Clinical Scorecard: 4 societies align on 2026–2027 respiratory vaccine guidance

At a Glance

Key Highlights

• The ATS, AAAAI, CHEST, and SCCM endorsed respiratory vaccine recommendations for the 2026–2027 season.
• Updated COVID-19 vaccination is recommended for adults aged 19 years or older; adults aged 65 years or older should receive 2 doses 6 months apart.
• RSV vaccination is recommended for adults aged 75 years or older and adults aged 50 to 74 years at increased risk for severe disease.
• Maternal RSVpreF vaccination is recommended at 32 weeks 0 days through 36 weeks 6 days of gestation during the seasonal window; eligible infants younger than 8 months may receive nirsevimab or clesrovimab.
• Annual influenza vaccination is recommended from age 6 months, and indicated influenza, RSV, and COVID-19 vaccines may be given at the same visit.

Guideline-Based Recommendations

Diagnosis

Management

• Recommend updated COVID-19 vaccination for adults aged 19 years or older, with particular emphasis on older adults and people with underlying conditions.
• Adults aged 65 years or older should receive 2 doses of the updated COVID-19 vaccine each season, 6 months apart.
• Recommend RSV vaccination for adults aged 75 years or older and adults aged 50 to 74 years at increased risk, including those with chronic heart or lung disease, asthma, or weakened immune systems.
• Consider additional RSV vaccine doses individually for selected immunocompromised adults.
• Recommend maternal RSVpreF (Abrysvo) vaccination from 32 weeks 0 days through 36 weeks 6 days of gestation during the recommended seasonal window.
• Infants younger than 8 months without adequate protection through maternal vaccination should receive nirsevimab or clesrovimab during their first RSV season.
• Recommend annual influenza vaccination beginning at age 6 months; adults aged 65 years or older should preferentially receive recombinant, adjuvanted, or high-dose vaccines when available.
• Indicated influenza, RSV, and COVID-19 vaccines may be administered during the same visit without a minimum interval.
• The panel endorsed updated COVID-19 vaccination for health care personnel and routine COVID-19 vaccination during pregnancy, regardless of trimester.

Monitoring & Follow-up

Risks

• The guidance identifies chronic pulmonary disease, cardiovascular disease, diabetes, and immunocompromising conditions as underlying conditions relevant to COVID-19 vaccination emphasis.
• Chronic heart or lung disease, asthma, and weakened immune systems are listed as conditions associated with increased risk for severe RSV disease.

Patient & Prescribing Data

Recommendations cover children from 6 months of age, adults, pregnant individuals, health care personnel, and people with chronic or immunocompromising conditions.

The guidance specifies seasonal COVID-19 dosing for adults aged 65 years or older, RSV vaccination groups and maternal timing, infant RSV antibody options, annual influenza vaccination, and coadministration without a minimum interval.

Clinical Best Practices

• Use the recommended maternal RSV vaccination window of 32 weeks 0 days through 36 weeks 6 days of gestation.
• For adults aged 65 years or older, preferentially use recombinant, adjuvanted, or high-dose influenza vaccine when available.
• Administer indicated influenza, RSV, and COVID-19 vaccines at the same visit when appropriate; no minimum interval is required.

Related Resources & Content

• CHEST Newsroom