Doctors say they’re filling a void left by CDC on vaccines. Here’s what to know about flu, Covid-19 and RSV this fall
By Jacqueline Howard, CNN
(CNN) — With children back in school and the looming threat of respiratory viruses like Covid-19, influenza and RSV on the horizon, many people may now be wondering how to stay healthy.
Typically, the US Centers for Disease Control and Prevention launches a fall campaign around this time of year, recommending seasonal immunizations such as the flu shot and Covid-19 vaccines. But under the second Trump administration, the agency has mostly been silent this year.
The CDC hasn’t issued new recommendations for RSV immunization or Covid-19 vaccines for this season. Last year, the agency updated Covid-19 vaccine guidance to shift away from a broad recommendation, instead saying that patients must consult with a healthcare provider to get the vaccine.
On Tuesday, the agency updated its clinical guidance for the flu shot to follow last year’s recommendations, noting on its website that “the CDC states the recommendations for seasonal influenza vaccination from the July 2025 immunization schedule remain in effect for the 2026-2027 influenza season.” The update does not mention the first mRNA flu vaccine, which was approved by the US Food and Drug Administration last month for use in older adults.
To help fill the void, the American Medical Association and the University of Minnesota’s Vaccine Integrity Project launched their own independent reviews of this fall’s vaccines – including those for flu, Covid and RSV – which was published Wednesday in the medical journal JAMA.
The review papers helped inform 2026-27 respiratory virus immunization recommendations released Wednesday by several medical groups, including the American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists and the Infectious Diseases Society of America.
“For more than 60 years, the United States has benefited from an established federal process for evaluating vaccine evidence and translating that science into recommendations for the American public. At the center of that process were the Centers for Disease Control and its Advisory Committee on Immunization Practices, the ACIP,” Dr. Bruce Gellin, board chair of the Vaccine Integrity Project and professor of medicine at Georgetown University, said at a news briefing.
“Unfortunately today, the federal government is not fulfilling that responsibility in the way that it historically has. But the need for that work has not disappeared. Influenza, SARS-CoV-2 and the RSV viruses will circulate again this fall and winter,” Gellin said.
“Clinicians will still have patients to care for. Parents will still have decisions to make for their children, and older Americans, pregnant women and people with underlying health conditions will still need to know how best to protect themselves,” he said. “We cannot allow the breakdown of a federal process to create a vacuum in evidence-based vaccine guidance.”
The US Department of Health and Human Services has not responded to CNN’s request for comment on the groups’ recommendations.
The recommendations provide guidance on which fall vaccines are recommended for whom and when is the optimal time to get them.
Flu and RSV immunizations are now available at major pharmacies, and updated Covid-19 shots were recently approved by the FDA and are becoming available.
“And really reassuringly, insurers have indicated to the major groups that they will cover these respiratory virus immunizations,” Dr. Sarah Nosal, president of the American Academy of Family Physicians, said in the news briefing.
“Vaccines are one of medicine’s greatest success stories. They prevent serious illness, reduce hospitalizations and long-term complications and save lives,” Nosal said in a news release. “As federal guidance evolves, the science behind vaccines remains strong. These recommendations are grounded in the latest evidence, informed by public health experts and shaped by what family physicians are seeing every day in their patients.”
RSV immunization
Who should get it
The groups eligible for RSV immunizations include older adults, pregnant people and infants.
“People age 50 and older with high-risk conditions, and everyone over 75 years old, should get one dose,” Nosal said. “This is not an annual vaccine. If you got one before, you do not need a new one this year. Getting one should protect you throughout the entire season.”
During pregnancy, RSV vaccination is recommended in the third trimester, between weeks 32 and 36.
Children younger than 8 months should be immunized against RSV using a monoclonal antibody unless their mother got an RSV vaccination during pregnancy, said Dr. Andrew Racine, president of the American Academy of Pediatrics.
“If the mother’s immunization status is unknown, that child should be immunized,” Racine said in the briefing. He added that children between 8 months and 19 months of age who are in certain high-risk groups for severe disease are also recommended to get the RSV monoclonal antibody.
And a single dose of RSV vaccine is recommended for adults who have weakened immune systems.
“Immunosuppressed individuals are at higher risk for severe disease than immunocompetent individuals,” Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center, who was not involved in the new recommendations, said in an email. “The vaccines are also generally less effective in immunosuppressed individuals compared with immunocompetent individuals.”
When to get it
For older adults, RSV vaccinations are typically recommended in late summer and early fall.
The advice slightly changed this year for pregnant people.
“ACOG now recommends that pregnant individuals receive a single dose of the maternal RSV vaccine, Abrysvo, from September 1 through March 1 instead of only through January 31,” Dr. Christina Davidson, chief medical officer of the American College of Obstetricians & Gynecologists, said in the news briefing.
“We made this change because the RSV disease season is now occurring later in the spring, and it is also more severe than it used to be,” Davidson said. “The extension of the eligibility window will help provide pregnant patients and their infants with additional protection.”
For infants, the RSV monoclonal antibody is typically recommended around virus season, from October through March.
Seasonal flu shots
Who should get it
Everyone 6 months and older is recommended to get an annual flu shot.
“On average, flu vaccines reduce the risk of needing to go to the doctor by 30% to 60%,” Nosal said.
“Adults 65 years and older should get an enhanced flu vaccine, one that is high-dose, adjuvanted or recombinant, when it’s available,” she said. “But do not delay your vaccination if that one’s not available.”
And for the first time, an mRNA-based flu vaccine is available for use in adults 50 and older.
The flu vaccine is also recommended during pregnancy, but pregnant people should avoid the nasal spray version, according to the recommendations.
“Pregnant and postpartum people still have a significantly higher risk of developing serious complications from infection compared with non-pregnant people,” Davidson said.
“The inactivated or recombinant influenza vaccines remain the only vaccines that are recommended for use in pregnancy in any trimester, so please work with your OB care clinician or pharmacist to get these,” she said. “Most importantly, if you are able to get the vaccine while you are pregnant, the immunity will also, in part, pass on to your baby.”
When to get it
October is the ideal time to get vaccinated, Nolan said, because “protection wanes throughout the season.”
Some providers use the slogan “flu before boo” to remind people to get a flu shot before Halloween.
Updated Covid-19 vaccines
Who should get it
Getting an updated Covid-19 vaccine is recommended for adults.
“If you’re older than 19, we recommend getting the Covid-19 vaccine,” Nosal said.
“This is especially important for people who are 65 years and older, at increased risk for severe Covid infection and those who’ve never received a Covid-19 vaccine,” she said. “For those adults 65 years and older, they should receive a second dose of the updated Covid-19 vaccine six months after that season’s initial dose to help maintain protection as immunity wanes over time.”
The vaccine is also recommended for infants between 6 months and 23 months of age, and children in certain high-risk groups or those whose families request vaccination.
And for people who are immunocompromised, the annual updated Covid-19 vaccine is recommended for ages 6 months and older.
Last year, the CDC recommended Covid-19 vaccines based on conversations with the patient’s healthcare provider, known as shared decision-making, Barouch noted, but the agency “also emphasized that the risk-benefit of the vaccines is most favorable for individuals who are at higher risk of severe disease.”
Davidson, of ACOG, said the vaccine is also recommended during pregnancy.
“The most important message is this: If you are pregnant, considering pregnancy or are a new or breastfeeding parent, please get your vaccine or your annual booster. All four of the available Covid vaccines are safe for you,” Davidson said.
Moderna offers two mRNA shots, Pfizer and BioNTech have another, and Sanofi and Novavax offer a more traditional protein-based version.
“A recommendation for the Covid vaccine is based on more than five years of research and millions of administered doses,” Davidson said. “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.”
When to get it
It’s recommended to get the updated vaccine now, but if you have been recently infected with Covid, experts advise waiting four to six months before getting the vaccine.
The updated Covid-19 vaccine “targets the most recent strain that’s been circulating, and so if you want to update your protection, that’s the best way to do it,” Dr. Sandra Adamson Fryhofer, president-elect of the American Medical Association, said in the news briefing.
“You know, your computer constantly needs to be updated. Well, your immune system, your immunity needs to be constantly updated too,” she said. “You’re going to get your most protection in those first few months after the vaccine. So if you have a big event – if you have to go to a wedding, or if you’re going on some fabulous trip, or you’re going to a fabulous birthday party, or just any birthday party or get-together – think about getting that vaccine a couple of weeks before that event, so you’ll stay healthy and well.”
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