Four leading physician organizations have made their vaccine recommendations for the coming respiratory virus season, clearly outlining their immunization advice for patients from birth to older adulthood, as well as for those who are pregnant or have compromised immune systems.
The respiratory virus season vaccine recommendations come from the American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG), and the Infectious Diseases Society of America (IDSA).
The recommendations are available at a new AMA website, SpreadTheFacts.org, and they were informed by a structured, evidence-based review process to assess vaccine safety and effectiveness for the 2026–2027 respiratory virus season. The effort was launched by the AMA and the Vaccine Integrity Project in February 2026.
The new website serves as a unified source of respiratory virus season immunization recommendations and features information on the Vaccine Integrity Project’s evidence reviews of vaccination for COVID-19, influenza and respiratory syncytial virus (RSV). The site also will include answers to patients’ frequently asked questions—sorted by pathogen and patient population—along with infographics, and other tools to help support patient-physician conversations, as well as public understanding of the recommendations.
“This collaboration—this work we've undertaken over the last six months—signifies our shared commitment across clinical medicine, science and public health. It ensures vaccine recommendations are grounded in sound evidence and developed through a transparent process,” said AMA President-elect Sandra A. Fryhofer, MD, during a news media briefing Tuesday.
Dr. Fryhofer is a board-certified internist in Atlanta who for many years served as the Association’s liaison to the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices. That committee’s work has been undermined by “massive changes at the federal level,” she noted.
“Physicians need evidence-based vaccine guidance we can trust so we can confidently advise our patients,” Dr. Fryhofer added. “Patients need and deserve vaccine recommendations that are clear, credible, and based on the best available scientific evidence so they can make informed vaccine decisions for themselves and for their families. That's why the AMA has collaborated with the Vaccine Integrity Project. Our goal is to restore a transparent, evidence-based process for vaccine recommendations. From the start of our work together, we've been laser-focused on making sure the public has clear, consistent science-based guidance, even while the federal process is in flux.”
Respiratory viruses exact a deadly toll
Flu, RSV and COVID-19 continue to sicken millions, land hundreds of thousands in the hospital, while killing tens of thousands of Americans. According to interim CDC estimates, during the 2025–2026 respiratory virus season there were at least 390,000 influenza-related hospitalizations and 24,000 deaths.
RSV—which puts infants and older adults at greatest risk—caused an estimated 2.8 million to 5.8 million outpatient visits, between 170,000 and 340,000 hospitalizations and as many as 25,000 deaths.
And while the severity of COVID-19 has thankfully lessened since the early days of the pandemic, last respiratory virus season SARS-CoV-2 was linked to between 4.6 million and 13.1 million illnesses, between 140,000 to 250,000 hospitalizations, and between 15,000 to 43,000 deaths in the United States.
How the Vaccine Integrity Project did its work
This group, based at the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP), published its review protocols online in April and examined studies published from Aug. 1, 2025, to the end of June this year. The group’s work built on its own previous 2025–2026 review.
Researchers looked in PubMed, Embase, Scopus and Cochrane CENTRAL for evidence related to products licensed or approved for use in this country, with a focus on safety, effectiveness and epidemiology. They include data from randomized controlled trials as well as observational studies. The studies were assessed on the quality of the evidence gathered and presented, explained Nicole Basta, PhD, MPhil, who helped lead the Vaccine Integrity Project’s evidence review.
The populations studied were:
- Infants: Under 6 months old; 6–11 months old.
- Children: 12–23 months old; 2–18 years old.
- During pregnancy, any gestational age, along with neonates and infants under 1 year old who were born after vaccination during pregnancy.
- Healthcare personnel.
- People with immunocompromising conditions or co-occurring conditions such as those on hemodialysis or who had respiratory conditions.
In all, 69 studies on influenza were included, along with 155 COVID-19 studies and 75 RSV studies, with more than a dozen randomized controlled trials or each pathogen.
What the vaccine evidence review shows
The Vaccine Integrity Project reached strong conclusions for the respiratory-virus immunizations studied. In a statement, Vaccine Integrity Project Executive Director Michael T. Osterholm, PhD, MPH, said that “immunization continues to be one of our best tools for preventing severe illness from respiratory viruses.” He added that “this year’s review confirms that the newest evidence remains consistent with research showing these immunizations reduce the risk of hospitalization and death among the people most likely to experience serious disease.”
On influenza, the newly published evidence shows that “influenza vaccines reduce the risk of severe disease,” Basta said in the news media briefing.
Among patients 65 or older, flu vaccination cut the risk of hospitalization by 31%, while the newly approved mRNA-1010 vaccine was 27% more effective against symptomatic disease in adults 50 or older compared with the standard-dose vaccine. Examining 10 seasons, researchers found that vaccination during pregnancy cut the risk of symptomatic disease in infants from birth to 6 months old by 44%.
Looking at eight seasons, flu vaccination was linked to an 80% drop in deaths among children between 6 months old and 17 years old. Vaccination was associated with a 77% decline in deaths among children with an underlying health condition that raised the risk of severe disease.
Meanwhile, Basta said, “no new safety concerns were identified, including among nearly 10 million people evaluated through postmarketing safety surveillance.”
On COVID-19, the evidence review found that patients at high risk for severe disease—including infants, during pregnancy and older adults—saw protective benefits from vaccination.
Notably, COVID-19 vaccination cut the risk of hospitalization by 53% for adults 65 or older during the last respiratory virus season. Meanwhile, adults with immunocompromising conditions who were vaccinated saw their risk of intensive-care unit admission or death drop between 32% and 53%, depending on the specifics of their condition and other factors.
And vaccination during pregnancy cut risk of emergency department or urgent-care visits by 58%, the Vaccine Integrity Project evidence review shows. COVID-19 vaccination also cut the risk of hospital visits among infants born to vaccinated mothers by 36% in the first year of life. And children between 9 months and 4 years old saw a 76% drop in emergency department visits after vaccination.
Again, based on the recently published studies, no new safety concerns emerged.
On RSV, the right preventive care helped substantially cut severe illness and hospitalization.
Adults 60 or older saw big drops in hospitalization, with vaccine effectiveness ranging from 69%–83%. Getting the RSV vaccine during pregnancy cut the risk of RSV among those vaccinated by 82% and also cut the risk of RSV-associated hospitalization among infants born subsequently.
Meanwhile, infant immunization with the monoclonal antibody nirsevimab cut the risk of hospitalization between 64% and 93% in the following six to 12 months. The review, which is available in full at SpreadTheFacts.org, identified no new safety concerns.
Physicians’ respiratory virus vaccine recommendations
Informed by the Vaccine Integrity Project evidence review, leading physician organizations offered their recommendations for vaccination in the upcoming respiratory virus season, which generally speaking runs October–May.
For children and adult patients, the AAFP is recommending:
- COVID-19 vaccination for patients 19 or older, especially those who are 65 or older. Those 65 or older should get a second dose after six months.
- Influenza vaccination for everyone 6 months old and up. Patients 65 or older should get the high-dose flu vaccine.
- RSV vaccination for patients 50–74 who have high-risk conditions, and everyone 75 and up should get a dose.
The AAFP also recommended that physicians and other healthcare personnel get vaccinated for COVID-19 and flu. RSV vaccination for health care personnel is based on their age and individual risk factors, rather than occupation.
For children, the AAP is recommending:
- COVID-19 vaccination for all children 6–23 months old, as well as children 2–18 years old who are at high risk of severe COVID-19 infections, or if the vaccine is desired.
- Influenza vaccination for everyone 6 months old and up.
- RSV vaccination for children under 8 months old during their first RSV season unless it is demonstrated that the maternal RSV vaccine was administered during pregnancy; and children 8–19 months old in certain risk groups.
In pregnancy, ACOG is recommending:
- COVID-19 vaccination for patients who are pregnant, considering pregnancy or a new or breastfeeding parents. “Our recommendation for the COVID vaccine is based on more than five years of research and millions of administered doses,” said ACOG Chief Medical Officer Christina Davidson, MD. “I want to emphasize that the evidence has found no increased risk of miscarriage, stillbirth, preterm birth, small-for-gestational age birth or birth defects. The risks of complications from COVID for pregnant people and their babies, however, is high, so please get the vaccine.”
- Influenza vaccination for people who are pregnant or postpartum.
- RSV vaccination (marketed as Abrysvo) for the first eligible pregnancy, ideally administered between Sept. 1 and March 1.
For patients with immunocompromising conditions, the IDSA is recommending:
- COVID-19 vaccination for patients 6 months old and up. “An additional booster dose, typically two to six months after the initial dose, may extend protection and should be discussed between patients” and their physicians or other health professionals, said IDSA President Ronald G. Nahass, MD, MHCM.
- Influenza vaccination for patients 6 months old and up. “The preferred formulations for these patients are high-dose or adjuvant, inactivated or recombinant vaccines to elicit a more robust immune response,” Dr. Nahass said. “Live, attenuated vaccines remain contraindicated in immunocompromised individuals and should be avoided.”
- RSV vaccination for adults 18 or older. Vaccination for patients under 18 who have immunocompromising conditions should, Dr. Nahass said, “be guided by shared clinical decision-making with their physicians.”
Dr. Nahass added that “we want our patients and clinicians to see the entire physician community stands united in delivering a clear, consistent, scientific and evidence-based message.”
Transparency at core of trust, credibility
Physicians are encouraged to explore the new SpreadTheFacts.org website, review the evidence, and share the information with patients and parents who have questions. In addition to monthly scientific meetings, the AMA conducted focus groups with patients.
What they revealed, Dr. Fryhofer said, is “that patients are very concerned about the authenticity of the information they're being given.” That is why the new website was created, she noted.
“All the information is there, and for people who want to do their own research—go to this website. It's transparent. You can look at all the studies and you can go step by step and see how the Vaccine Integrity Project came to its conclusions,” she said. “And then you can also see why the medical specialty societies made their recommendations based on this evidence-based research. That should be very reassuring.”
