The guidance gives doctors who care for people with lung disease and critical illness a single, current reference for the 2026–27 respiratory virus season.

Four national medical societies have endorsed  vaccine recommendations for flu, RSV and COVID-19 for this respiratory virus season that aligns with guidance from other major medical societies. Justin Ortiz, MD, MS, Professor of Medicine at the University of Maryland School of Medicine (UMSOM), co-chaired the panel that reviewed the evidence and wrote the guidance.

The four societies are the American Academy of Allergy, Asthma & Immunology (AAAAI), the American Thoracic Society (ATS), the American College of Chest Physicians (CHEST) and the Society of Critical Care Medicine (SCCM). They announced the guidance on Nov. 5.

The panel did not create new recommendations. Instead, it checked how four other medical groups built their vaccine advice and endorsed that advice. Those groups are the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), the American College of Obstetricians and Gynecologists (ACOG) and the Infectious Diseases Society of America (IDSA).

Why the guidance was needed

For decades, U.S. doctors have used advice from a federal committee to decide which vaccines to give and when. That committee is the Advisory Committee on Immunization Practices (ACIP).

In June 2025, the Secretary of Health and Human Services (HHS) removed all 17 ACIP members and named new ones. HHS and the new committee then changed several vaccine recommendations.

In March 2026, a federal court in Massachusetts temporarily paused those changes. The pause covers the new members’ appointments, the votes they took and a January 2026 change to the childhood vaccine schedule. The government has appealed, and ACIP has not been able to meet while the case goes on.

The four societies formed the panel so that clinicians caring for people with lung disease and critical illness would have one up-to-date reference during this period.

“Our four societies care for some of the patients most vulnerable to severe respiratory infections,” said Dr. Ortiz, a respiratory physician who is also a vaccine researcher at UMSOM’s Center for Vaccine Development and Global Health.  He co-chaired the panel with Tina Hartert, MD, MPH, from Vanderbilt University. “Preventing these infections is an important part of that care. We came together to ensure clinicians have clear, evidence-based vaccine guidance to help protect their patients’ health.”

How the panel did its work

From March to September 2026, the panel reviewed the evidence on vaccines for flu, RSV and COVID-19. It used ACIP’s recommendations from before June 2025 as a starting point.

The panel also:

• Reviewed independent, systematic evidence reviews done by the Vaccine Integrity Project and  the methods and evidence summaries provided by the relevant professional societies, which formed the basis of ACIP’s recommendations before June 2025.
• Met with representatives of AAP, AAFP, ACOG and IDSA to learn how each group reviewed evidence and made its recommendations.
• Consulted a former ACIP chair to understand how the committee weighed evidence before June 2025.

All panel members disclosed any conflicts of interest. The panel endorsed a recommendation only when all four societies agreed. It may review more recommendations the same way in the future.

“Vaccine recommendations must be grounded in rigorous evidence review and independent clinical judgment,” said UMSOM Dean Mark T. Gladwin, MD, who is also Vice President for Medical Affairs, University of Maryland, Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor. “This panel made its methods transparent and put the health of patients first. Its work gives clinicians guidance they can trust because the recommendations follow the evidence.”

What the guidance recommends

The guidance, written for clinicians, notes that the Flu, RSV and COVID-19 vaccines can be given at the same visit to help patients avoid missing a needed vaccine. It addressed immunization across the life course covering the general population, people at risk for severe respiratory disease, and those whose vaccination does the most to curb spread and protect our health care system.

Other recommendations include:

Flu

• Everyone 6 months and older should get a flu shot every year.
• Adults 65 and older should get a stronger (high-dose, adjuvanted or recombinant) flu vaccine if one is available. If not, they should get a standard flu shot rather than wait.
• People with egg allergies can get any flu vaccine approved for their age.
• Most adults should get vaccinated in September or October.
  
  

RSV

• All adults 75 and older should get an RSV vaccine. So should adults 50 to 74 who are at higher risk, such as people with lung or heart disease, asthma or a weakened immune system.
• Pregnant people can get an RSV vaccine late in pregnancy (32 to 36 weeks), during RSV season, to protect their newborn.
• Babies younger than 8 months whose mothers did not get the RSV vaccine during pregnancy should get a protective antibody shot before or during their first RSV season.
  
  

COVID-19

• All adults should get an updated COVID-19 vaccine.
• Adults 65 and older should get two doses this season, six months apart.
• COVID-19 vaccination is recommended during pregnancy.
• All children 6 to 23 months old should be vaccinated. Older children and teens at higher risk.