromised, annual updated COVID-19 vaccination is recommended beginning at 6 months of age.
Pregnancy and COVID-19 Vaccination
Doctors are also recommending updated COVID-19 vaccination for people who are pregnant, considering pregnancy, postpartum or breastfeeding. The medical groups cited evidence from millions of administered doses and said available evidence has not found an increased risk of miscarriage, stillbirth, preterm birth, small-for-gestational-age birth or birth defects associated with COVID-19 vaccination. The available vaccines include mRNA options from Moderna and Pfizer-BioNTech, as well as a protein-based vaccine from Sanofi and Novavax. Doctors emphasize that COVID-19 itself can pose significant risks to pregnant people and their babies, making vaccination an important part of protection during pregnancy.
When Should You Get the Updated COVID-19 Vaccine
The updated COVID-19 vaccine is recommended now for eligible people who want to refresh their protection. However, people who have recently had COVID-19 may be advised to wait four to six months before receiving the vaccine. The updated shot targets the most recent circulating strain, and doctors say protection is strongest during the first few months following vaccination. People planning major events, travel or large gatherings may also consider timing vaccination a couple of weeks before the event to allow protection to build.
What Comes Next
The fall respiratory virus season is approaching with updated flu, COVID-19 and RSV protection available for eligible groups. While federal vaccine guidance remains limited in some areas, major medical organizations have published recommendations intended to give doctors and families a clearer framework for decisions this season. Insurance coverage is also expected to continue for these respiratory virus immunizations, according to representatives of major medical groups.
FAQ
Who should get a flu vaccine in 2026-27?
Everyone 6 months and older is recommended to receive an annual flu vaccine.
When is the best time to get a flu shot?
October is considered the ideal time because protection gradually wanes during the flu season.
Who should get an RSV vaccine?
Adults 75 and older, people ages 50 and older with certain high-risk conditions, pregnant people during the recommended pregnancy window and certain other high-risk groups should receive RSV protection.
Who should get an updated COVID-19 vaccine?
The recommendations include adults over 19, infants 6 months to 23 months, certain high-risk children and people who are immunocompromised. Vaccination is particularly emphasized for older adults and people at higher risk of severe disease.
Can pregnant people receive flu, COVID-19 and RSV vaccines?
Yes. The recommendations include flu and COVID-19 vaccination during pregnancy, while RSV vaccination is recommended during weeks 32 through 36 of pregnancy.
