Four major U.S. medical organizations have issued coordinated vaccination recommendations for the 2026–27 respiratory-virus season, covering influenza, COVID-19 and respiratory syncytial virus (RSV) across different patient populations.
The American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG) and Infectious Diseases Society of America (IDSA) released guidance for their respective populations on Sept. 2. The American Medical Association (AMA) and Vaccine Integrity Project supported the evidence review underpinning the recommendations.
The groups said the coordinated guidance is intended to provide physicians and patients with a consistent, evidence-based reference as the U.S. federal vaccine-policy process remains unsettled.
Flu Vaccination Remains Broadly Recommended
The organizations continue to support influenza vaccination for broad segments of the population.
The AAFP recommends influenza vaccination for everyone aged 6 months and older. For adults 65 and older, it recommends preferential use of enhanced influenza vaccines when available, while advising that vaccination should not be delayed when a preferred formulation cannot be obtained.
The AAP recommends annual influenza vaccination for children beginning at 6 months of age, unless medically contraindicated. Its 2026–27 pediatric guidance also addresses antiviral treatment during the influenza season.
COVID Recommendations Vary by Risk
COVID-19 vaccination recommendations differ according to age and individual medical circumstances.
For adults, the AAFP recommends COVID-19 vaccination, with particular emphasis on people aged 65 and older. The AAP recommends vaccination for children 6 months through 23 months and for older children in specified higher-risk circumstances, while also supporting vaccination when parents choose it.
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The IDSA separately recommends COVID-19 vaccination for immunocompromised people aged 6 months and older, with additional doses considered according to individual circumstances.
RSV Protection Targets Higher-Risk Groups
RSV recommendations are more narrowly focused on populations considered at greater risk of severe disease.
The AAFP recommends RSV vaccination for adults aged 75 and older and for those aged 50 to 74 with qualifying high-risk conditions. The IDSA recommends RSV vaccination for immunocompromised adults aged 18 and older, while clinical judgment guides vaccination decisions for younger patients.
For infants, the AAP recommends RSV immunization for children younger than 8 months entering their first RSV season unless they are already protected through maternal vaccination. The group also expanded recommendations covering certain high-risk children aged 8 through 19 months entering their second RSV season.
Pregnancy Has Specific Immunization Guidance
ACOG provides recommendations specifically addressing vaccination during pregnancy.
The organization recommends influenza and COVID-19 vaccination during pregnancy and recommends maternal RSV vaccination during the first eligible pregnancy during the appropriate seasonal window. Its 2026 maternal immunization schedule lists influenza and COVID-19 vaccination as routinely recommended during pregnancy.
ACOG said its recommendations are based on available evidence concerning the benefits and safety of maternal immunization.
Evidence Review Found No New Safety Concerns
The recommendations were informed by an evidence review conducted through the Vaccine Integrity Project in collaboration with the AMA.
The review examined evidence on the effectiveness and safety of influenza, COVID-19 and RSV vaccination. It found no new safety concerns that would overturn the medical organizations’ recommendations.
For RSV, the review found substantial protection against severe disease and hospitalization among older adults, pregnant people and infants receiving recommended preventive measures.
Pediatric RSV Guidance Expands
The AAP’s updated RSV recommendations include expanded categories of children aged 8 through 19 months who may qualify for RSV immunization because of elevated risk of severe disease.
The organization continues to recommend protection for infants entering their first RSV season unless maternal vaccination has already provided protection. Its guidance also maintains COVID-19 vaccination recommendations for younger children and children with specified risks.
Groups Apply Evidence to Different Populations
The four organizations are not proposing one identical vaccination schedule for every person. Instead, each applies the reviewed evidence to the populations it primarily serves.
The AAFP’s recommendations address family medicine and adult care, while the AAP focuses on children. ACOG addresses pregnancy, and IDSA provides guidance relevant to people with compromised immune systems.
That approach allows the recommendations to account for differences in age, medical risk and pregnancy while maintaining a common evidence-based framework.
The guidance arrives ahead of the fall and winter period when respiratory viruses typically increase in the United States. The AAP released its influenza recommendations in August and its COVID-19 and RSV guidance on Sept. 2 as part of its annual immunization process.
The coordinated recommendations do not resolve broader disagreements over U.S. vaccination policy. They instead provide clinicians with population-specific guidance based on the organizations’ review of current evidence as the 2026–27 respiratory-virus season approaches.
Reporting Credit: American Academy of Family Physicians; American Academy of Pediatrics; American College of Obstetricians and Gynecologists; Infectious Diseases Society of America; American Medical Association; Vaccine Integrity Project.
