Leading US medical societies have published their own immunisation recommendations for the upcoming respiratory virus season, filling the void left by federal agencies amid ongoing policy stalls and litigation, and urging vaccinations across a broad demographic to combat flu, Covid, and RSV.
With fresh federal advice for the 2026-27 respiratory virus season still largely missing, four of the biggest US medical societies have published their own playbook for doctors and patients, urging annual flu vaccination from six months of age, broader Covid vaccination than the Trump administration now formally supports, and targeted RSV protection for older adults, pregnant patients and some children. The recommendations were rolled out on the morning of 2 September, just days after the FDA cleared updated Covid vaccines and as new doses began reaching pharmacies. (aafp.org)
That intervention is unusual because, in most years, autumn vaccine guidance comes from the Centers for Disease Control and Prevention and its outside advisers. Instead, that process remains snarled in litigation after the administration moved last year to scale back some long-standing vaccine recommendations without new supporting evidence. NPR reported that the CDC quietly extended its 2025 flu advice into this season, but had still said nothing comparable on Covid or RSV by early September. Bruce Gellin of the University of Minnesota’s Vaccine Integrity Project said: “We cannot allow the breakdown of the federal process to create a vacuum in evidence-based vaccine guidance.” (theguardian.com)
The replacement guidance was coordinated by the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists and the Infectious Diseases Society of America, working with the American Medical Association and the Vaccine Integrity Project. The scientific reviews behind it were published in JAMA and, for influenza, assessed evidence released between 1 August 2025 and 30 June 2026, finding continued protection against severe disease and hospitalisation with no new safety concerns. The AMA has also begun posting the recommendations and underlying evidence on SpreadTheFacts.org so clinicians and the public can see the reasoning in one place. (media.jamanetwork.com)
On flu, the message is close to the long-standing public health consensus: nearly everyone aged six months and over should be vaccinated, with particular urgency for older adults, pregnant women, young children and people with chronic illness. The new JAMA review said vaccination in the 2025-26 season was associated with a 31% reduction in influenza-related hospitalisation among older adults, while vaccination during pregnancy was linked to a 44.4% reduction in confirmed flu infection among infants in their first six months. Over eight seasons, registry data also linked paediatric flu vaccination to 80% effectiveness against influenza-associated death. For patients aged 65 and over, family doctors said an enhanced vaccine such as a high-dose, adjuvanted, recombinant or mRNA product should be used when available, but vaccination should not be postponed to wait for one. Moderna’s new mRNA flu vaccine, mFlusiva, which the FDA approved on 5 August for people aged 50 and over, showed 26.6% relative effectiveness against laboratory-confirmed influenza-like illness compared with a standard-dose shot, although it produced more grade 3 short-term reactions in trials. (jamanetwork.com)
Covid advice is where the split with Washington is sharpest. While federal approval now focuses on higher-risk groups, the family physicians’ guidance says all adults aged 19 and over should be offered a Covid vaccine, especially those aged 65 and over, those with underlying risk factors and those never previously vaccinated. It also calls for a second updated dose six months later for people aged 65 and over. For children, the doctors’ groups back vaccination for all aged six to 23 months, a risk-based approach for those aged two to 18, and continued access for any family that wants a shot. Obstetricians likewise continue to recommend Covid vaccination in any trimester and during lactation. Christina Davidson of ACOG said: “These vaccines not only protect mom’s health and reduce the risk of adverse outcomes during pregnancy, but they also protect the newborn when they are unable to get vaccinated.” Independent evidence reviews found last autumn’s Covid vaccines were 53% effective against hospitalisation in adults aged 65 and over and cut emergency department visits for very young children by 76%. (aafp.org)
RSV guidance is similarly more expansive than the current federal silence. Family doctors said one-off RSV vaccination should be offered to everyone aged 75 and over, to adults aged 50 to 74 who are at higher risk, and to immunocompromised adults and adolescents. Pregnant patients are advised to receive Pfizer’s Abrysvo between 32 and 36 weeks of pregnancy from September to March, while babies under eight months without maternal protection should receive nirsevimab or clesrovimab; some higher-risk children aged eight to 19 months entering a second season should also receive nirsevimab. The emphasis reflects a virus that still imposes a heavy burden: CDC estimates cited by Al Jazeera put RSV at millions of outpatient visits, 170,000 to 340,000 hospitalisations and up to 25,000 deaths. (aafp.org)
Despite the policy confusion, the route to getting the vaccines appears less disrupted than many clinicians feared. NPR reported that private insurers were still expected to cover the respiratory vaccines, Medicare would continue paying, and the Vaccines for Children programme would go on supplying free doses for roughly half of US children. It also reported that most states have uncoupled pharmacists’ authority to administer these vaccines from federal recommendations and now rely more heavily on medical society guidance. Brigid Groves of the American Pharmacists Association said the coming season should be “business as usual”, though a few states may still require a prescription in some cases. (northcountrypublicradio.org)
Even the groups leading this effort are not pretending they can permanently replace the CDC. The accompanying JAMA perspective says such functions should ultimately return to the federal government, and outside experts warned NPR that there is “no substitute” for the kind of clear national messaging the CDC traditionally provided. But with September under way, respiratory season approaching and comprehensive new federal recommendations still absent, the country’s leading medical societies have decided they would rather publish their own evidence-led advice than wait any longer. (jamanetwork.com)
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
