Getting ready for the fall and winter respiratory virus season can raise questions about immunizations you might need, when to get them and how to keep your family safe. As part of a coordinated effort, the leading national medical groups issued joint respiratory immunization guidance for the 2026-2027 season in September 2026, in the wake of administrative changes and litigation against the federal Advisory Committee on Immunization Practices (ACIP), The Hill reports.

The coalition, which includes 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), based their joint guidelines on a detailed scientific review published in JAMA, in partnership with the American Medical Association (AMA) and the Vaccine Integrity Project at the University of Minnesota.

The best way to prevent severe illness, hospitalization and death from the “tripledemic” threats of influenza, COVID-19 and respiratory syncytial virus (RSV) is through comprehensive protection. Federal advisory groups are considering legal and administrative changes, but practicing clinicians strongly recommend adherence to evidence-based medical consensus. Knowing how these vaccines work, which ones are suitable for you and your family, and how to schedule them in time means your family will remain healthy as the weather cools down.

Can you get COVID and RSV at the same time?

Yes, it is possible to have simultaneous infections with both COVID-19 and respiratory syncytial virus (RSV), a clinical condition known as viral coinfection, UC Health Today notes. Both pathogens attack the respiratory mucosal lining and are circulating during the overlapping late fall and winter seasons, meaning that exposure to one does not confer immunity to the other.

If multiple different viruses invade the respiratory system at the same time, the physiological load can be much worse. According to the National Institutes of Health (NIH), co-infection often increases inflammation in the local airways, overwhelms the alveoli’s ability to exchange gases and exhausts the defense mechanisms of the mucous membranes.

Dr. Justus Rabach, MD, tells Blavity Health, “The combination of these two viruses is especially harmful for infants, young toddlers and older adults with cardiopulmonary conditions, and significantly increases the risk of severe bronchiolitis, acute respiratory distress syndrome (ARDS), bacterial pneumonia and intensive care admissions.”

Vaccine 1: Seasonal Influenza (Flu)

Influenza vaccination remains the single most important component of fall preventive health care, and the influenza A and B strains that circulate each winter continue to change rapidly, NIH explains.

Based on the revised consensus recommendations published in JAMA, the medical coalition recommends that everyone 6 months of age and older receive a flu vaccine every flu season. A two-dose series, four weeks apart, is needed for children ages 6 months to 8 years receiving the flu shot for the first time to establish baseline antibody protection.

All persons 6 months of age and older should be vaccinated against the flu each flu season, including special formulations for higher-risk groups among adults. High-dose, adjuvanted, and recombinant influenza vaccines, as well as newer mRNA vaccines approved for influenza, are all highly recommended for adults aged 65+, as they are more likely to elicit a strong humoral immune response in aging immune systems.

A pregnant woman should get an inactive flu shot at any stage of her pregnancy, as this can not only protect her from serious lung complications, but also pass immunity to the baby through the placenta, as well as boost the baby’s immune system for its first six months of life.

Vaccine 2: Updated COVID-19

While SARS-CoV-2 continues to evolve antigenically, new COVID-19 formulations are designed to target the most recent circulating subvariant and ensure robust levels of neutralizing antibodies each year.

The unified medical guidelines have established a well-defined age-stratified approach to the care of children and adolescents: Infants and toddlers aged 6-23 months should receive the revised COVID-19 vaccine series. Epidemiological data also show that under two years of age, infants are at a similar or greater risk of being hospitalized as elderly adults 65 years of age or older because of their completely naive immune systems and small airway diameters.

The coalition recommends vaccinating children and adolescents aged 2 to 18 years who are at higher risk for certain clinical conditions, such as obesity, congenital heart defects, asthma, diabetes, immunosuppressive conditions, and other clinical conditions, as well as those who are vaccinated due to family preference (shared clinical decision making).

All adults should get the updated COVID-19 vaccine every year, especially those aged 50 and older, those living in long-term care settings, and immunocompromised people, who continue to be at higher risk of serious lower respiratory illness and post-acute sequelae of COVID-19.

Vaccine 3: Respiratory Syncytial Virus (RSV)

RSV is a seasonal virus that commonly causes cold-like illness in healthy adults, but is the number one cause of infant hospitalizations and one of the most important causes of severe pneumonia in older adults.

The medical guidelines state that nirsevimab, a long-acting monoclonal antibody vaccine, should be given to all infants aged 8 months and under, shortly before or in the first RSV season of the baby’s life, if the mother had not been given the maternal RSV vaccine during pregnancy. A dose is recommended for young children between 8 and 19 months old who are entering their second RSV season and who are considered to be at high risk for RSV from chronic lung disease of prematurity, severe cystic fibrosis or congenital heart anomaly.

Mothers who are expecting can also directly protect their newborns by getting vaccinated against RSV during pregnancy with the maternal RSV bivalent vaccine (Abrysvo) between 32 and 36 weeks, which boosts maternal antibodies that are transferred to the fetus.

The medical coalition advises giving the RSV vaccine once in life to all adults aged 75 and older. Also, adults aged 50 to 74 years should get the vaccine once if they have chronic heart failure, chronic obstructive pulmonary disease (COPD), end-stage renal disease or severe diabetes.

Best practices

Multiple seasonal shots may seem like a logistical hassle, but evidence-based clinical practices help get the most protection.

The Mayo Clinic states that timing is an important factor in vaccine effectiveness. Late September and October are the best times to get the influenza and COVID-19 vaccines. Vaccination during this fall window allows for the number of neutralizing antibodies to peak at the same time as the peak of community viral transmission, which is between December and February.

It is safe and very effective to administer several vaccines at a single clinical visit (coadministration). Getting your flu shot and COVID-19 vaccine at the same time won’t diminish the immune response to either vaccine. When two shots are given at the same time, the healthcare provider will use a different arm, or the injection sites will be at least 1 inch apart on the same arm, so it is easier to see if there is any discomfort at the injection site.

Clinicians recommend delaying routine vaccinations if patients have acute moderate or severe disease with a high fever, to prevent an acute vaccine reaction from being misinterpreted as disease progression. If you are suffering from mild congestion or low-grade sniffles, it shouldn’t put off your visit. Moreover, having recently recovered from a diagnosed COVID-19 infection, you can wait about three months for your next COVID-19 booster, as natural infection provides strong, temporary mucosal immunity.

Bottom line

Immunization recommendations for the 2026–2027 respiratory season from key medical groups offer straightforward, evidence-based guidance for protecting people against influenza (the flu), COVID-19 and RSV. Flu vaccines for all over 6 months of age, COVID-19 vaccines by age and RSV vaccines for targeted groups of infants, pregnant people and high-risk older adults create a comprehensive defense against severe diseases during the season. Scheduling shots between late September and October will provide high antibody levels during the winter peak period and help protect vulnerable family members.

Frequently Asked Questions

Is it safe to get the RSV and flu vaccines at the same time?

Yes, extensive clinical trial data show that it is safe to receive the RSV vaccine and seasonal flu shot during the same medical visit without diminishing the effectiveness of either immunization.

What is the recommended gap between two vaccines?

Most standard inactivated and mRNA respiratory vaccines do not require a waiting period between doses and can be given simultaneously; however, live attenuated vaccines must either be administered on the same day or spaced at least four weeks apart.

Citations

Choi J, Weixel N. What to know about respiratory vaccine recommendations. The Hill. Published September 3, 2026. https://thehill.com/newsletters/healthcare/6070586-what-to-know-about-respiratory-vaccine-recommendations/

UCHealth. Did you know you can get combinations of COVID, flu and RSV at the same time? UCHealth Today. Published January 26, 2024. https://www.uchealth.org/today/did-you-know-you-can-get-combinations-of-covid-flu-and-rsv-at-the-same-time/

Sumitomo T, Kawabata S. Respiratory tract barrier dysfunction in viral-bacterial co-infection cases. The Japanese Dental Science Review. 2024;60:44-52. doi:10.1016/j.jdsr.2023.12.006

Nypaver C, Dehlinger C, Carter C. Influenza and Influenza Vaccine: A Review. Journal of Midwifery & Women’s Health. 2021;66(1):45-53. doi:10.1111/jmwh.13203

Mayo Clinic. Questions about vaccination? Mayo Clinic can help. Mayo Clinic. Published March 13, 2024. https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857