As cooler weather settles across the United States, the nation enters its annual respiratory virus season. This period, typically spanning from fall through early spring, brings an anticipated increase in cases of COVID-19, influenza (flu), and Respiratory Syncytial Virus (RSV). In its annual outlook report, the Centers for Disease Control and Prevention (CDC) projects the 2025-26 season will see a similar number of peak hospitalizations from these three viruses compared to the previous year.
Medical experts consistently state that vaccination is the most effective single measure to reduce the risk of severe illness, hospitalization, and death from these circulating viruses. “We are so fortunate to be in a time that we have these protective measures, especially for our children,” said Dr. Hansa Bhargava, a board-certified pediatrician at Children’s Health Care of Atlanta and adjunct Professor at Emery University, in an interview with ABC News.
She further emphasized the importance of community-wide protection, stating, “It’s really important to get the vaccines that your doctor recommends, both for yourself and also because even if you get vaccinated and there isn’t herd immunity, which means the community is not protected, then [your family is] at greater risk to get the illness if it comes through.”
However, navigating the latest recommendations can be confusing. This guide breaks down everything you need to know about the COVID-19, flu, and RSV vaccines for the 2025-26 season, explaining who should consider them, what the new guidelines are, and where you can find them.
A Closer Look at the Three Viruses
Before diving into the vaccines, it’s helpful to understand the threats they are designed to combat. COVID-19, influenza, and RSV are all contagious respiratory illnesses, but they are caused by different viruses and can affect populations in distinct ways.
- COVID-19: Caused by the SARS-CoV-2 virus, it can lead to a wide range of symptoms, from mild cold-like signs to severe pneumonia, blood clots, and long-term complications often referred to as “Long COVID.” It continues to circulate year-round, with surges often occurring in the colder months.
- Influenza (Flu): The seasonal flu virus is a familiar annual threat. It can cause mild to severe illness, and at its worst, can lead to hospitalization and death, particularly among the very young, older adults, and those with certain chronic health conditions.
- Respiratory Syncytial Virus (RSV): For most adults and older children, RSV presents as a common cold. However, it can be extremely serious for infants, young children, and older adults with weakened immune systems or underlying lung or heart conditions. It is a leading cause of bronchiolitis and pneumonia in babies under one year old.
Vaccination remains the cornerstone of public health defense against these viruses, reducing the burden on healthcare systems and protecting the most vulnerable members of our communities.
COVID-19 Vaccines: Updated Guidance for a New Phase
The most significant change in this year’s respiratory vaccine landscape involves the COVID-19 shot. Earlier this month, the CDC formally signed off on updated recommendations from its Advisory Committee on Immunization Practices (ACIP), moving away from a universal recommendation for all Americans.
Key Changes in Recommendation:
- Previous Guidance: The CDC recommended that everyone aged 6 months and older receive a COVID-19 vaccine.
- Current Guidance (2025-26): The CDC now states that Americans can get the vaccine “based on individual-based decision-making,” or personal choice. This means that while the vaccine remains available to all aged 6 months and older, the decision is intended to be made in consultation with a healthcare provider, such as a doctor, nurse, or pharmacist.
This shift followed a decision by the U.S. Food and Drug Administration (FDA) to narrow the marketing authorization for the updated COVID-19 vaccines. The FDA’s authorization now specifically targets those aged 65 and older and younger Americans who have at least one underlying medical condition that puts them at high risk for severe COVID-19 (e.g., heart disease, lung disease, diabetes, weakened immune systems).
What This Means for You:
- For Most Adults and Children: The recommendation is no longer a blanket “should” but a “may.” The CDC encourages a discussion with a healthcare provider to weigh individual risks and benefits. Most people who choose to get vaccinated will only need a single dose of the updated 2025-26 formula.
- For High-Risk Groups: Certain groups are strongly encouraged to stay up-to-date. This includes adults 65 and older, the immunocompromised, and those with chronic health conditions. These individuals may be eligible for more frequent dosing, such as one dose every six months, as their healthcare provider advises.
- For Young Children: Despite the CDC’s broader shift, the American Academy of Pediatrics (AAP) has maintained its recommendation that children ages 6 months to 23 months should receive a COVID-19 vaccine due to their higher risk of severe illness.
- For Pregnant Women: The American College of Obstetricians and Gynecologists (ACOG) continues to recommend the COVID-19 vaccine for all women who are pregnant, planning to become pregnant, or nursing. This recommendation was reaffirmed following comments from Health Secretary Robert F. Kennedy Jr. about cutting recommendations for these groups.
This change in guidance has created some confusion among the public. Neal Smoller, a pharmacist and owner of Village Apothecary in Woodstock, New York, told ABC News, “The administration has done a tremendous amount of work creating confusion and chaos over the past year… Now we have disparate recommendations, and so it has confused a lot of people of what is and is not available for them.”
Why Consider the Vaccine?
Public health experts stress that the virus has not disappeared. “COVID has not gone away,” said Dr. William Schaffner, a professor of preventative medicine at Vanderbilt University Medical Center. “It still causes a substantial amount of illness, and we are seeing, locally and around the country, hospitalizations due to COVID itself, and the people who are being hospitalized continue to be people at high risk… who are not up to date with their vaccines. So, you can certainly mitigate, reduce your risk of hospitalization by getting vaccinated.”
Availability and Cost:
COVID-19 vaccines are widely available at most pharmacies, many doctors’ offices, and public health departments. For the 2025-26 season, most insurance plans are expected to cover the full cost of the shot. For the uninsured, programs like the CDC’s Bridge Access Program may provide no-cost vaccines.
Influenza Vaccines: The Unchanged Annual Essential
In contrast to the COVID-19 vaccine, the recommendation for the seasonal flu shot remains broad and consistent. The CDC firmly recommends that everyone aged 6 months and older receive an annual flu vaccine, ideally by the end of October.
Vaccine Options for Different Ages:
There is no longer a one-size-fits-all flu shot. Several vaccine options are available, and the best choice may depend on your age and health status.
- Standard-Dose Inactivated Vaccines: These are the most common flu shots and are approved for anyone aged 6 months and older.
- Nasal Spray Vaccine (LAIV): A live attenuated influenza vaccine is available for healthy, non-pregnant individuals between the ages of 2 and 49.
- Recombinant Vaccine: This is an egg-free vaccine option produced without the influenza virus, approved for adults 18 and older. It may be a preferred option for those with severe egg allergies.
- Adjuvanted and High-Dose Vaccines: Specifically designed for adults aged 65 and older, these vaccines create a stronger immune response. As older adults often have a weaker immune system, these formulations offer better protection against severe flu outcomes.
Dosing Schedule:
- One Dose: Recommended for most people, including children aged 9 and older, and children between 6 months and 8 years who have received two or more total doses of flu vaccine in the past.
- Two Doses: Recommended for children between 6 months and 8 years old who are getting a flu vaccine for the first time, or who have only received one dose in their lifetime. The two doses should be administered at least four weeks apart.
Safety and Efficacy:
The flu vaccine has a long-established safety record. “It’s incredibly safe. It’s given in the millions upon millions of doses around the world each year,” Dr. Schaffner noted. “The major adverse events are sore arm, and there are some people who get a day or two of sore arm, may even have a degree of fever, and feel a little puny for 24 to 48 hours.”
While the vaccine’s effectiveness can vary from year to year based on how well the vaccine strains match circulating viruses, it consistently reduces the risk of doctor’s visits, hospitalization, and death. Even when it doesn’t prevent illness entirely, it can often lessen the severity of the infection.
Availability and Cost:
Flu shots are perhaps the most accessible vaccines, available at primary care offices, pharmacies, grocery stores, and health departments. They are fully covered by virtually all health insurance plans without a copay.
RSV Vaccines: New Tools for Vulnerable Populations
The availability of RSV vaccines for older adults and pregnant women is a relatively new and significant advancement in the fight against respiratory viruses. Unlike the flu and COVID-19 shots, the RSV vaccine is not an annual recommendation for most people.
Recommendations for Older Adults:
The CDC recommends RSV vaccination for two key groups of adults:
- All adults aged 75 and older.
- Adults aged 50 to 74 who are at increased risk of severe RSV disease. Risk factors include:
- Chronic lung diseases (e.g., COPD, asthma)
- Chronic heart conditions (e.g., heart failure)
- Weakened immune systems (from illness or medications)
- Diabetes, kidney, or liver disorders
- Residing in a nursing home or long-term care facility
Currently, three RSV vaccines are licensed by the FDA for use in adults.
Protection for Infants: Two Pathways
There are two approved methods to protect infants from severe RSV, which is a major cause of hospitalization in babies.
- Maternal RSV Vaccination: Pregnant women are recommended to receive a single dose of an RSV vaccine during 32 through 36 weeks of pregnancy. This allows protective antibodies to be transferred to the baby, providing defense for the first six months of life.
- Monoclonal Antibody Shot for Infants: For babies whose mothers did not receive the RSV vaccine during pregnancy, a direct injection of protective antibodies (nirsevimab) is available. This is recommended for:
- All infants younger than 8 months old born during or entering their first RSV season.
- Some high-risk children between 8 and 19 months old are entering their second RSV season.
“It’s very important for babies to be protected against RSV and, therefore, is recommended that pregnant women… from 32 to 36 weeks get the vaccine,” Dr. Bhargava explained.
Dosing and Timing:
A critical point of clarification is that the adult RSV vaccine is not an annual shot. “If you’re like me, and you have received an RSV [vaccine] last year, you do not need another one now,” Dr. Schaffner confirmed. Protection from the vaccine is currently understood to last for at least one full RSV season, and early data suggest it may provide protection for two or even three seasons. The monoclonal antibody shot for infants is a one-dose, seasonal protection.
Availability and Cost:
RSV vaccines for adults and the monoclonal antibody for infants are available at pharmacies, doctors’ offices, and health departments. They are covered by most private insurance plans, Medicare Part D, and Medicaid.
Making Your Vaccination Plan
With three different vaccines to consider, creating a personal and family vaccination plan is a wise step for the fall. Here are some actionable tips:
- Talk to Your Healthcare Provider: This is the most important step. Discuss your age, health status, occupation, and lifestyle with your doctor to make informed decisions, especially regarding the updated COVID-19 guidance.
- Check Your Vaccination Records: Do you know if you received an RSV vaccine last year? Are your children up to date on all their immunizations? A quick check can prevent unnecessary doses.
- You Can Get Multiple Vaccines at Once: The CDC has stated that it is safe to receive the COVID-19 and flu vaccines at the same appointment. If you are eligible for the RSV vaccine, it can also be co-administered. Discuss the best plan for you with your pharmacist or provider.
- Don’t Wait Too Long: It takes about two weeks after vaccination for the body to build full protection. Aim to get vaccinated by the end of October, before virus activity widely escalates.
Conclusion
The landscape of respiratory virus protection is evolving, offering more tailored tools than ever before. While the guidance for COVID-19 vaccines has shifted toward personal choice, the recommendations for flu and RSV vaccines remain strong for their respective target populations. By understanding the latest recommendations and consulting with healthcare professionals, individuals and families can make empowered decisions to navigate the upcoming respiratory virus season with greater confidence and protection.