Fall Vaccines in 2026: What Changed and Who Is Eligible

CDC's vaccine advisory committee (ACIP) has not met in 2026: CDC's meetings page lists its March, June and October 21–23 meetings as cancelled "due to ongoing litigation," and the last one listed is December 4–5, 2025. Instead, CDC posted interim flu (September 1) and COVID-19 (September 23) guidance, and four medical societies issued their own advice on September 2. For you, flu advice is unchanged (everyone 6 months and older, every season), while COVID-19 advice now differs between CDC, the FDA labels and the societies.

Key takeaways

Flu: CDC's September 1, 2026 interim guidance keeps the July 2025 flu recommendations: yearly vaccination from 6 months, ideally in September or October.
COVID-19: FDA's August 27, 2026 approvals cover adults 65 and older and younger people with a high-risk condition. CDC's September 23 page recommends a vaccine for all adults 18 and older and marks some of that use as off-label.
RSV: CDC (page updated February 24, 2026) recommends one dose for all adults 75 and older and for adults 50 to 74 at increased risk. It is not a yearly shot.
Medicare Part B covers flu and COVID-19 shots; RSV falls under Part D. Private-plan rules are tied to ACIP, and the insurers' pledge does not reach every plan.

What it means for you

Adults 75 and older: a yearly flu shot (CDC prefers high-dose, recombinant or adjuvanted for 65 and older) and one RSV dose if you have never had one.
Adults 65 to 74: the same flu preference; one RSV dose only if you are at increased risk of severe RSV. For COVID-19, CDC lists two 2026–27 doses for everyone 65 and older, while the FDA label covers one.
Adults 50 to 64 with health conditions: a yearly flu shot, an RSV dose if you are at increased risk, and COVID-19 vaccination within the FDA label if a condition puts you at high risk of severe COVID-19.
Healthy adults under 50: a yearly flu shot. CDC recommends a COVID-19 vaccine from 18 but marks use without a high-risk condition as off-label. CDC does not currently recommend RSV vaccination for this group.
Pregnant people: ACOG recommends flu, COVID-19 and RSV vaccination, with a longer RSV window than CDC's.
Parents of young children: flu shots from 6 months; the AAP recommends COVID-19 vaccination for all children 6 to 23 months; see the RSV section for infant antibodies.

Flu vaccine for 2026–27

CDC's interim clinical considerations, updated September 1, 2026, say that "because of legal uncertainties and inquiries," the flu recommendations from the July 2025 immunization schedule remain in effect for the 2026–27 season. Adults 65 and older should preferentially get a high-dose, recombinant or adjuvanted vaccine, or any other age-appropriate one if none is available. CDC's flu vaccine page says everyone 6 months and older should get a flu vaccine every season, with rare exceptions.

Formulation

FDA's advisory committee met March 12, 2026, and FDA's composition page lists the 2026–27 strains. CDC's 2026–27 season page says all three components changed from 2025–26, including a change aimed at the influenza A(H3N2) subclade K virus, and that all projected US supply is trivalent (three-component).

Component	Egg-based vaccines	Cell- or recombinant vaccines
A(H1N1)	A/Missouri/11/2025-like	A/Missouri/11/2025-like
A(H3N2)	A/Darwin/1454/2025-like	A/Darwin/1415/2025-like
B (Victoria lineage)	B/Tokyo/EIS13-175/2025-like	B/Pennsylvania/14/2025-like

Timing

CDC says vaccination should ideally be offered in September or October, should continue through the season while flu circulates, and is not recommended in July and August for most groups. An October 15, 2026 AAMC guide notes that a flu shot gives protection into March or even April.

COVID-19 vaccines: labels vs advice

FDA: strain and approvals

After its advisory committee met May 28, 2026, FDA's formula page advised manufacturers that the 2026–27 vaccine should be a monovalent JN.1-lineage XFG vaccine. FDA's product pages list August 27, 2026 approval letters for four vaccines. Each is approved for adults 65 and older and, at younger ages, only for people with at least one underlying condition that puts them at high risk of severe COVID-19:

Spikevax (Moderna): from 6 months
Comirnaty (Pfizer-BioNTech): from 5 years
mNEXSPIKE (Moderna) and Nuvaxovid (Novavax): from 12 years

CDC: broader advice than the label

CDC's 2026–27 COVID-19 guidance (updated September 23, 2026) says a 2026–27 vaccine "is recommended for all adults ages 18 years and older." For ages 6 months to 17 years, it is recommended with moderate or severe immunocompromise; otherwise parents decide with a clinician (shared clinical decision-making).

The page marks several uses as off-label, including vaccinating people 12 to 64 without a high-risk condition and giving adults 65 and older more than one dose. Yet its table lists two doses for that group, 6 months apart (minimum 2 months, or 3 months for mNEXSPIKE). No ACIP vote stands behind the page, since ACIP has not met since December 2025.

Getting the shot at a pharmacy also depends on state rules. Washington's health department, for example, updated a statewide standing order on September 8, 2026 authorizing providers, including pharmacists, to give COVID-19 vaccines.

RSV vaccines for adults and babies

CDC's adult RSV guidance (updated February 24, 2026) recommends a single dose for all adults 75 and older and for adults 50 to 74 at increased risk of severe RSV. Listed risk factors include chronic heart or lung disease, end-stage kidney disease or dialysis, complicated diabetes or diabetes treated with insulin or an SGLT2 inhibitor, chronic liver disease, a BMI of 40 or higher, moderate or severe immune compromise and nursing home residence, plus other factors a clinician judges to raise risk, such as frailty.

CDC has no preference among Arexvy, Abrysvo and mResvia. Late summer or early fall (about August to October in most of the continental US) gives the most benefit. Abrysvo and mResvia are FDA-approved for at-risk adults 18 to 49, but CDC is still reviewing evidence for that group.

Pregnancy and infants

CDC's July 2025 adult schedule notes list one dose of Abrysvo at 32 through 36 weeks of pregnancy, September through January in most of the continental US. CDC's infant guidance (updated August 18, 2025) recommends nirsevimab or clesrovimab for infants under 8 months entering their first season unless the mother was vaccinated at least 14 days before birth. For some high-risk children 8 to 19 months entering a second season, it recommends nirsevimab only.

One caveat: the Congressional Research Service noted (July 29, 2026) that after the March court stay "it is unclear whether a CDC/ACIP recommendation for clesrovimab remains," while nirsevimab's "remains in effect."

Where CDC and medical groups differ

Immunize.org reported that on September 2, 2026, the AAP (children through 18), AAFP (immunocompetent adults), ACOG (pregnant patients) and IDSA (immunocompromised people) released 2026–27 respiratory recommendations.

On March 16, 2026, a federal judge in Massachusetts stayed the HHS Secretary's ACIP appointments, the votes of that committee and the January 5, 2026 schedule (IDSA is a plaintiff). On appeal, a First Circuit calendaring notice in No. 26-1503 set oral argument for October 6, 2026. The Hill reported that it went ahead and that the schedule part of the ruling was not appealed. As of October 20, the court's opinions page listed no decision in the case.

Topic	CDC	Medical societies (September 2, 2026)
COVID-19, adults	2026–27 vaccine for adults 18 and older	AAFP: all adults 19 and older, especially 65 and older; a second dose 6 months after the first for 65 and older
COVID-19, young children	Shared clinical decision-making; recommended for immunocompromised children	AAP: 2026–27 vaccine for all children 6 to 23 months
Flu, adults 65+	High-dose, recombinant or adjuvanted preferred	AAFP: enhanced vaccine (high-dose, adjuvanted, recombinant or mRNA) preferred if available, without delaying vaccination to get one
RSV, pregnancy	Abrysvo, September through January	ACOG, per Contemporary OB/GYN: September 1 through March 1
RSV, second-season children	Nirsevimab for some high-risk children 8 to 19 months	AAP: broader high-risk criteria, including birth before 32 weeks and certain heart, lung, neuromuscular and chromosomal conditions

Insurance: Medicare and private

Medicare

CMS's July 2026 fact sheet says Part B covers flu and COVID-19 vaccines with no patient coinsurance or deductible, and that RSV is a Part D vaccine. Part D enrollees pay nothing for ACIP-recommended adult vaccines, but a plan may charge for one that is not ACIP-recommended. Medicare.gov says the flu shot is free if the provider accepts assignment, as is the RSV vaccine with Part D.

Private and marketplace plans

Under the ACA, per CMS guidance, an ACIP recommendation counts once the CDC director adopts it, and non-grandfathered plans must cover it without cost-sharing from the first plan year that begins one year or more after that. Per CRS (June 11, 2026), a removed recommendation generally stays covered to the end of the plan year. This fall's CDC pages did not come from an ACIP vote, so ask your plan about a specific shot, especially off-label use. HealthCare.gov says $0 cost "isn't guaranteed in all cases."

CRS also reports that the insurer group AHIP updated its voluntary pledge in May 2026 to cover "all ACIP-recommended immunizations with no cost-sharing through the end of 2027." More than 60% of privately insured people are in self-insured employer plans, which such pledges do not necessarily cover, though the federal requirement does.

Frequently asked questions

Can I get a flu shot and a COVID-19 shot at the same visit?

CDC's flu guidance says inactivated and recombinant flu vaccines can be given at the same time as other vaccines. The AAMC guide quotes an expert who suggests one shot in each arm. ACOG, per Contemporary OB/GYN, says the flu, COVID-19 and RSV vaccines approved for pregnancy can be given together.

Should people who had COVID-19 this summer wait?

The AAMC guide says doctors advise waiting a few months after an infection, and quotes one infectious-disease physician saying about three months is probably fine. CDC's COVID-19 page does not address this, so ask your clinician about your own timing.

Is the nasal spray flu vaccine an option?

CDC says FluMist is approved for ages 2 through 49, and FDA has approved it for self-administration by people 18 through 49. CDC says it should not be used in pregnancy, or by caregivers of severely immunosuppressed people who need a protected environment.

Is there an mRNA flu vaccine this year?

The AAMC guide says an mRNA flu vaccine (mFlusiva) is approved for people 50 and older. According to Contemporary OB/GYN, ACOG says it is not approved for pregnancy and has no data for lactating people. AAFP lists mRNA among the enhanced options for adults 65 and older.

Do I need an RSV shot every year?

No. CDC says the adult RSV vaccine "is not currently an annual vaccine," and people who already had a dose should not get another at this time.

Checklist before you book

Adults 65 and older: ask for a high-dose, adjuvanted or recombinant flu vaccine. If you are 75 or older, or 65 to 74 with a risk condition, ask whether an RSV dose is on your record.
Ask the pharmacy whether your state and age group need a prescription for COVID-19 vaccination.
Ask your plan whether the shot is covered in-network at no cost, particularly for off-label use or clesrovimab. On Medicare, ask for Part D billing for RSV.
This article is educational, not medical advice. Talk with a clinician or pharmacist about which vaccines fit your health history.