On September 2, five leading US medical organizations, working with the Vaccine Integrity Project, published joint fall vaccine recommendations in JAMA, saying they could no longer wait for the CDC to issue its usual seasonal guidance.
The recommendations were shaped by an independent review of 299 peer-reviewed studies.
All three vaccines still work, still look safe, and the practical question for readers is who should get what, and when.
The Vaccine Integrity Project at the University of Minnesota's CIDRAP partnered with the American Medical Association to review 299 studies published between August 1, 2025 and June 30, 2026.
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The American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists and the Infectious Diseases Society of America then translated that evidence into practical recommendations.
Flu: Everyone 6 months and older
The groups recommend an annual flu shot for anyone 6 months or older.
Adults 65 and up should receive a high-dose, adjuvanted, recombinant or otherwise enhanced formulation.
Pregnant patients and immunocompromised individuals should avoid the nasal-spray version.
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The review found flu vaccination cut hospitalization risk in adults 65 and older by 31 to 43 percent, and lowered symptomatic illness in infants under 6 months by 44 percent when mothers were vaccinated during pregnancy.
The CDC only reiterated last year's flu recommendations, without mentioning the newly approved Moderna mRNA flu shot cleared for older adults ahead of the season.
COVID-19: Young children and higher-risk adults
Where the CDC deferred to parents and doctors, the specialty groups were specific.
They recommend the vaccine for all children between 6 and 23 months, and for children ages 2 to 18 with high-risk conditions.
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Adults 19 to 64 are recommended for vaccination, and adults 65 and older should receive a second dose six months after the first.
Pregnant patients are recommended in any trimester.
The evidence review found roughly 53 percent lower hospitalization risk in adults 65 and older, and a 58 percent drop in emergency and urgent care visits tied to vaccination during pregnancy.
The guidance follows this summer's FDA approvals of the updated COVID shots, which arrived without accompanying federal use recommendations.
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RSV: Pregnancy window now runs into March
The RSV vaccine is recommended for adults 75 and older, and for adults 50 to 74 at high risk, as a one-time dose. It is not repeated annually.
Infants are protected through nirsevimab, a long-acting monoclonal antibody, given during their first RSV season if the mother was not vaccinated in pregnancy.
The most notable change is the pregnancy window.
ACOG now recommends a single dose of the bivalent RSV vaccine between weeks 32 and 36, given from September 1 through March 1, extending the previous January cutoff.
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Maternal RSV vaccination was 51 to 70 percent effective against RSV-related hospitalization in infants, and the shots cut hospitalization by 69 to 83 percent in adults 60 and older.
This article is made and published by Ida-Marie Palm Varbæk, who may have used AI in the preparation.