Leading U.S. medical groups issued updated fall flu and COVID-19 vaccination advice on Wednesday, trying to cut through the confusion that has swirled around federal guidance. The new recommendations say nearly everyone starting at age 6 months should get a flu shot, while older adults, pregnant women, young children and people with chronic health problems should pay close attention to where they fit in the lineup.
The timing matters because flu vaccination is already beginning and updated COVID-19 shots are starting to arrive after approval by the Food and Drug Administration last week. Winter also brings RSV, another vaccine-preventable risk, and doctors are trying to give patients a simple answer now rather than let the season turn into a guessing game about what to take and when.
The American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists and the Infectious Diseases Society of America each released guidance for the people they treat, a rare show of unity in a season that has been anything but orderly. Sandra Fryhofer of the American Medical Association said there has been a great deal of confusion and chaos around vaccine recommendations and that the public needs clear, consistent, science-based guidance while the federal process is in flux.
That confusion is not abstract. The Centers for Disease Control and Prevention has not answered questions about new fall guidance, and its website suggests doctors follow last year's flu recommendations. That leaves the medical groups trying to set the tone themselves, even as the CDC normally gives fall vaccine advice with help from its independent advisers.
For flu, the societies say almost everyone age 6 months and older should be vaccinated, but the risks are heaviest at the extremes and for people with underlying illness. Flu is especially dangerous for those 65 and older, pregnant women, young children and people of any age with chronic health problems. The last two flu seasons were unusually hard on children, with a high number of child deaths, and the vast majority of those deaths were among children who had not been vaccinated.
Older adults have a separate decision to make, and it is one the groups tried to simplify. Three enhanced flu vaccines are designed to protect seniors better than a standard shot, and the American Academy of Family Physicians recommends that older adults choose one of them. Sarah Nosal said seniors should not wait for a preferred enhanced dose if it is not on hand, adding that they should get vaccinated rather than delay. The Vaccine Integrity Project added to that case on Wednesday in JAMA, saying older-adult hospitalizations were reduced by 31%.
There is also a new option this year. The FDA approved an mRNA flu vaccine last week for people ages 50 and older, and Moderna expects some doses of mFlusiva to reach certain pharmacies soon. One study found it was 27% more effective against symptomatic illness among 50- to 64-year-olds than a standard shot. FluMist remains an option for people ages 2 to 49 who meet the other health criteria.
The unresolved question is whether the rest of the system will follow the new medical guidance or cling to the older federal language. For now, the groups have drawn their line: get the shot, do not wait on a perfect match, and do not let a confusing season become a missed one.
