The quick guide to fall vaccines and when you should get them

“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. 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. 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, like 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, like 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, like 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. 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.