Here are the recommendations from REAL experts for vaccines
To fill the information void, the Vaccine Integrity Project
(VIP) at the University of Minnesota’s Center for Infectious Disease Research
and Policy (CIDRAP, publisher of CIDRAP News), and the American Medical
Association (AMA) published the results of their independent evidence review of
the influenza, COVID-19, and RSV vaccines today in JAMA.
Filling in gaps left by federal vaccine-process breakdown
During a press briefing yesterday on the evidence reviews,
four of the country’s major medical organizations—the American Academy of
Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the
American College of Obstetricians and Gynecologists (ACOG), and the Infectious
Diseases Society of America (IDSA)— provided their vaccine recommendations for
the 2026-27 respiratory illness season.
“We cannot allow the breakdown of a federal process to
create a vacuum in evidence-based vaccine guidance,” Bruce Gellin, MD, MPH,
chair of the VIP Board of Advisors, said during the briefing.
“Americans are hearing conflicting messages about vaccines right now, and it’s understandable that people are asking whom they should trust,” he added. “I would encourage them to look at the process behind the development of these recommendations.”
What the science says
The VIP Evidence Review team, co-led by Nicole Basta, PhD, examined studies that reviewed all licensed or approved products in the United States designed to prevent COVID-19, flu, and RSV, with a focus on safety, effectiveness, and epidemiology.
When it comes to the flu, the evidence shows that “influenza
vaccines reduce the risk of severe disease,” said Basta.
Being vaccinated against flu cuts the risk of
hospitalization in people ages 65 and older by 31%. Flu vaccination in
pregnancy lessens the likelihood of symptomatic illness in infants from birth
to 6 months by 44%, while vaccination in children ages 6 months to 17 years is
associated with an 80% drop in deaths from flu, Basta said. The COVID-19
vaccine is linked to a lower risk of a hospital stay or death.
“The evidence that we reviewed supported the effectiveness
of COVID-19 vaccines at reducing the risk of hospitalization and mortality for
those at high risk of severe disease, including older adults, infants, and
during pregnancy,” she said.
In adults 65 and older, COVID vaccination is tied to a 53%
lower risk of hospitalization. The vaccine also cuts the rates of intensive
care unit stays and death for people with weakened immune systems by 32% to
53%, based on the particular medical condition.
COVID vaccination during pregnancy slashes emergency
department and urgent care visits by 58% and hospital visits for
infants by 36% in their first year. Visits to pediatric emergency departments
dropped 76% in vaccinated children aged 9 months to 4 years.
RSV vaccination protects older adults, pregnant women, and
infants from serious illness or hospitalization, Basta said.
“RSV vaccination of older adults and during pregnancy, and
infant immunization with monoclonal antibodies substantially reduced severe
illness and hospitalization,” she said. “For adults 60 and older, multiple
studies showed significant reductions in hospitalization with vaccine
effectiveness, ranging from 69% to 83%.”
Women vaccinated while pregnant reduce their chances of RSV
by 82% and also protect their infants from RSV-associated hospital stays.
Infants who receive the monoclonal antibody nirsevimab (Beyfortus) have a 64%
to 93% lower risk of hospitalization.
“More evidence is needed to determine if repeated or annual
RSV vaccination is necessary,” Basta said. “Our review identified evidence gaps
for this question.”
Individual organization recommendations
Each medical organization’s recommendations for vaccination vary slightly based on patient population. Physicians at each organization reviewed the VIP data to guide their advice for the upcoming respiratory illness season.
The AAFP recommends:
- An
updated COVID-19 vaccine for everyone older than 19 years
- A
COVID-19 vaccine and a booster spread out over six months for those over
65
- An
updated flu vaccine for everyone ages 6 months to 64 years
- An
enhanced, adjuvanted, high-dose, or recombinant flu vaccine for people 65
and older
- An RSV
vaccine for people ages 50 to 74 with high-risk conditions
- An RSV
vaccine for everyone older than 75
The AAP recommends:
- The
RSV monoclonal antibody nirsevimab for all children younger than 8 months
in their first RSV season, if their mother did not receive an RSV vaccine
during pregnancy
- Nirsevimab
for children 8 to 19 months at severe risk for disease in their second RSV
season, regardless of the mother’s vaccination status
- A
COVID-19 vaccine for all infants ages 6 to 23 months
- A
COVID-19 vaccine for children ages 2 and older at risk for severe
infection
- An
annual flu vaccine for everyone older than 6 months
The IDSA recommends:
- A
COVID-19 vaccine for everyone ages 6 months and older with a weakened
immune system
- Discussion
with a clinician about a COVID-19 booster dose two to six months after the
first dose for people with high risk conditions
- An
annual high-dose, adjuvanted, inactivated, or recombinant flu vaccine for
patients with weakened immune systems
- The
live attenuated flu vaccine isn’t recommended for people with suppressed
immunity
- An RSV
vaccine for adults with weakened immune systems
ACOG recommends:
- An
updated COVID-19 vaccine for women who are pregnant, considering
pregnancy, or are breastfeeding
- An
inactivated or recombinant flu vaccine for women who are pregnant or
postpartum
- Either
an RSV vaccine during pregnancy or administration of nirsevimab to a
newborn
The AMA also has resources for clinicians, and
the VIP website offers
links to research.
Every organization agrees that regular vaccination remains
important.
“Physicians know that patients may have questions about
vaccines and are ready to have conversations about why they are important and
how they help protect you and your loved ones,” Sarah C. Nosal, MD, president
of the AAFP board of directors, said in the press briefing. “Staying up to date
on vaccines is one of the best ways to keep the country healthy.”
