How do IDSA’s 2026–27 COVID-19 vaccination recommendations differ from CDC’s clinical considerations?

IDSA strongly recommends age-appropriate vaccination for adults and children with compromised immunity, and recommends that household members and close contacts be up to date. CDC also recommends vaccination for people age 6 months and older with moderate or severe immunocompromise. IDSA and CDC recommend an initial vaccination series for people with moderate or severe immunocompromise. IDSA references the schedule originally approved by ACIP in 2023–24 and which was the basis for the dosing tables published on CDC’s website at: www.cdc.gov/covid/hcp/vaccine-considerations/immunocompromised.html.

IDSA emphasizes timing by disease and treatment. For example, IDSA suggests vaccination at least 2 weeks before solid-organ transplantation or at least 3 months afterward, and consideration of at least 3–6 months after B-cell-depleting treatment in relevant groups. IDSA supports vaccination during treatment when optimal timing is not feasible. CDC provides detailed dose schedules, generally advises vaccination at least 2 weeks before starting or resuming immunosuppression, and advises approximately 4 weeks before the next ongoing B-cell-depleting treatment. These approaches require coordination with the treating clinician.

For people who have completed the initial series, CDC specifies two seasonal doses (generally spaced 6 months apart). IDSA does not explicitly recommend a second dose but it notes that a second current season dose may extend protection. See IDSA guidance at www.idsociety.org/practice-guideline/Seasonal-RTI-Vaccinations-in-Immunocompromised-Patients/ and CDC guidance at www.cdc.gov/covid/hcp/vaccine-considerations/immunocompromised.html.