Respiratory Virus Season 2025–2026: What Updated CDC Vaccine Guidance Means for You

Why this respiratory season matters

Every fall and winter, influenza (flu), COVID-19, and respiratory syncytial virus (RSV) circulate at the same time in the United States. That combination can strain hospitals and disrupt schools, workplaces, and long-term care facilities.

The practical takeaway for 2025–2026: most Americans are recommended to receive a seasonal flu shot and an updated COVID-19 vaccine, and certain older adults and high-risk groups should consider RSV vaccination. Vaccination does not eliminate all infections, but it consistently reduces the risk of severe disease, hospitalization, and death.

Current recommendations come from the Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP), which reviews clinical trial data, safety monitoring, and real-world effectiveness before issuing guidance.

What CDC recommends for 2025–2026

COVID-19: Updated seasonal vaccine

CDC recommends updated COVID-19 vaccination for everyone ages 6 months and older, with timing and number of doses depending on age, prior vaccination, and immune status.

Most adults and children should receive one updated seasonal dose if they are eligible and it has been long enough since their last COVID-19 shot.
Adults 65 and older and some people who are moderately or severely immunocompromised may be advised to receive additional doses spaced several months apart.
People who recently had COVID-19 can usually wait about 3 months after infection before getting the updated vaccine, though individual circumstances vary.

The updated formulation targets currently circulating variants. As CDC notes on its Respiratory Viruses Hub, protection against infection may decrease over time, but protection against severe outcomes remains stronger, especially after recent vaccination.

Influenza: Annual vaccination for everyone 6 months and older

CDC continues to recommend annual influenza vaccination for everyone ages 6 months and older, with rare exceptions.

Adults 65 and older are preferentially recommended to receive a high-dose or adjuvanted flu vaccine because these formulations produce a stronger immune response in older adults.
Children ages 6 months through 8 years receiving flu vaccine for the first time may need two doses spaced at least four weeks apart.

Flu vaccine effectiveness varies year to year depending on how well the vaccine strains match circulating viruses. Even in moderate years, vaccination reduces the risk of hospitalization and serious complications.

RSV: Targeted protection for older adults and infants

RSV guidance is more targeted than flu or COVID-19.

Adults ages 75 and older are recommended to receive a one-time RSV vaccine.
Adults ages 60–74 may receive RSV vaccination based on risk factors and shared decision-making with a clinician, such as chronic heart or lung disease, diabetes, kidney disease, or residence in a long-term care facility.
Pregnant people may receive a maternal RSV vaccine during a specific window (typically 32–36 weeks of pregnancy) to protect newborns during their first RSV season.
Infants may receive nirsevimab, a long-acting monoclonal antibody given during RSV season, if maternal vaccination was not given or if they are at higher risk.

RSV vaccination for older adults is not currently an annual shot. CDC guidance describes it as a one-time dose for most eligible adults, based on current evidence about duration of protection.

What’s new or clarified this season

For 2025–2026, key points include:

Continued use of updated COVID-19 vaccines tailored to dominant variants.
Clearer age-based RSV recommendations, with a firm recommendation for adults 75+ and risk-based guidance for ages 60–74.
Ongoing emphasis that co-administration of respiratory vaccines is generally safe.

CDC updates guidance as new safety and effectiveness data become available. Variant trends and vaccine performance are monitored throughout the season.

Can you get COVID-19, flu, and RSV vaccines at the same visit?

In most cases, yes. CDC states that COVID-19, influenza, and RSV vaccines can be given during the same visit, in different injection sites.

Getting multiple vaccines at once may increase the chance of short-term side effects such as:

Sore arm
Fatigue
Low-grade fever
Headache or muscle aches

These reactions typically resolve within a few days. Serious adverse events are rare, and vaccine safety continues to be monitored through federal systems.

Some people choose to space vaccines by a week or two to better distinguish side effects. That is a personal decision and not medically required for most individuals.

Who is at higher risk for severe illness?

Across COVID-19, influenza, and RSV, the following groups face higher risks of hospitalization and complications:

Adults 65 and older
People with chronic heart, lung, kidney, or liver disease
People with diabetes or obesity
Immunocompromised individuals
Pregnant people
Residents of long-term care facilities

For these groups, early vaccination and prompt treatment if symptoms develop are especially important. Antiviral medications are available for both flu and COVID-19 when started early.

How vaccine coverage works in the United States

Medicare

According to the Centers for Medicare & Medicaid Services (CMS):

Influenza and COVID-19 vaccines are covered under Medicare Part B with no cost-sharing when given by a participating provider.
RSV and other ACIP-recommended adult vaccines are covered under Medicare Part D, also without cost-sharing due to recent federal changes.

Beneficiaries should confirm that the pharmacy or clinic accepts Medicare assignment.

Medicaid

Federal Medicaid policy requires coverage of ACIP-recommended vaccines without cost-sharing for most enrollees, though details can vary slightly by state. The Medicaid Preventive Services guidance outlines these requirements.

Private insurance under the Affordable Care Act

Under the Affordable Care Act, most private insurance plans must cover ACIP-recommended vaccines without cost-sharing when delivered in-network. HealthCare.gov notes that network rules apply, so patients should verify that the pharmacy or clinic participates in their plan.

If you are uninsured

Community health centers, local health departments, and some pharmacies may offer low- or no-cost vaccination options. Availability can vary by location and funding.

What remains uncertain

Respiratory virus seasons are unpredictable. Key uncertainties include:

Which COVID-19 variants will dominate later in the season
How well flu vaccine strains will match circulating viruses
How long RSV protection lasts beyond the first season after vaccination

CDC and public health partners monitor hospitalization rates, variant patterns, and vaccine effectiveness throughout the year. Recommendations can evolve if the data change.

Practical next steps

Check your vaccination status and schedule flu and COVID-19 shots early in the season.
If you are 75 or older—or 60–74 with chronic conditions—ask your clinician or pharmacist about RSV vaccination.
Bring your insurance card and vaccination record to your appointment.
If you develop symptoms such as high fever, worsening cough, shortness of breath, or dehydration—especially if you are high risk—seek medical advice promptly.

Respiratory virus season does not look the same every year, but the fundamentals remain steady: vaccination, early testing, and timely treatment reduce severe outcomes. For most Americans, this season’s guidance is straightforward—stay up to date, especially if you or someone you care for is at higher risk.

Sources

This article is for general informational purposes only and is not medical advice. Research findings can be early, limited, or subject to change as new evidence emerges. For personal guidance, diagnosis, or treatment, consult a licensed clinician. For current outbreak or public health guidance, follow your local health department, the CDC, or another relevant public health authority.