The fall season has arrived and children have returned to school. This means that the season for respiratory viruses, such as “Covid-19”, influenza and respiratory syncytial virus (RSV) is approaching.
While seasonal influenza rates remain low nationally, some indicators are beginning to rise, particularly in the western United States, where King County, Washington state, has recorded an increase in emergency visits due to influenza since mid-August.
Vaccines are now available that help prevent the disease and reduce the risk of severe infection and the need for hospitalization, making this a good time for some people to receive them.
At this time, the US Centers for Disease Control and Control (CDC) usually launches a campaign for seasonal vaccinations, including influenza and “Covid-19” vaccines. But after sweeping changes to the Vaccine Advisory Committee during the second Trump administration, along with ongoing lawsuits, the agency finally published guidelines calling for following last year's recommendations for the two vaccines.
In contrast, the American Medical Association and the University of Minnesota's Vaccine Integrity Project launched independent reviews of influenza, Covid-19, and RSV vaccines, the results of which were published in JAMA in September.
The reviews helped prepare vaccination recommendations for the 2026-2027 season, which were issued by several medical associations, including the American Academy of Pediatrics, the American Society of Family Physicians, the American Society of Obstetricians and Gynecologists, and the Infectious Diseases Society of America.
For more than 60 years, the United States has benefited from a well-established federal system for evaluating scientific evidence about vaccines and turning it into recommendations for the public, with the agency and its Advisory Committee on Immunization Practices (ACIP) at the heart of it, said Dr. Bruce Guillén, chairman of the Vaccine Integrity Project and a professor of medicine at Georgetown University.
He added that the federal government does not currently fulfill this responsibility in the same way, but the need for it has not disappeared, as influenza, coronavirus, and RSV viruses will spread again this fall and winter.
Guillen noted that doctors will continue to care for patients, while parents, the elderly, pregnant women, and people with underlying health problems will need evidence-based guidance on the best means of protection, warning that the absence of a federal system should not leave a vacuum in this area.
The US Department of Health and Human Services did not respond to CNN's request for comment on the medical groups' recommendations.
Flu, coronavirus, and RSV vaccines are now available in most major pharmacies, and Dr. Sarah Nosal, president of the American Academy of Family Physicians, said insurance companies will cover their cost.
Vaccines have also begun to be requested through the federal “Vaccines for Children” program, which provides routine vaccinations for free to children who are uninsured or whose insurance does not cover their cost, and about half of the children in the United States benefit from it.
Nosal said that vaccines are “one of the greatest success stories in medicine,” as they prevent serious diseases, reduce hospitalizations and long-term complications, and save lives, stressing that the scientific evidence supporting them remains strong despite the development of federal guidelines.
Vaccination against respiratory syncytial virus
Groups recommended for vaccination include the elderly, pregnant women, and infants.
Nosal said that those aged 50 and over who have health problems that increase their risk of developing complications, along with everyone over the age of 75, should get one dose. This vaccine is not considered annual, and anyone who has previously received a dose does not need a new dose this year.
During pregnancy, it is recommended to receive the vaccine between weeks 32 and 36. As for children under 8 months of age, it is recommended to give them a monoclonal antibody against RSV, unless the mother received the vaccine during pregnancy. Some children between 8 and 19 months who are at higher risk for severe infection are also advised to get the antibody.
Immunocompromised adults are also recommended a single dose of the RSV vaccine, as they are more susceptible to severe infection and the vaccines are generally less effective for them.
When is it recommended to receive it?
Older adults are usually recommended to receive the RSV vaccine in late summer and early fall.
As for pregnant women, the American College of Obstetricians and Gynecologists now recommends that they receive one dose of the Abrevo vaccine between September 1 and March 1, instead of January 31 previously. Davidson said extending the period provides additional protection for pregnant women and their infants.
For infants, it is usually recommended to give them a monoclonal antibody during the virus season, from October to March.
Seasonal influenza vaccines
Who should get it?
Everyone ages 6 months and older are recommended to receive the flu vaccine annually.
On average, the vaccine reduces the risk of needing to visit a doctor due to influenza by 30% to 60%, Nosal said.
She added that adults aged 65 years and over should receive, when available, a booster influenza vaccine, whether high dose, adjuvant or recombinant, without delaying vaccination if this type is not available.
For the first time, an mRNA-based influenza vaccine is available for adults ages 50 and older.
It is also recommended to receive the influenza vaccine during pregnancy, while avoiding the vaccine in the form of a nasal spray. Davidson said that pregnant women and postpartum women are at a higher risk of developing serious complications from the infection.
Inactivated or recombinant influenza vaccines provide the recommended protection during pregnancy, and vaccination also provides some protection for the baby.
When is it recommended to receive it?
October is an ideal time to get a flu shot, Nolan said, because “protection declines during the season.”
Some health care providers are using the slogan "Flu vaccine before Halloween" to remind people of the importance of getting the vaccine before Halloween.
Updated COVID-19 vaccines
Who should get it?
Adults are recommended to receive the updated COVID-19 vaccine.
“If you are over 19, we recommend receiving the COVID-19 vaccine,” Nosal said.
She added that this is particularly important for people aged 65 and over, those who face an increased risk of severe Covid-19 infection, as well as those who have not received a Covid-19 vaccine before.
For adults aged 65 and over, it is recommended to receive a second dose of the updated “Covid-19” vaccine 6 months after the first dose this season, to help maintain protection as immunity declines over time.
The vaccine is also recommended for infants between 6 and 23 months, and for children who belong to specific groups at greater risk of severe infection, or whose families request them to be vaccinated.
As for people with weak immunity, they are advised to receive the updated “Covid-19” vaccine annually, starting at the age of 6 months.
Barouch pointed out that the US Centers for Disease Control and Prevention last year recommended receiving coronavirus vaccines after discussing the matter with a health care provider, in what is known as “shared decision-making,” but he explained that the agency “also stressed that the benefits of vaccines compared to their risks are more appropriate for people who are most vulnerable to severe disease.”
Covid-19 vaccination is also recommended during pregnancy, said Davidson, of the American College of Obstetricians and Gynecologists (ACOG).
“The most important message is this: If you are pregnant, thinking about becoming pregnant, new to a mother or breastfeeding, please receive the vaccine or annual booster shot,” Davidson added. “All four available COVID-19 vaccines are safe for you.”
When is it recommended to receive it?
It is recommended to receive the updated coronavirus vaccine now, but if you have recently had COVID-19, experts advise waiting 4 to 6 months before receiving the vaccine.
Dr. Sandra Adamson Freehofer, president-elect of the American Medical Association, said during a press briefing that the updated Corona vaccine “targets the latest circulating strain, so if you want to update your level of protection, this is the best way to do it.”
