A coalition of four major respiratory and critical care medical organizations has formally endorsed updated immunization guidelines for influenza, respiratory syncytial virus (RSV), and COVID-19 for the 2026–27 respiratory virus season. Announced on November 5, 2026, by the American Thoracic Society (ATS), the unified framework brings together experts from the ATS, the American Academy of Allergy, Asthma & Immunology (AAAAI), the American College of Chest Physicians (CHEST), and the Society of Critical Care Medicine (SCCM) to offer clinicians and patients a consolidated, evidence-based reference for seasonal respiratory protection.

Operating together as the Vaccine Guidance Review Panel, the four groups unanimously endorsed immunization protocols developed by four frontline specialty organizations: the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), and the Infectious Diseases Society of America (IDSA).

The panel stated that its goal is to give healthcare providers a practical point-of-care reference to protect both the general public and patients with underlying lung illnesses or critical health risks.

Why Medical Societies Formed a Unified Review Panel

According to the American Thoracic Society, the Vaccine Guidance Review Panel was created to provide clinical clarity during a period of disruption in federal immunization advisory processes. In its announcement, the panel noted that multiple vaccine decisions made by the Department of Health and Human Services (HHS) and the Advisory Committee on Immunization Practices (ACIP) have faced a temporary stay dating back to May 2025. The coalition stated that subsequent changes to Centers for Disease Control and Prevention (CDC) and ACIP procedures prompted independent medical societies to collaborate on maintaining standards aligned with ACIP recommendations issued prior to June 2025.

Between March and September 2026, the panel evaluated immunization data for influenza, RSV, and COVID-19.

Panel members consulted with representatives from the originating medical societies to review their recommendation-development methods and spoke with a former ACIP chair to compare those protocols with pre-June 2025 federal evaluation standards. According to a report by the Texas Medical Association / Texas Medicine, the underlying professional-society recommendations were also supported by independent systematic evidence reviews conducted by the American Medical Association (AMA) and the Vaccine Integrity Project at the University of Minnesota.

"Clinicians and their patients with serious lung disease should not have to navigate a labyrinth of confusion, particularly as we face the upcoming respiratory virus season," ATS President Michelle Ng Gong, MD, ATSF, said in the announcement. "The evidence-based vaccine recommendations endorsed by ATS, AAAAI, CHEST and SCCM provide clinicians with confidence and practical vaccine guidance when treating patients at the highest risk of severe illness."

AAAAI President Carla Davis, MD, noted in the release that the shared standards reflect scientific evidence and clinical expertise designed to help healthcare professionals make informed decisions.

CHEST President Neil Freedman, MD, added that bedside care for chronic and acute respiratory conditions is much more effective when backed by clear preventative medicine guidelines.

Updated Recommendations for Influenza and COVID-19

The interim joint guidance published by the American Thoracic Society outlines specific, age-based and risk-based vaccination schedules for the 2026–27 season across the lifespan. In addition to protecting the general population, the endorsed recommendations emphasize immunizing individuals at high risk for severe respiratory complications, healthcare personnel, and close contacts of vulnerable patients.

For seasonal influenza, the panel endorses routine annual vaccination for everyone aged 6 months and older. For most adults, immunization is ideally timed for September or October, though vaccination should continue throughout the season as long as influenza viruses are circulating. Adults aged 65 years and older are advised to receive an enhanced influenza vaccine—specifically a recombinant, adjuvanted, or high-dose formulation—whenever available.

However, if an enhanced option is not on hand at the time of an appointment, clinicians are advised to administer an age-appropriate standard-dose flu vaccine rather than delay protection.

For COVID-19, the endorsed 2026–27 vaccination guidance varies by age and health status:

  • Young children (6 to 23 months): Routine vaccination with the updated 2026–27 COVID-19 vaccine is recommended for all children in this age group.
  • Children and adolescents (2 to 18 years): Vaccination is recommended for youths belonging to defined risk groups for severe illness. For children and teens without risk factors, the vaccine should be offered if a parent or guardian desires protection.
  • Older adults (65 years and older): Because older individuals face higher risks of hospitalization and severe complications from respiratory infections, the guidance recommends that adults aged 65 and up receive two updated seasonal COVID-19 doses spaced 6 months apart.

RSV Protection for Older Adults, Pregnant Patients, and Infants

Respiratory syncytial virus remains a significant cause of lower respiratory tract infections among both older adults and newborns. For older populations, the panel endorses a single RSV vaccine dose for all adults aged 75 years and older, as well as for adults aged 50 to 74 years who are at increased risk of severe RSV disease.

Eligible adults may receive the shot at any time of year, though administration in late summer or early fall is preferred ahead of peak viral circulation.

To protect infants during their vulnerable early months, the guidance details two primary avenues of immunization: maternal vaccination during pregnancy or infant immunization with long-acting monoclonal antibodies.

For pregnant individuals, the endorsed guidance recommends one dose of the maternal RSVpreF vaccine (Abrysvo) administered between 32 weeks 0 days and 36 weeks 6 days of gestation. In most locations across the continental United States, this maternal vaccination window runs from September through March 1. If a patient received a maternal RSV vaccine during a previous pregnancy, a repeat dose is not recommended for a subsequent pregnancy; instead, the newborn should be protected directly after birth with a monoclonal antibody.

For infants younger than 8 months entering their first RSV season, the panel recommends immunization with a long-acting RSV monoclonal antibody—either nirsevimab or clesrovimab—if the birth parent did not receive the maternal RSV vaccine during pregnancy, if the maternal shot was given fewer than 14 days prior to delivery, or if the parent's vaccination status is unknown.

The guidance also recommends monoclonal antibody protection for certain children aged 8 to 19 months who are at increased risk for severe RSV disease as they enter their second RSV season.

Frequently Asked Questions

Can I receive my flu, COVID-19, and eligible RSV vaccines at the same appointment?

Yes. According to the guidance endorsed from the AAFP, ACOG, and IDSA, clinicians should offer coadministration of indicated influenza, RSV, and COVID-19 vaccines during the same visit to reduce missed opportunities for immunization. These vaccines can be given simultaneously with no minimum waiting interval between them, alongside other routine vaccinations.

If I am 65 or older, should I wait if an enhanced flu vaccine is out of stock?

No. While recombinant, adjuvanted, or high-dose influenza vaccines are preferred for adults aged 65 and older, the panel explicitly advises against delaying immunization. If an enhanced vaccine is not immediately available at your clinic or pharmacy, you should receive a standard-dose, age-appropriate flu shot.

How should patients determine which vaccines apply to their specific health conditions?

Because eligibility for certain immunizations—such as RSV vaccination for adults aged 50 to 74 or COVID-19 vaccination for older children—depends on underlying medical conditions and immune status, patients and caregivers should consult their primary care physician, pulmonologist, or obstetrician to review their personal health history.

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