Leading U.S. medical groups are urging individuals to receive updated flu and COVID-19 vaccinations this fall. On Wednesday, they issued guidelines and emphasized the scientific basis behind these recommendations, aiming to reduce confusion stemming from previous inconsistent advice from the Trump administration. Flu vaccinations are beginning, and COVID-19 shots are starting to arrive following the FDA's approval of this year's updated versions last week. Additionally, the winter season poses another vaccine-preventable risk known as RSV. The guidelines clarify who should receive one or more of these vaccines and when.
Typically, the Centers for Disease Control and Prevention (CDC) provides this advice, with assistance from independent advisers. However, last year, Trump administration health officials began retracting some established recommendations for fall virus protection and routine vaccinations for children, despite a lack of new scientific evidence. The CDC has not responded to inquiries about new fall guidance but has suggested on its website that doctors adhere to last year's flu recommendations.
To address this gap, several medical societies, including the American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, and the Infectious Diseases Society of America, have released vaccination guidelines for their respective patient populations. Dr. Sandra Fryhofer from the American Medical Association stated, "There's been a lot of confusion and chaos regarding vaccine recommendations."
The recommendations and evidence regarding vaccine safety and effectiveness will be made available on websites to provide the public with clear, consistent, science-based guidance during this period of uncertainty. The medical societies agree that nearly everyone aged 6 months and older should receive a flu vaccination, particularly those aged 65 and older, pregnant women, young children, and individuals with chronic health issues such as asthma, diabetes, heart disease, and weakened immune systems. The last two flu seasons have seen unusually high numbers of child deaths, primarily among unvaccinated children.
While flu vaccines do not prevent all infections, they significantly reduce severe outcomes, decreasing hospitalizations among older adults by 31%, according to the Vaccine Integrity Project, a public health group based at the University of Minnesota. This analysis was published in the medical journal JAMA. Three enhanced flu vaccines are available to better protect seniors, and the American Academy of Family Physicians recommends selecting one, advising against delays if that option is unavailable.
This year, individuals aged 50 and older have a new option: the first flu vaccine utilizing mRNA technology, which was instrumental in combating the COVID-19 pandemic. A study found that Moderna's mFlusiva was 27% more effective against symptomatic illness in individuals aged 50 to 64 compared to standard shots. The FDA has approved this new option, with doses expected to be available soon at select pharmacies.
For those averse to shots, a nasal spray option, FluMist, is available for individuals aged 2 to 49 who meet specific health criteria. COVID-19 vaccinations, once recommended for nearly everyone by federal health agencies, are now formally approved only for higher-risk individuals, including those aged 65 and older or younger individuals with at least one health condition that increases their risk. However, family physicians recommend that all adults, particularly seniors and those with risk factors, receive a COVID-19 vaccination. Adults aged 65 and older should receive a fall dose followed by a second dose six months later to maintain immunity.
The American Academy of Pediatrics recommends COVID-19 vaccinations for all children aged 6 months to 23 months and for older children with high-risk conditions, as well as for any child whose parent wishes for them to be vaccinated. Dr. Christina Davidson from ACOG emphasized that there is no evidence suggesting that COVID-19 vaccination during pregnancy increases the risk of miscarriage or other complications.
Individuals can choose from vaccines developed by Moderna, Pfizer, or the non-mRNA version from Novavax and Sanofi, depending on their age. Similar to flu vaccines, these COVID-19 shots are more effective at preventing severe disease than mild cases. The Vaccine Integrity Project reported that last fall's COVID-19 vaccinations reduced hospitalization risk by 53% among seniors and significantly decreased emergency room visits for very young children.
Common side effects of flu and COVID-19 vaccines are generally mild and temporary, including sore arms, fatigue, headaches, muscle aches, and mild fever, with a slightly higher incidence reported for the new mFlusiva compared to standard flu shots. While pediatricians and some clinics offer both flu and COVID-19 vaccinations, they are most commonly available at pharmacies.
For COVID-19 vaccinations, states have varying pharmacy regulations. For instance, Walgreens provides these shots without a prescription in all but two states, Arizona and Oregon, and can administer doses to children as young as 3 in some states, while others have higher age limits. Medicare covers the fall vaccinations, and most private health insurers plan to continue coverage through 2027.
October is considered an ideal time for flu vaccinations, as influenza typically begins spreading in November. COVID-19 cases tend to rise in late summer and again after the winter holidays. Dr. Fryhofer noted that timing the COVID-19 shot a few weeks before an important event is advisable to avoid illness.
RSV, or respiratory syncytial virus, is generally a mild illness during the fall, winter, and early spring but can be severe for infants and older adults. Family physicians recommend a one-time vaccination for adults aged 75 and older, individuals aged 50 to 74 at increased risk, or younger individuals with weakened immune systems. Additionally, vaccination during late pregnancy is recommended to protect infants born during RSV season, and pediatricians suggest a vaccine-like medication for high-risk infants whose mothers were not vaccinated.
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