Vaccines anchor fall virus guidance as winter season nears

Vaccines for flu, COVID-19 and RSV are now widely available as doctors urge Americans to prepare before winter infections accelerate.

The campaign begins in a less centralized vaccine environment than in past autumns. Several medical groups have issued their own guidance after disputes around the federal advisory process and the absence of updated flu guidance from the Centers for Disease Control and Prevention.

Flu advice starts at 6 months

The American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, and Infectious Diseases Society of America continue to support annual flu vaccination for almost everyone beginning at 6 months old. The groups place added weight on older adults, pregnant women, young children and people with asthma, diabetes, heart disease or weakened immune systems.

Influenza usually brings several days of illness for healthy adults, but its national burden is larger. In a typical year, flu sends hundreds of thousands of Americans to hospitals and is linked to tens of thousands of deaths.

Children have been a particular concern after the past two flu seasons produced unusually high pediatric death counts. Most children who died were unvaccinated, according to the medical guidance summarized in the source material.

Vaccination does not block every infection, but it is aimed at reducing the worst outcomes. Dr. Ryan Stanton of the American College of Emergency Physicians said vaccination is “Just like the seat belt in your car, it decreases risk” of severe outcomes.

Older adults get more options

Most Americans can receive a standard flu shot, while three enhanced flu vaccines are designed to create stronger protection in older adults. The American Academy of Family Physicians recommends that seniors choose an enhanced product when available, but doctors say people should not delay vaccination if the preferred version is not on hand.

A new product has also entered the market for adults 50 and older. The Food and Drug Administration approved Moderna’s mFlusiva, the first flu vaccine using the mRNA platform widely used during the COVID-19 pandemic.

In a clinical study, mFlusiva was 27% more effective at preventing symptomatic influenza in adults ages 50 to 64 than a standard flu vaccine. The University of Minnesota-based Vaccine Integrity Project estimated last season’s flu vaccines reduced flu-related hospitalizations among older adults by 31%.

People who want to avoid an injection may have another route if they meet eligibility rules. FluMist remains available as a nasal-spray vaccine for people ages 2 to 49.

COVID rules vary by group

COVID-19 recommendations are less uniform. The Food and Drug Administration has approved the latest shots mainly for adults 65 and older and for younger people with at least one medical condition that raises the risk of serious illness.

The American Academy of Family Physicians recommends COVID-19 vaccination for all adults, with emphasis on seniors and people with underlying medical risks. For those 65 and older, the group recommends a fall dose followed by another dose about six months later as protection declines.

Pediatric guidance is more targeted. The American Academy of Pediatrics recommends COVID-19 vaccination for all children ages 6 months through 23 months, for older children with risk-raising conditions and for older children whose parents want vaccination.

Pregnant women are also being encouraged to stay current. The American College of Obstetricians and Gynecologists says research after millions of vaccinations has found no evidence that COVID-19 vaccination during pregnancy increases miscarriage risk or other major pregnancy complications.

Americans can choose mRNA vaccines from Moderna and Pfizer, while Novavax and Sanofi offer a non-mRNA option. The Vaccine Integrity Project found last fall’s COVID-19 vaccines reduced hospitalization risk among seniors by 53% and reduced emergency-room visits among very young children.

October gives shots time

Flu specialists generally view October as an ideal month to get vaccinated because the immune system needs roughly two weeks to build a stronger response. Later vaccination can still help if flu activity has not yet peaked.

COVID-19 timing may depend more on exposure plans. Some physicians suggest scheduling a dose several weeks before travel, holiday gatherings or other events where illness would carry higher personal or family costs.

Flu and COVID-19 vaccines are available through doctors’ offices, pediatricians, clinics and pharmacy chains. Medicare covers .

If vaccination rates hold up, doctors expect fewer severe cases to reach emergency rooms and hospital wards. If uptake weakens during a confusing guidance cycle, the pressure would fall first on older adults, young children, pregnant women and people with chronic disease, while pharmacies and clinics would remain the main access points for late-season vaccination.