Issue 1895: September 25, 2026

A: Giving patients an influenza VIS is mandatory under the National Childhood Vaccine Injury Act of 1986. The VIS must be given to all adults as well as to parents or guardians of children prior to vaccination. Two VISs are available, one for live attenuated influenza vaccine (LAIV) and one for inactivated influenza vaccine (IIV) and recombinant vaccine (RIV). The IIV and RIV VIS and all of its translations are available here: www.immunize.org/vaccines/vis/influenza-inactivated. The LAIV VIS and all of its translations are available here: www.immunize.org/vaccines/vis/influenza-live. Current influenza vaccine VISs are dated January 31, 2025. No specific VIS is available for mRNA influenza vaccine (mFlusiva) at this time.

Immunize.org also offers a printable PDF document with QR codes for easy access to all of the IIV and RIV influenza vaccine VIS translations: www.immunize.org/wp-content/uploads/catg.d/p2092.pdf. Healthcare providers or recipients can scan the codes to access a digital copy of the translation on their mobile device.

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A: AAP has developed one-page immunization fact sheets intended to supplement, but not replace, the CDC Vaccine Information Statements (VISs) for vaccines given to children. VISs are required by federal law to be provided for all vaccines covered by the National Vaccine Injury Compensation Program, which includes all vaccines routinely recommended for children or during pregnancy.

The fact sheets, some of which are available in Spanish, can be downloaded at no cost from the AAP website at www.aap.org/en/patient-care/immunizations/immunization-fact-sheets.

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A: Recommendations for the use of the 2026–2027 Formula COVID-19 vaccines were issued by the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG), and the Infectious Diseases Society of America (IDSA) on September 2, 2026. Their recommendations were informed by the Vaccine Integrity Project (VIP) of the University of Minnesota and the American Medical Association (AMA), which conducted a systematic review of relevant scientific literature published since the previous season’s vaccination recommendations were made. There is no preference expressed for any product: Spikevax (mRNA, age 6 months and up), Comirnaty (mRNA, age 5 years and up), mNexspike (mRNA, age 12 years and up), and Nuvaxovid (protein subunit, age 12 years and up).

In the 2025–26 season, CDC’s recommendation was for COVID-19 vaccination following shared clinical decision-making (a conversation about individual risks and benefits of vaccination) for all people, beginning at age 6 months.

The 2026–27 recommendations from medical societies are summarized below:

AAP (children through age 18 years):

• Age 6 through 23 months: routine use in all children.
• Age 2 through 18 years:
  • at high risk of severe COVID-19, or
  • who are residents of long-term care facilities or other congregate settings, or
  • who have never been vaccinated against COVID-19, or
  • whose household contacts are at high risk for severe COVID-19, or
  • who meets none of the above conditions, but whose parent or guardian desires their protection.

AAFP (immunocompetent adults and healthcare professionals):

• All adults age 19 years and older should receive a dose of 2026–2027 Formula COVID-19 vaccine.
• Adults age 65 years or older should receive a second dose of 2026–2027 Formula COVID-19 vaccine 6 months after the first dose to sustain protection.
• All healthcare personnel should be age-appropriately vaccinated.

ACOG (pregnancy):

• A dose of 2026–2027 Formula COVID-19 vaccine is routinely recommended for all individuals who are pregnant, contemplating pregnancy, recently pregnant, or lactating.

IDSA (immunocompromised people):

• A dose of 2026–2027 Formula COVID-19 vaccine is routinely recommended for people who are immunocompromised and, if they are moderately or severely immunocompromised, who have completed an initial vaccination series.
• A second booster dose can be given 2 to 6 months after dose one based on shared decision making and current levels of transmission.
• IDSA refers readers to previous guidance from CDC for the dosing schedules for an initial vaccination series recommended for a person with a moderate or severe immunocompromising condition. IDSA’s recommendations also give guidance for optimal timing of doses for certain subgroups based upon their disease or specific treatment.

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A: The minimum interval is 8 weeks if using Spikevax (Moderna), Comirnaty (Pfizer-BioNTech), or Nuvaxovid (Sanofi-Novavax), and 3 months if using mNexspike (Moderna). An early dose of mNexspike inadvertently administered at least 8 weeks after a previous dose does not need to be repeated.

The exception to this standard interval is when the updated product dose is part of an initial vaccine series given to a young child or to a moderately or severely immunocompromised person. In those situations, simply continue with the series schedule using the updated product.

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A: CDC’s recommendation for the use of nirsevimab (Beyfortus, Sanofi) in children age 8 through 19 months entering their second RSV season is limited to those children at the highest risk of severe RSV disease who were previously recommended to receive palivizumab (Synagis, AstraZeneca), plus American Indian/Alaska Native children. Palivizumab use was quite limited due to its high cost and monthly dosing. For the 2026–27 season, to address the burden of severe RSV disease in a broader population of high-risk children who could benefit from use of nirsevimab, AAP expanded its recommendation for nirsevimab in this age group:

• Children born preterm, at less than 32 weeks, 0 days’ gestation, regardless of the need for medication or other support
• Children with chronic lung disease attributable to prematurity or to other significant neonatal conditions (e.g., meconium aspiration or congenital diaphragmatic hernia) who required medical support (i.e., chronic corticosteroid therapy, diuretic therapy, or supplemental oxygen) at any time during the 6-month period before the start of the second RSV season
• Children with hemodynamically significant congenital heart disease (i.e., a defect that can result in symptoms and/or cardiac chamber dilation)
• Children with anatomic pulmonary abnormalities or neuromuscular disorders that put them at risk for severe RSV disease
• Children with severe immunocompromise
• Children with Down syndrome or other chromosomal differences placing them at higher risk of severe RSV disease
• Children with cystic fibrosis who have either:
  • Manifestations of severe lung disease (previous hospitalization for pulmonary exacerbation in the first year after birth or abnormalities on chest imaging that persist when stable), or
  • Weight-for-length that is less than the 10th percentile
• American Indian or Alaska Native children

Both CDC and AAP criteria are listed on Immunize.org’s standing orders template for administration of nirsevimab: www.immunize.org/wp-content/uploads/catg.d/p3097.pdf.
 

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A: The answer is no. The American Academy of Pediatrics and CDC recommend only a single dose of RSV preventive antibody product for infants younger than 8 months of age, administered during, or just before, RSV season. An infant who receives nirsevimab at the end of one season and who is younger than age 8 months at the beginning of the next season should not be given an additional dose of either RSV preventive antibody product. Likewise, children younger than 8 months of age born near the end of the previous RSV season to mothers who received an effective dose of Abrysvo RSV vaccine during pregnancy are NOT recommended to receive an RSV preventive antibody product at the beginning of the next season.

Children who meet the high-risk criteria to receive a dose of nirsevimab to protect them through their second RSV season should be at least 8 months of age (and younger than 20 months of age) at the time of administration of the second-season nirsevimab dose.