Flu, COVID-19, RSV immunizations: What to know this respiratory virus season

Four leading organizations that represent doctors have made immunization recommendations for the coming respiratory virus season, which is often called the cold-and-flu season. In the recommendations, these physician organizations clearly outlined their immunization advice for patients, all the way 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 & Gynecologists (ACOG), and the Infectious Diseases Society of America (IDSA).

The recommendations are available at an AMA website, SpreadTheFacts.org, and they were informed by a review process to understand 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.

The website serves as a unified source of respiratory virus season immunization recommendations and features information on the Vaccine Integrity Project’s evidence reviews of safety and effectiveness for COVID-19, influenza (flu), and respiratory syncytial virus (RSV) immunizations. The site also includes answers to patients’ frequently asked questions, along with infographics and other tools to help support patient-physician conversations, as well as public understanding of the recommendations.

These cover critical topics such as why vaccines matter to your health (PDF) and myths and facts on:

Meanwhile, this resource at SpreadTheFacts.org (PDF) offers a one-stop shop for patients and families to quickly find out which vaccines are recommended by physicians to help protect them this respiratory virus season.

“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 in September.

“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,” she added. “That's why the AMA has collaborated with the Vaccine Integrity Project.”

Here are some more details and answers to key questions about respiratory virus season vaccines.

What respiratory virus vaccines are recommended for kids, from birth to 18 years old?

Flu: All children 6 months old and older should get an annual flu vaccine.

COVID-19:

All infants and children aged 6–23 months should get the COVID-19 vaccine.
Older children and adolescents 2–18 years old at increased risk of severe COVID-19, regardless of prior COVID-19 vaccination status should get the COVID-19 vaccine.
Children 2 through 18 years of age who are not at increased risk of severe COVID-19 whose parent or guardian wants them to be protected from COVID-19 should be offered a single dose of the COVID-19 vaccine.

RSV:

All infants under 8 months old born during or entering their first RSV season should get a RSV immunization, unless the infant has documented protection from vaccination of their pregnant parent;
Infants and children 8–19 months old who are at high risk of severe RSV disease and entering their second RSV season should get a RSV immunization.

What respiratory virus vaccines are recommended for adults, 19–64 years old?

Flu: Everyone 6 months and older should get an annual flu vaccine.

COVID-19: All adults 19 or older should receive an annual updated COVID-19 vaccine.

RSV:

For healthy adults 19–49 years old, there is no RSV vaccine recommendation for this population.
For adults 50 or older, a one-time RSV vaccination is recommended for adults aged 50 to 74 years at increased risk for severe disease.

What respiratory virus vaccines are recommended for adults 65 or older?

Flu: Adults 65 or older should preferentially receive a high-dose inactivated, adjuvanted inactivated, recombinant influenza vaccine, or mRNA influenza vaccine when available.

COVID-19: All adults 65 or older should get an annual updated COVID-19 vaccine every six months, followed by a second dose six months later to boost protection (with a minimum interval of two months).

RSV: A single dose of RSV vaccine is recommended for all adults 75 or older and adults 50–74 years old who are at an increased risk of severe RSV.

What respiratory virus vaccines are recommended for patients during pregnancy?

Flu: All pregnant patients should get an annual flu vaccine. If you are pregnant, you should get a flu shot and not the nasal spray flu vaccine.

COVID-19: All pregnant and lactating patients should receive an updated COVID-19 vaccine.

RSV: During RSV season, patients are recommended to receive the RSV vaccine to protect their infants after birth. Patients should receive the vaccine when they are between 32 and 36 weeks pregnant between Sept. 1 and March 1, as long as they:

Do not have a planned delivery within two weeks.
Did not receive the maternal RSV vaccine during a previous pregnancy.
And are not planning to have their infant receive a monoclonal antibody—nirsevimab or clesrovimab.

What respiratory virus vaccines are recommended for patients with immunocompromising conditions?

Flu:

All immunocompromised individuals 6 months old and up should receive a seasonal influenza vaccine. 
Household members and close contacts should also receive inactivated seasonal influenza vaccines to reduce transmission risk. 
Avoid the nasal spray flu vaccine.

COVID-19: All immunocompromised patients 6 months old and up should receive at least one dose of COVID-19 vaccine. Additional doses may be recommended based on prior vaccination history and clinical judgment.  

RSV:

All immunocompromised individuals 18 or older should receive the RSV vaccine. 
There was no evidence available for immunocompromised children and adolescents. These patients should discuss the risks and benefits of RSV vaccination with their clinician.

When should I get my respiratory virus season vaccinations?

Most people should get a flu, COVID-19 or RSV vaccine in September or October. It is best to get the vaccines by the end of October but getting them later is still helpful if the viruses are still spreading in your community.

What else can I do to protect myself from flu, COVID-19 and RSV?

Vaccines are one critical component of a preventive health strategy that patients and families should take. Some key tips from physicians are to:

Stay away from sick people.
Cover your coughs and sneezes.
Wash your hands often.
Keep air clean and fresh indoors.

People with immunocompromising conditions also can wear a mask in crowded places.

How many people get sick or die from flu, COVID-19 and RSV?

These respiratory viruses continue to sicken millions and and hundreds of thousands in the hospital, while killing tens of thousands of Americans. According to Centers for Disease Control and Prevention 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—the virus that causes COVID—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 U.S.

How did the Vaccine Integrity Project do 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 examined the medical literature for evidence related to products licensed or approved for use in this country, with a focus on safety, effectiveness and epidemiology. They included data from randomized controlled trials as well as observational studies. 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 in each of these.

What did the respiratory virus vaccine evidence review find?

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.”

How effective are the flu, COVID-19 and RSV vaccines?

Flu: The newly published evidence shows that influenza vaccines reduce the risk of severe disease. 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. No new safety concerns were identified.

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.

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.

Why should patients trust these respiratory virus immunization recommendations?

“Patients are very concerned about the authenticity of the information they're being given,” noted Dr. Fryhofer, the AMA’s president-elect. That is why the new website was created.

“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” reviewed the data, 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.”

Learn more with these FAQs from the AMA:

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