Fall Vaccine Checklist: What to Know for 2026

As respiratory illness season approaches, updated vaccines can help protect against influenza, COVID-19, and respiratory syncytial virus (RSV). Recommendations vary by age, medical history, and other individual circumstances.

The most important step is to review which vaccines are recommended for you and your family before respiratory viruses begin circulating more widely. Vaccination is especially important for older adults, young children, pregnant individuals, and people with medical conditions that increase their risk of serious illness. In addition to vaccination, everyday precautions can provide added protection. Consider improving indoor ventilation, washing your hands regularly, avoiding close contact with people who are sick, and wearing a well-fitting mask in crowded indoor settings when respiratory illness levels are high.

This checklist reflects the most recent information available at the time of publication. The strains included in the 2026–2027 flu vaccine have been selected, but some detailed recommendations about who should receive specific flu vaccines and when were still being finalized. For COVID-19, final vaccine approvals, dosing schedules, and CDC recommendations were also still pending. Readers should check with their healthcare provider for the latest guidance.

This information is educational and should not replace individualized medical advice. Recommendations may change as final 2026–2027 guidance is released.

If you develop respiratory symptoms, get tested for flu and COVID-19 when possible. If you are at increased risk of serious illness, contact your healthcare provider promptly because treatment works best when started early.

Flu

It is important to receive a flu vaccine every year because influenza viruses change and protection from vaccination decreases over time. Annual vaccination reduces the risk of flu and its complications, particularly among those who have an increased risk of serious illness.¹ Even when vaccination does not prevent infection completely, it can reduce the severity of illness.

The 2026–2027 flu vaccine remains trivalent, meaning it protects against three influenza viruses: two influenza A viruses and one influenza B virus. All three components have been updated from the previous season to better match the viruses that are expected to circulate, including an influenza A(H3N2) virus that was common during the 2025–2026 season.²

Several types of flu vaccines are available. Most people receive a traditional injectable flu vaccine, with different formulations available depending on age and health history. For eligible people ages 2–49, FluMist® offers a nasal spray option that can be used at home, either self-administered by eligible adults or given to children by a caregiver.³ New for this season, the FDA has also approved mFlusiva, the first mRNA-based flu vaccine, for adults ages 50 and older.⁴ In clinical trials, mFlusiva offered better protection against confirmed flu than the standard flu vaccines used for comparison.⁴ Guidance on how this new option will fit into seasonal flu vaccine recommendations is still being finalized.⁵

The recommendations below reflect the most recent guidance available when this article was prepared. Because flu guidance may be updated as the season approaches, check with your healthcare provider about the best vaccine and timing for you.

Flu Vaccine Recommendations

• Everyone aged 6 months and older, with rare exceptions, should get a flu vaccine every season.^6,7
• Adults 65 and older should preferentially receive a high-dose, adjuvanted or recombinant flu vaccine when available. If none is available, they should receive another age-appropriate flu vaccine rather than delay vaccination.
• Some children aged 6 months through 8 years need two doses of flu vaccine at least four weeks apart, depending on their prior vaccination history. Parents should confirm the appropriate schedule with their child’s healthcare provider.
• Pregnant individuals should receive an injectable flu vaccine during any trimester. The nasal-spray vaccine should not be used during pregnancy.
• Flu vaccination is also safe while breastfeeding. Those who were not vaccinated during pregnancy should receive a flu vaccine after delivery if they have not already been vaccinated for the season. Antibodies passed through breast milk may provide some protection to infants, including those younger than 6 months who are too young to be vaccinated.⁸

COVID-19

COVID-19 vaccine recommendations have evolved as population immunity, circulating variants and available evidence have changed. Vaccination can provide meaningful protection across age and risk groups by reducing the likelihood of infection and helping protect against severe illness and hospitalization. Evidence also suggests that vaccination may reduce the risk of infection and Long COVID.⁹ The benefits are especially important for older adults, people who are immunocompromised and those with underlying health conditions, but healthy children and adults may also benefit as immunity decreases, and the virus continues to change.

The FDA has advised manufacturers that the 2026–2027 COVID-19 vaccines should target the XFG variant, which belongs to the JN.1 lineage and more closely matches currently circulating SARS-CoV-2 viruses. The updated vaccines may include both mRNA and protein-based options, depending on final FDA approvals and product availability.¹⁰

Final CDC recommendations for the 2026–2027 COVID-19 vaccines had not been issued when this article was prepared. Below, we summarize the CDC’s 2025–2026 guidance for adults¹¹ and current guidance from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP), which maintain independent immunization guidance.¹² Recommendations may be updated as the new vaccines become available.

CDC COVID-19 vaccine Guidance for adults (2025-2026)

For 2025–2026, CDC recommended vaccination for everyone aged 6 months and older through individual-based decision making with a healthcare provider.¹¹ The potential benefits were greatest for people at increased risk of severe COVID-19. These include:

• Adults aged 65 and older
• People with health conditions or other factors that increase their risk of severe COVID-19
• People who are immunocompromised
• Pregnant individuals
• Residents and employees of long-term care facilities or other congregate settings

AAP and AAFP COVID-19 Vaccine recommendations

Guidance from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) supports COVID-19 vaccination across age groups. The AAFP maintains recommendations for both adults and children, while the AAP provides pediatric guidance.^12,13

COVID-19 vaccination is recommended for:

• Adults aged 19 and older, with additional doses recommended for adults aged 65 and older and certain people who are immunocompromised.¹³
• Pregnant individuals¹³
• All infants and children aged 6 to 23 months^12,13
• Children and adolescents aged 2 to 18 years who:^12,13
  • Have a medical condition that increases their risk of severe COVID-19, such as chronic lung or heart disease, diabetes, certain neurological conditions, or a weakened immune system
  • Live with someone at increased risk of severe COVID-19
  • Live in a long-term care facility or other congregate setting
  • Have not previously received a COVID-19 vaccine
  • Have a parent or guardian who would like them to be vaccinated

RSV

RSV is a highly contagious virus that usually causes cold-like symptoms but can lead to severe or even life-threatening illness in infants, older adults and people with certain medical conditions. The age range for risk-based adult vaccination has expanded from ages 60–74 to ages 50–74. CDC now recommends vaccination for higher-risk adults in this age group, as well as all adults aged 75 and older.¹⁴

Three RSV vaccines are available for eligible adults, including the protein-based vaccines Abrysvo® and Arexvy® and an mRNA-based vaccine, mResvia®. RSV vaccination is not currently annual; people who have already received one dose should not get another dose. Eligible adults who have not yet been vaccinated can receive a dose at any time, although late summer or early fall is considered the best time.

To protect infants, one dose of Abrysvo® vaccine is recommended during weeks 32–36 of pregnancy, particularly during RSV season (September through January in most of the U.S). Alternatively, eligible infants may receive a long-acting monoclonal antibody, either Beyfortus® (nirsevimab) or Enflonsia™ (clesrovimab). Most infants need maternal vaccination or an infant antibody, but not both. These antibodies substantially reduce the risk of RSV-related hospitalization in infants.

RSV Vaccines for Older Adults

• Adults aged 75 years and older should receive a single dose of RSV vaccine.¹⁴
• Adults aged 50 to 74 years who are at increased risk of severe RSV illness should receive a single dose of RSV vaccine. Risk factors include chronic heart or lung disease, a weakened immune system, certain other medical conditions, frailty, and residence in a nursing home or other long-term care facility.

RSV Vaccines During Pregnancy

• For those who will be 32 to 36 weeks pregnant during the months of September through January, a single dose of Abrysvo® is recommended to help prevent severe RSV in infants from birth through 6 months.^15–17

RSV Antibodies for Infants

• Infants younger than 8 months old who were born during or entering their first RSV season (typically fall through spring), should receive an infant RSV antibody if their mother did not receive an RSV vaccine during pregnancy, her vaccination status is unknown, or the infant was born within 14 days of maternal vaccination.^7,15,18
• Certain children aged 8 through 19 months who are at increased risk of severe RSV should receive Beyfortus® (nirsevimab) before their second RSV season. This includes some children with chronic lung disease, severe immunocompromise or cystic fibrosis, as well as American Indian or Alaska Native children.¹⁸

Frequently asked questions

Where are vaccines available?

Vaccines are available through many healthcare providers, pharmacies, health centers, and local health departments. Vaccines.gov can help locate vaccination sites nearby, and many pharmacy chains, including CVS, offer online scheduling. Availability and eligibility can vary by vaccine and location, so it is a good idea to confirm that the vaccine you need is available when making an appointment. The HHS vaccine access guide also provides information on where to get vaccinated, including options for people without insurance.

Can flu, COVID-19 and RSV vaccines be given together?

Yes. Flu, COVID-19, and RSV vaccines can generally be administered during the same visit at different injection sites.

Receiving more than one vaccine together may increase temporary side effects such as soreness, fatigue or headache. However, it can also reduce the need for multiple appointments. There is no required minimum waiting period if someone prefers to receive the vaccines separately.¹⁹

Can the flu vaccine cause the flu?

No. Injectable flu vaccines do not contain infectious influenza virus. The nasal-spray vaccine contains weakened virus that is designed not to cause flu illness.

When is the best time to get vaccinated?
Early fall is a good time for many people to get vaccinated because protection takes time to develop before respiratory viruses begin circulating more widely. The best timing depends on the vaccine, your age, pregnancy status, and vaccination history.

Should someone who recently had COVID-19 get vaccinated?

A previous infection does not eliminate the potential benefit of vaccination. Under the most recent CDC guidance, people who recently had COVID-19 may consider waiting up to three months after symptoms began, or after a positive test if they had no symptoms, before receiving a vaccine. The best timing may depend on personal risk, exposure and community transmission. 

What should someone do if symptoms develop?

Contact your healthcare provider promptly if you develop respiratory symptoms and are at increased risk of serious illness. Antiviral treatments for flu and COVID-19 work best when started early.

Seek urgent medical care for warning signs such as difficulty breathing, persistent chest pain, confusion, dehydration, pauses in an infant’s breathing or rapidly worsening symptoms.