09/11/26 Health Advisory: 2026–2027 Respiratory Illness Season Immunization Recommendations

Gloved giving a shot in the arm.

Summary of 2026-27 guidance from AAP, AAFP, ACOG, and IDSA:

We recommend you rely on evidence-based immunization guidance from trusted national medical specialty societies, including:

  • American Academy of Pediatrics (AAP).
  • American Academy of Family Physicians (AAFP).
  • American College of Obstetrics and Gynecology (ACOG).
  • Infectious Diseases Society of America (IDSA).

Find a summary of their recommendations below, as well as at SpreadTheFacts.org. For more detail, see the childhood and adult vaccine schedules and guidelines for immunocompromised patients (the brief summary below does not include guidance for immunocompromised patients).

Influenza:

  • Everyone 6 months or older should get seasonal influenza vaccine.

COVID-19:

  • Stop giving last year’s COVID-19 vaccine formulation (2025–2026).
  • Everyone 6–23 months old, 2–18 years old at high risk, and 19 years or older should get 2026–2027 COVID-19 vaccine.
  • All others 2–18 years old may get 2026–2027 COVID-19 vaccine if desired.

RSV:

  • Adults:
    • All adults 75 years or older should get a one-time dose of RSV vaccine.
    • Adults 50–74 years old at increased risk of RSV should get a one-time dose of RSV vaccine.
  • Infants and young children:
    • All infants younger than 8 months born during or entering their first RSV season should be protected via:
      • Maternal RSV vaccination (Abrysvo) during 32–36 weeks gestation, beginning Sept. 1, or RSV monoclonal antibody starting Oct. 1.
      • Expanded recommendation: High risk toddlers 8–19 months old entering their second RSV season should receive RSV monoclonal antibody nirsevimab starting Oct. 1.

Co-administration of COVID-19, flu, and RSV vaccines is safe.

More details for each disease:

COVID-19 vaccine recommendations

AAP recommends:

  • Infants 6–23 months and children 2–18 years with a high-risk condition should receive COVID-19 vaccine.
  • All other children 2–18 years may receive COVID-19 vaccine.
  • Find details in the AAP immunization schedule.

AAFP recommends:

  • All adults 19 years or older should receive an annual updated COVID-19 vaccine.
  • All immunocompromised adults should receive at least one dose of the current season’s COVID-19 vaccine. Base additional doses on prior vaccination history and clinical judgment (see IDSA 2026 guidelines for immunocompromised patients).
  • Adults 65 years or older should receive 2 doses each season, separated by 6 months.
  • Find details in the AAFP immunization schedule.

ACOG recommends:

Approved COVID-19 vaccine products for the 2025–2026 season include:

  • 2026–2027 Pfizer‑BioNTech COVID‑19 vaccine: Comirnaty for 5 years–64 years with at least one high risk condition and all people 65 years or older.
  • 2026–2027 Moderna COVID‑19 vaccine: Spikevax for 6 months–64 years with at least one high risk condition and all people 65 years or older.
  • 2026–2027 Moderna COVID‑19 vaccine: mNEXSPIKE for 12 years–64 years with at least one high risk condition and all people 65 years or older.
  • 2026–2027 Novavax COVID‑19 Vaccine: Nuvaxovid for 12 years or older.

For most people, the minimum interval between their last COVID-19 vaccine dose and their updated dose is 8 weeks.

To support access, DOH maintains a statewide standing order under the direction of the State Health Officer. It authorizes healthcare providers to vaccinate people 6 months or older, including pregnant people, who do not have contraindications to the vaccine. For some, vaccination will be “off-label” use. Learn more in frequently asked questions (FAQs) for healthcare providers.

Influenza vaccine recommendations

AAP, AAFP, and ACOG recommend everyone 6 months or older get updated 2026–2027 influenza vaccine. It reduces the risk of influenza and its potentially serious complications. All influenza vaccines are trivalent this year.

Some children 6 months–8 years old need 2 doses of influenza vaccine, including those who:

  • Are getting influenza vaccine for the first time.
  • Previously got only 1 dose of influenza vaccine.
  • Have an unknown vaccination history.

People who are pregnant or might be pregnant during influenza season should get influenza vaccine. They and those with certain medical conditions or those who are immunocompromised should not get live, attenuated intranasal influenza vaccine.

FDA approved a new influenza vaccine for adults 50 years or older this year, Moderna mFLUSIVA. For adults 65 years or older, it received accelerated approval, with a requirement for additional post-approval evidence confirming clinical effectiveness.

Adults 65 years or older should preferentially get high dose, recombinant, adjuvanted, or mRNA influenza vaccine when available. However, if these options are not immediately available, another influenza vaccine is acceptable and should be offered.

Most people should ideally get influenza vaccine in September or October. Continue to offer influenza vaccine throughout the season, as long as influenza viruses are circulating.

RSV recommendations for children

AAP recommends protection against RSV for:

  • All infants born during or entering their first RSV season.
  • Certain children 8–19 months old at increased risk for severe RSV disease.

Infants younger than 8 months born during or entering their first RSV season can be protected via:

  • Maternal vaccination: Pregnant people should receive the Abrysvo RSV vaccine during 32–36 weeks gestation.
  • Infant monoclonal antibody immunization: Infants should receive RSV immunization after birth.

Children 8–19 months old at increased risk for severe RSV disease entering their second RSV season should get the RSV monoclonal antibody nirsevimab.

Abrysvo maternal vaccination details:

  • Administer Sept. 1–Jan. 31.
  • 1 dose during 32–36 weeks gestation.
  • Subsequent pregnancies: additional doses not recommended.
  • Abrysvo is the only FDA-approved RSV vaccine for pregnant people.

RSV monoclonal antibody details:

  • Administer Oct. 1–March 30.
    • For infants born during this time, monoclonal antibody should be administered within 1 week of birth, ideally at the hospital.
  • AAP recommends RSV monoclonal antibody for infants if:
    • The mother did not get RSV vaccine during pregnancy.
    • You don’t know the mother’s RSV vaccination status.
    • The infant was born within 14 days of maternal RSV vaccination.
  • AAP recommends nirsevimab for children up to 19 months old entering their second RSV season if they have certain risk factors for severe disease (note that the list of risk factors has been expanded in the 2026-27 guidance). See footnotes in AAP schedule.
  • Two products are available this season:
    • Clesrovimab (Enflonsia): 1 dose for infants younger than 8 months regardless of weight entering their first RSV season. Not recommended for infants 8 months or older.
    • Nirsevimab (Beyfortus):
      • A single dose for infants younger than 8 months (50 mg for infants <5 kg and 100 mg for infants ≥5 kg) entering their first RSV season.
      • A single 200 mg dose administered as 2 IM injections (2 x 100 mg) for children up to 24 months old, regardless of body weight, in the risk groups listed above.
  • Except in rare circumstances, infants younger than 8 months who are born 14 or more days after their mother got RSV vaccine don’t need RSV monoclonal antibody. Learn more about special situations and populations.

RSV reccomendations for adults

3 RSV vaccines are licensed for use in adults 50 years or older:

  • Arexvy (GlaxoSmithKline).
  • mRESVIA (Moderna).
  • Abrysvo (Pfizer).

AAFP recommends a one-time dose of RSV vaccine for all adults 75 years or older, as well as adults 50–74 years old who are at increased risk of severe RSV disease based on comorbid medical conditions. See footnotes of AAFP schedule for a list of conditions.

RSV recommendations for immunocompromised adults and adolescents

IDSA recommends a one-time dose for all immunocompromised adults and adolescents.

  • Adults 18 years or older should receive a one-time dose.
  • For adolescents under 18 years, clinicians should discuss vaccination based on individual risk factors through shared clinical decision making.
  • Additional doses for adults and adolescents may be considered on a case-by-case basis based on individual risk through shared clinical decision making.

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