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Labor Day is in the rearview mirror, kids are back to school, and a squall of pumpkin spice is upon us. It’s that time again to prepare for the equally inevitable respiratory virus season with annual vaccines.
With fervent anti-vaccine activist Robert F. Kennedy Jr. as the country’s top health official, it might seem the rollout of this year’s shots could be a disaster. For instance, one of Kennedy’s first actions as health secretary last year was to obliterate an ad campaign for flu shots amid a particularly deadly flu season. As we head into this fall, the Centers for Disease Control and Prevention’s vaccine advisory committee—which normally sets vaccination recommendations and insurance coverage for the shots—is nonfunctioning. A federal judge ruled in March that the anti-vaccine allies Kennedy installed on the panel were illegally appointed and unfit to serve. All their changes to vaccine policy have been temporarily voided. And meanwhile, Kennedy spent last week trying to obscure the number of babies who died from measles so far this year (it was two, including a newborn).
Big picture
Despite all of that, the fall vaccine effort is looking it will ly be somewhat smooth, potentially unremarkable even. The Food and Drug Administration has approved updatedflu and COVID-19 shots for this season. Those shots have already begun arriving at pharmacies—in case your pharmacy hasn’t already sent you multiple texts and reminders. While there are still some snags for access, it seems it will be a lot last year’s fall vaccine rollout.
Major insurance plans have agreed to continue covering vaccines previously recommended by the CDC’s advisory panel, including the seasonal ones, at no charge. That agreement runs at least through the end of 2027.
State and local health officials are also expecting a generally normal rollout and are keeping an eye toward improving vaccination rates.
“As we head into another respiratory virus season, state and territorial health agencies are doing what we do best: preparing early, watching the data closely, and working with our healthcare and community partners to keep people safe,” Manisha Juthani, president of the Association of State and Territorial Health Officials (ASTHO) and commissioner for the Connecticut Department of Public Health, said. “Vaccination remains one of the most effective tools we have to prevent severe illness, hospitalization, and death from flu, COVID-19, and RSV.”
As we saw last year, leading medical organizations have stepped in to fill the void of the CDC’s advisory committee and produced their own evidence-based vaccine recommendations, complete with a transparent scientific review explaining the basis for the recommendations.
The 2026–27 respiratory virus immunization recommendations and the evidence base behind them were released last week in a collaborative effort by the American Medical Association, the Vaccine Integrity Project, the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), the American College of Obstetricians and Gynecologists (ACOG), and the Infectious Diseases Society of America (IDSA).
Overall, little has changed in the evidence-based recommendations from last year. But here’s the breakdown.
Recommendations
Credit: AMA
Credit: AMA
For flu
This year’s trivalent flu vaccines are recommended by the medical groups for all children (6 months and up) and all adults. There’s also a nasal spray for people ages 2 to 49, but it’s not recommended for people who are pregnant or immunocompromised. People age 65 and older are recommended to get a high-dose vaccine.
The biggest uncertainty this season will ly be with the new mRNA flu vaccine, approved for adults 50 and up in early August. The vaccine, Moderna’s mFlusiva, was found to be 27 percent more effective than a standard shot in trials but may have more mild side effects, fatigue and injection-site soreness. It’s unclear how available this vaccine will be this year, given its late approval in the year. It’s also unclear what insurance coverage will look , given its lack of a previous recommendation from the CDC’s advisory committee. Medicare is expected to cover mFlusiva, and some state Medicaid programs may cover it as well. But other federal programs, Vaccines for Adults, may not cover it, and commercial insurance coverage is also uncertain.
The best time to get a flu vaccine is generally the span between late September and the end of October. This typically ensures the vaccine’s protection is at its strongest in the window when influenza typically peaks, between December and February. After a flu shot, it takes about two weeks for protection to kick in, but then it wanes through the flu season, which can sometimes stretch out to May.
There are some exceptions to the September–October recommendation, including if children need two shots or if a shot needs to be timed during pregnancy to provide protection to a baby after birth. These groups may want to get their flu shots earlier.
For COVID-19
Under the Trump administration and Kennedy, the FDA again approved COVID-19 vaccines for limited groups: those age 65 and older, and those age 6 months to 64 years who have a condition that puts them at higher risk. The list of qualifying conditions is long and varied, ranging from cancers to physical inactivity. Many Americans qualify.
Last year, Kennedy’s dubious CDC vaccine advisors actually voted to ease access to COVID-19 vaccines from the FDA’s restrictions (potentially accidentally); they made access based on individual decision-making instead of qualifying health conditions. This meant that, aside from a few states with restrictive laws regulating pharmacists, most people under 65 could go to a big pharmacy, CVS or Walgreens, and self-attest that they had a reason to be vaccinated, no prescription or medical documentation needed.
This year, the federal court ruling in March that blocked Kennedy’s vaccine advisors also reversed the advisors’ vote for individual decision-making. That puts the official federal recommendation for COVID-19 vaccines in limbo. Nevertheless, vaccine access is looking pretty similar to what happened last year. Big pharmacies, CVS and Walgreens—where most people get their COVID-19 shots—have said they’ll continue to let people under 65 self-attest, again with a few state exceptions. For instance, people under 65 in Louisiana may need a prescription to get a COVID-19 vaccine at a pharmacy. Doctors, meanwhile, can provide the vaccines off-label in any state.
Without federal recommendations, healthcare providers can turn to the medical groups’ recommendation. They urge seasonal COVID-19 vaccination for children ages 6 months to 23 months and all adults, including during pregnancy. Those age 65 and up are recommended to get a second dose six months later. Children ages 2–18 are recommended to get the vaccine if they are at higher risk or if they just want to get vaccinated.
The timing of COVID-19 vaccines can be tricky to decide because the SARS-CoV-2 virus has different seasonal trends than flu and other respiratory viruses. Waiting until cases are clearly on a sharp incline can mean protection will come too late. But getting it too early may mean protection could wane before the wave, the flu shot.
Currently, cases are on the rise nationally in a late-summer surge but are still relatively low. For convenience, some experts recommend getting your COVID-19 shot along with your flu shot. But if you want to hold out for peak protection during a winter wave, you may want to plan for a shot as late as November.
For RSV
The respiratory syncytial virus (RSV) vaccine is not a seasonal vaccine, but it protects against a seasonal virus. As before, people 75 and older are recommended to get a one-time RSV vaccine, as are people ages 50 to 74 who are at higher risk.
Between September 1 and March 1, pregnant people should get a one-time RSV vaccine in their first eligible pregnancy between 32 and 36 weeks. The timing of the vaccination allows for protective maternal antibodies from the vaccine to be passed to babies who are then born during RSV season. This recommendation includes a notable update from the medical groups’ recommendations last year, which previously identified the RSV season from September 1 to only the end of January. The update reflects new trends in RSV transmission.
Babies less than 8 months old who were born without such maternal vaccine protection are recommended to get a monoclonal antibody drug to protect against severe disease, as are babies at high risk between 8 and 19 months.
Beth Mole Senior Health Reporter
Beth is Ars Technica’s Senior Health Reporter. Beth has a Ph.D. in microbiology from the University of North Carolina at Chapel Hill and attended the Science Communication program at the University of California, Santa Cruz. She specializes in covering infectious diseases, public health, and microbes.
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Arstechnica.com
