With the respiratory virus season approaching, pharmacies and doctors’ offices are starting to offer annual vaccines to protect against Covid, influenza and respiratory syncytial virus.
On Wednesday, major medical organizations issued recommendations for all three vaccines, based on reviews of the latest evidence published in the medical journal JAMA. They said they were filling a gap left by the Trump administration in “evidence-based vaccine guidance.”
“Unfortunately, today the federal government is not fulfilling that responsibility in the way that it historically has, but the need for that work has not disappeared,” said Dr. Bruce Gellin, chair of the board of the Vaccine Integrity Project at the University of Minnesota, one of the groups in the consortium that released the recommendations. Other participants included the American Medical Association and professional organizations in pediatrics, family medicine, obstetrics and infectious diseases.
Normally, the Centers for Disease Control and Prevention would release recommendations on the new Covid shots. But it hasn’t done so and it’s not clear whether it will, because its vaccine advisory panel is in legal limbo. (A spokeswoman for the Department of Health and Human Services said only that more information would come “soon.”)
The government also typically releases new flu shot recommendations each year. But this year, citing “legal uncertainties and inquiries,” the C.D.C. reaffirmed last year’s recommendations.
Covid-19
Members of the consortium recommended an updated Covid shot for all adults, including those who are pregnant or breastfeeding.
A second dose is recommended six months later for people 65 and older and might benefit immunocompromised people, too.
Members also recommended that all children 6 to 23 months old, and children 2 years and older with underlying medical conditions, receive a vaccine. While they did not specifically recommend updated vaccination for all children over 2, Dr. James Campbell, the chairman of the American Academy of Pediatrics’ infectious diseases committee, said it was appropriate for any child whose parents wanted it.
The Food and Drug Administration approved new Covid shots only for people who have a high-risk condition or are at least 65. However, doctors can administer the shots to anyone.
In most states, the updated vaccines will also be available in at least some pharmacies to people who say that they meet the criteria. In some states, children may be unable to get a shot at a pharmacy but can get it from a pediatrician.
The new evidence review in JAMA concluded that receiving an updated Covid vaccine still has benefits. The C.D.C. estimates that, from October 2025 through August 2026, Covid caused up to 250,000 hospitalizations and up to 44,000 deaths in the United States.
The shots are associated with fewer hospitalizations for adults, fewer emergency-room visits for pregnant women and young children, and fewer I.C.U. admissions and deaths for immunocompromised adults.
Serious side effects are very rare, and the review found no new safety concerns.
Influenza
The consortium urged flu vaccinations for everyone 6 months and older, ideally by the end of October.
A number of options are available, including traditional shots, a new mRNA vaccine developed by Moderna for people over 50 and a nasal spray for people ages 2 to 49 that can be administered at home. (The spray isn’t recommended for those who are pregnant or immunocompromised.)
People over 65 should ideally receive a high-dose traditional flu shot, or the mRNA vaccine, which can trigger more antibodies in older adults for greater protection. If one of these vaccines isn’t available, don’t wait — get the vaccine you can find early in the season, said Dr. Sarah Nosal, the president of the American Academy of Family Physicians.
The evidence review on influenza affirmed that vaccination reduced the risk of severe disease.
The vaccines’ effectiveness varies depending on how well they match the strains that are circulating. But “even in a year where there’s not a great match, we see tremendous decreases in hospitalization and death,” Dr. Nosal said.
The flu is particularly dangerous for people over 65 or under 2, but can be serious for anyone. Every year, it leads to more than 36,000 deaths nationwide and hundreds of thousands of hospitalizations.
Respiratory syncytial virus
Members of the consortium recommended one-time vaccination against R.S.V. for all adults 75 and older, and adults 50 to 74 at increased risk. Immunocompromised adults and adolescents should also be vaccinated, with the number and frequency of doses decided case by case.
They also recommend that, between September and March 1, women who are 32 to 36 weeks pregnant should receive the vaccine to pass protection to their babies during the R.S.V. season.
Infants under 8 months should receive monoclonal antibodies — shots that mimic the immune system’s response to an infection — for their first R.S.V. season if their mother wasn’t vaccinated during pregnancy, or if there is any question that she was. Children 8 to 19 months old who are at higher risk should be immunized for their second season, too, regardless of prior vaccination.
R.S.V. was the leading cause of hospitalization for babies in the United States before immunizations were introduced; roughly 2 to 3 percent of all infants under 3 months are hospitalized with it each year. Other high-risk groups include children who were born prematurely or have certain medical conditions like lung disease, adults over 75 or who have certain chronic diseases and people in nursing homes.
The new review found that immunization reduced the risk of severe illness and hospitalization.
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