Respiratory viruses will once again pose a threat this fall, prompting medical experts to outline who should receive flu, COVID-19, and RSV vaccines as the 2026-27 season approaches. The guidance, published in JAMA by the Vaccine Integrity Project and the American Medical Association, provides specific recommendations for children, adults, pregnant people, and immunocompromised individuals. Because the CDC has not yet issued new COVID-19 or RSV guidance for this year, these updated frameworks aim to help clinicians and patients make informed decisions about protection.
Flu, RSV, and COVID-19 Recommendations
The recommendations are not identical for all three vaccines. Age, pregnancy, underlying health conditions, and immune status can affect whether a vaccine is routinely recommended or given based on individual circumstances. Flu vaccination remains the broadest recommendation across age groups, while RSV protection focuses mainly on infants, older adults, and high‑risk groups. COVID‑19 vaccination recommendations vary more by age and individual risk.
Related: Teva reports positive Phase 2a anti-IL-15 celiac results
For the flu, the guidance is fairly standard. Children should receive the vaccine annually starting at six months of age, and adults 19 to 64 generally need the updated shot each season. Older adults 65 and up are advised to get an annual dose, often a high‑dose formulation designed to trigger a stronger immune response. Pregnant people should also get vaccinated annually, avoiding the nasal‑spray version, as it helps protect both the mother and the newborn after birth.
RSV protection is more targeted. Infants under eight months need protection if they were not exposed to the virus through maternal vaccination during pregnancy. For adults 75 and older, a one‑time vaccination is routinely recommended because the virus can cause particularly serious illness in that demographic.
What’s New in the 2026-27 Flu Formula?
Flu vaccines are reformulated most years to match circulating strains, and the 2026-27 update brings a notable change. The FDA has confirmed the composition for egg‑based and cell‑based vaccines, which include strains like A/Missouri/11/2025 (H1N1)pdm09‑like virus and A/Darwin/1454/2025 (H3N2)‑like virus. This selection is based on analysis of global and US surveillance data, as well as serological responses to prior season vaccines.
Related: HPV vaccine cuts cervical cancer risk significantly
A significant development this year is the first mRNA‑based flu vaccine approved in the United States. The FDA granted full approval on August 5, 2026, for Moderna’s mFLUSIVA, which is available for adults 50 and older. The vaccine, which uses the same platform as COVID‑19 shots, showed 26.6% more effectiveness than standard‑dose flu vaccines in adults aged 50 to 64 and 27.4% higher relative efficacy in adults 65 and up.
Reviewing the Evidence
Before making the recommendations, the experts carried out a broad review of the latest research and safety information. They looked at evidence published between August 1, 2025, and June 29, 2026, including research studies, public health data, and safety information collected after vaccines were in use. The review resulted in separate evidence summaries for COVID‑19, influenza, and RSV.
Related: Smart Eating Resolutions for a Healthier Life
This work builds on a similar, large‑scale review conducted for the 2025‑2026 season. That earlier review screened more than 17,000 publications and brought together findings from 511 studies. The evidence was then used by four major medical organizations to develop recommendations for different groups, including the American Academy of Pediatrics for children, the American College of Obstetricians and Gynecologists for pregnant people, the Infectious Diseases Society of America for immunocompromised people, and the American Academy of Family Physicians for adults and healthcare workers.
Final Recommendations
The evidence reviewed by medical experts shows a consistent pattern: vaccination helps reduce serious outcomes. For eligible people, discussing which vaccines are appropriate based on age, health conditions, pregnancy status, and individual risk factors with a healthcare professional is recommended.
