Medical Societies Step In With Flu, COVID and RSV Vaccine Guidance as Federal Process Stalls

Every fall, parents ask their pediatrician the same question: what shots does my kid actually need this year? This year, for the first time in decades, the usual answer, "follow the CDC's recommendation," has become complicated. So four of the country's most trusted physician groups decided to answer the question themselves.

On Wednesday, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists and the Infectious Diseases Society of America released joint vaccine recommendations for flu, COVID-19 and RSV covering the 2026-27 respiratory virus season. They did it because the federal government hasn't.

For more than 60 years, that job belonged to the CDC's Advisory Committee on Immunization Practices, known as ACIP. Think of ACIP as the country's quality-control panel for vaccines: a rotating group of scientists who pored over safety data and disease trends, then translated it into plain guidance that doctors, insurers and school nurses could all point to. It wasn't a perfect system. But it gave everyone a shared reference point.

That reference point broke down last year, when the Department of Health and Human Services dismissed ACIP's members and replaced them. In January, the reshaped committee and the CDC narrowed the childhood immunization schedule, moving six major vaccines from "routinely recommended" to a murkier category called shared clinical decision-making. In practice, that means a vaccine is only offered to higher-risk kids or after an individual conversation with a doctor, rather than being a standard part of every child's care.

Medical groups pushed back hard. The AAP and others sued HHS to reverse the changes, and in March a federal judge in Massachusetts blocked significant portions of the overhaul, ruling that officials had acted unlawfully. The fight didn't end there. In late May, the White House issued a directive backing HHS's reduced vaccine schedule anyway, and last month President Trump signed an executive order calling for fewer required childhood vaccinations. The result: nearly five months without a functioning federal immunization recommendation process, even as flu, COVID and RSV prepare for their usual winter return.

What the Evidence Review Found

Into that gap stepped the Vaccine Integrity Project, an independent initiative housed at the University of Minnesota's Center for Infectious Disease Research and Policy. Working with the American Medical Association, the project combed through hundreds of peer-reviewed studies published since August 2025, building on a similar review it conducted the year before. JAMA published the full evidence reviews for RSV, influenza and SARS-CoV-2 on Wednesday, and the project's website now hosts a searchable tool where anyone, clinician or curious parent, can look up the underlying studies by virus or by population.

The conclusion was reassuring, if not surprising to anyone who has followed vaccine research closely: immunizations still meaningfully reduce the risk of severe illness, hospitalization and death, and no new safety concerns turned up.

"Immunization continues to be one of our best tools for preventing severe illness from respiratory viruses," said Michael Osterholm, the project's executive director. "This year's review confirms that the newest evidence remains consistent with research showing these immunizations reduce the risk of hospitalization and death among the people most likely to experience serious disease."

Bruce Gelin, a member of the project's Board of Advisors, put the stakes in blunter terms during a press briefing this week. The old federal system, he said, "was not perfect, and no scientific process is." But it gave the public a consistent, transparent source of guidance. "Unfortunately, today the federal government is not fulfilling that responsibility in the way that it historically has," he said.

The viruses, of course, don't care about bureaucratic disputes. "Clinicians will still have patients to care for. Parents will still have decisions to make for their children," Gelin said. "We cannot allow the breakdown of the federal process to create a vacuum in evidence-based vaccine guidance."

The new recommendations lay out, by age and risk group, who should get what. All children six months and older are advised to get an annual flu shot. Infants under eight months whose mothers didn't get an RSV vaccine during pregnancy, along with certain higher-risk children eight to nineteen months old, should receive RSV protection. Pregnant people are advised to get an annual flu vaccine, a one-time RSV vaccine between 32 and 36 weeks if it's their first eligible pregnancy, and an annual updated COVID-19 vaccine. Adults 65 and older are urged to get a high-dose flu vaccine when possible, an RSV vaccine if they're 75 or older or at increased risk, and a COVID-19 vaccine followed by a second dose six months later for extra protection. Immunocompromised patients and healthcare workers have their own tailored recommendations as well.

None of this is radical. It largely echoes what ACIP itself recommended before the upheaval. That consistency is, in some ways, the point: the science hasn't changed, even if the federal process around it has.

AMA President-elect Sandra Adamson Fryhofer, who served for years as the association's liaison to ACIP, said she's watched trust erode in real time. "Changes to the childhood schedule by the administration over the last year were made without any new scientific evidence, and that's created confusion for both physicians and our patients," she told reporters.

To address that confusion, the AMA surveyed physicians and ran patient focus groups over the summer. What it heard was fairly consistent: doctors want short, practical materials like one-page clinical summaries, and patients judge vaccine information by three things: whether it's consistent across sources, who's behind it, and whether it feels authentic rather than scripted. Patients specifically said they want to see both the benefits and the risks laid out plainly, not just reassurance. In response, the AMA launched a new resource hub, SpreadTheFacts.org, meant to give both clinicians and the public one place to find vetted guidance on all three viruses.

Why It Matters

Vaccine guidance only works if people trust where it comes from. When the federal system that has anchored that trust for six decades stumbles, it doesn't erase the underlying science, but it does leave real people, pregnant patients, new parents, older adults with chronic conditions, without a clear signal on how to protect themselves this winter. That four major medical societies felt compelled to fill that gap themselves says as much about the current moment as the recommendations do. The virus season is coming regardless of who's issuing the guidance. What matters now is whether patients and clinicians can find it, trust it, and act on it in time.