What Top Doctors Now Recommend for COVID, Flu and RSV Vaccines

As the Trump administration continues to offer conflicting messages about vaccines, top medical groups are stepping in to ease confusion with a set of independent recommendations.

The guidelines were released through a partnership among leading medical groups, including the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG) and Infectious Diseases Society of America (IDSA).

Some of these groups, including ACOG and AAP, had already released recommendations about specific vaccines after the Trump administration limited COVID vaccine recommendations in 2025 and issued a memo in January 2026 removing universal recommendations for childhood vaccines that protect against flu and several other diseases, including meningococcal disease, COVID-19 and hepatitis A and B.

A federal judge blocked some of those changes in March, specifically those concerning COVID-19 and hepatitis B immunizations. The Department of Health and Human Services vowed to appeal. Earlier this month, President Donald Trump signed an executive order calling for more vaccine flexibility and research and fewer childhood vaccinations, repeating unsupported claims about vaccines without evidence.

Research by the University of Minnesota’s Vaccine Integrity Project, an independent group of vaccine and public health experts, in tandem with the American Medical Association, helped inform the newly released independent guidelines. The organizations conducted an evidence review of nearly 300 eligible, peer-reviewed studies, which was then published in the journal JAMA.

“The American public deserves clear, credible information — based on the best available scientific evidence — when making decisions about vaccination,” said AMA President-elect Dr. Sandra Adamson Fryhofer in a press release. “The latest evidence reviews and recommendations are the result of our shared commitment across clinical medicine, science and public health to ensure vaccine recommendations are grounded in sound evidence and developed through a transparent process.”

Flu Vaccine Recommendations

The medical associations’ guidelines for flu vaccines are consistent with what the CDC has historically recommended:

• Everyone 6 months or older, including pregnant people, should get a shot every year, with a few exceptions for people with certain medical conditions.
• People 65 and older should receive a higher-dose vaccine, if possible.

Like many vaccines, flu immunization does not guarantee you will not get sick. Rather, it reduces the likelihood of serious illness or hospitalization, especially among people more vulnerable to severe symptoms, such as children, older adults and those with compromised immune systems. People with chronic or underlying health issues, including asthma and diabetes, are also at higher risk.

The Vaccine Integrity Project’s research review found that:

• Vaccination reduced flu-related hospitalizations by 31% in people 65 and older.
• The shot was 80% effective in preventing influenza-associated deaths among children and adolescents, though this data included only laboratory-confirmed cases, which generally represent a fraction of actual cases.
• When a person is immunized during pregnancy, the risk of symptomatic disease fell by 44% in their newborns up to 6 months old.

Despite the Trump administration’s changing vaccine recommendations, the CDC’s flu vaccine page said, as of its last update on Sept. 1, that everyone 6 months and older in the United States, with rare exceptions, should get a flu vaccine every season.

Adults 65 and older should choose one of the three higher-dose flu vaccines when possible: Fluzone High-Dose, Flublok Recombinant or Fluad Adjuvanted, according to the AMA and CDC.

A new mRNA flu vaccine is also an option. In one study, it was 27% more effective at protecting older adults from illness than a standard shot. The FDA approved it in August for people older than 50.

COVID-19 Vaccine Recommendations

Until last year, the COVID-19 vaccine had a similar blanket recommendation for most people. In May 2025, Kennedy announced that the shot would no longer be included in the CDC’s recommended immunization schedule for healthy children and pregnant women, breaking with expert guidance.

Subsequent FDA approvals cleared a new round of COVID vaccines, but only for people 65 and older and those younger than 65 with health conditions that increase their risk. This was also the case in 2026, when the FDA formally approved updated COVID-19 vaccines for those groups.

As of Sept. 3, the CDC’s COVID-19 vaccine page said the agency recommends a 2025-2026 COVID-19 vaccine for people ages 6 months and older based on individual decision-making, also known as shared clinical decision-making. This means a vaccine may be appropriate for some people after they discuss the benefits and risks with a health care provider.

The medical associations suggest an annual COVID-19 vaccine for:

• All children ages 6 to 23 months.
• Children ages 2 to 18 in certain risk groups or if desired.
• All adults ages 19 through 64, including pregnant people.
• Adults 65 and older, who should receive an annual updated COVID-19 vaccine and a second dose 6 months later.

The Vaccine Integrity Project’s research review found that:

• Updated COVID-19 vaccination was 53% effective against hospitalization among adults 65 and older.
• Updated vaccination reduced hospitalization among adults ages 18 through 64 by approximately half.
• Vaccination reduced COVID-related emergency room visits by 76% in children ages 9 months to 4 years.
• During the first 2 months of life, babies born to vaccinated mothers were 50% to 54% less likely to have a COVID-related hospital visit.

RSV Vaccine Recommendations

Vaccination for respiratory syncytial virus, or RSV, is usually targeted toward the highest-risk groups: infants and older adults. It can be especially important during pregnancy because its benefits extend to infants after birth.

RSV can cause typical cold-like symptoms for some people but can quickly become deadly for vulnerable groups. Recommendations around RSV have not been subject to the same recent changes as other vaccines, so advice has remained mostly consistent.

The medical associations suggest a one-time vaccine or antibody treatment for:

• Pregnant people between 32 and 36 weeks pregnant, given between Sept. 1 and March 1.
• Infants younger than 8 months if the mother was not vaccinated. These infants should receive nirsevimab, which is not a vaccine but a monoclonal antibody shot. A vaccine teaches the immune system to fight a virus, while a monoclonal antibody provides virus-fighting antibodies directly.
• Children ages 8 to 19 months in certain risk groups.
• Adults ages 50 to 74 who are at increased risk.
• All adults 75 and older.

The Vaccine Integrity Project’s research review found that:

• Vaccination reduced RSV-related hospitalization by 69% to 83% in adults 60 and older.
• Maternal RSV vaccination reduced RSV-related infant hospitalizations by 51% to 70%.
• Nirsevimab reduced RSV-related hospitalizations among infants by approximately 66% to 93% within 6 months after immunization.