Vaccine Guidance Set for Fall and Winter

Medical societies issued independent 2026-27 respiratory vaccination recommendations based on systematic reviews of influenza, COVID-19, and RSV evidence.

Independent Guidance for the 2026-27 Season

On Sept. 2, a group of U.S. medical societies issued collective respiratory virus vaccination recommendations for the 2026-2027 fall and winter season. The guidance recommends age- and risk-based vaccination, with specific recommendations for children, immunocompromised individuals, healthcare professionals, and pregnant patients. ACOG recommends maternal influenza, COVID-19, and RSV vaccination, affirming eligible vaccines can be administered safely at the same time.

“For more than 60 years, the United States has benefited from an established federal process for evaluating vaccine evidence and translating that sciencFe into recommendations to the American public. At the center of that process were the Centers for Disease Control (CDC) and its Advisory Committee on Immunization Practices—the ACIP,” said Bruce Gellin, MD, MPH.

To fill that gap, the Vaccine Integrity Project collaborated with the American Medical Association (AMA) to provide updated, credible data to inform evidence-based vaccine guidance for the upcoming respiratory virus season. Their systematic review of available and approved vaccines against influenza, COVID-19, and respiratory syncytial virus (RSV) from August 2025 to June 2026 included 69 eligible studies on influenza, 155 on COVID-19, and 75 on RSV from PubMed, Embase, Scopus, and Cochrane Central.

Resources for Clinicians and Patients

The results of the independent review were outlined in three separate reviews published simultaneously in JAMA. “We’re making this underlying evidence broadly accessible so that clinicians, researchers, the public, and journalists can examine it themselves,” Dr. Gellin said.

The American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG), and Infectious Diseases Society of America (IDSA) then used this evidence to make their fall/winter 2026-27 vaccination recommendations.

Physician and patient focus groups conducted by the AMA found that patients prioritize consistency, source credibility, and authenticity when evaluating vaccine recommendations and want balanced information about vaccine risks and benefits, said AMA President-Elect Sandra Adamson Fryhofer, MD.

To meet these priorities, the AMA launched a new vaccine information resource at SpreadTheFacts.org, which provides tools for both patients and clinicians to easily access credible respiratory vaccine information and recommendations. The guidance is organized by patient population.

Specific Recommendations by Disease

“The bottom line is that vaccines are one of the country’s greatest success stories,” said AAFP President Sarah C. Nosal, MD, FAAFP. “They prevent serious illness and death. Making sure families get recommended vaccines during respiratory illness season not only keeps individuals healthy, but helps protect entire communities, especially those who are more vulnerable to getting sick.”

AAFP’s fall immunization recommendations align closely with those of the other participating societies. COVID-19 vaccine guidance recommends an annual updated dose for all adults 19 to 64 years. It emphasizes the added protection of a second “booster” dose given six months after the first for those 65 years and older. The guidance also outlines special provisions for those who have recently been infected with SARS-CoV-2.

The annual flu vaccine is recommended for all adults 19 and older. An enhanced, high-dose formulation should be provided for those 65 years and older, if available. All adults 75 years and older should receive a one-time immunization for respiratory syncytial virus (RSV). Those considered high risk may be eligible for a one-time RSV vaccination anytime between the ages of 50 and 74 years.

Focus on Vulnerable Groups

Healthcare professionals should follow age- and risk-based recommendations, including annual flu and COVID-19 vaccination due to higher risk of exposure. The American Academy of Pediatrics has a very long history of making recommendations with regard to vaccines that are evidence-based, and we take that responsibility very seriously and are going to continue to do that,” affirmed AAP president Andrew D. Racine, MD, PhD. “However, we find ourselves in a position, once again, of issuing those guidelines independent of the federal government.”

The AAP recommendations include the annual flu vaccine for all children 6 months and older. The COVID-19 vaccine is recommended for all children 6 to 23 months old, and those with higher risk aged 2 to 18 years. RSV vaccination is recommended for all infants younger than 8 months who were not exposed to the vaccine during pregnancy, and children between 8 and 19 months with increased risk.

In the absence of clarity from our national public health officials, we want our patients and clinicians to see the entire physician community stands united in delivering a clear, consistent, scientific, and evidence-based message,” IDSA President Ronald G. Nahass, MD, MHCM, FIDSA, said. The 2026 IDSA immunization recommendations match those of the previous year, Nahass said. The newly published data from AMA and the Vaccine Integrity Project “firmly warrants our continued strong recommendation for the use of these vaccines across immunocompromised populations,” he said.

“The updated systematic review builds on [last year’s] solid foundation, continuing to demonstrate substantial protection against hospitalization and severe illness, with little or no serious adverse side effects.”

“Vaccination for individuals who are pregnant, postpartum, or who may become pregnant during the respiratory season is standard preventive care,” said Christina Davidson, MD, chief medical officer for ACOG. “These vaccines not only protect mom’s health and reduce the risk of adverse outcomes during pregnancy, but they also protect the newborn in their first few months of life, when they are unable to be vaccinated.”

After reviewing all updated efficacy and safety data, ACOG recommends the maternal flu, COVID-19, and RSV vaccinations for eligible individuals, and affirms that these vaccines can be given safely at the same time.