Who Can Get the Updated COVID Shot This Fall

If you got a COVID vaccine last year without thinking twice about it, this year's rules may feel different.

For the 2026 to 2027 season, the FDA has approved updated COVID vaccines for adults 65 and older and for certain younger people with underlying conditions that put them at higher risk of severe COVID-19. The FDA has also updated the vaccine formula to target the JN.1-lineage XFG variant. The FDA's 2026 to 2027 vaccine update explains the new formula and the current approved populations.

At the same time, the CDC's published COVID vaccination guidance uses individual-based decision-making, also called shared clinical decision-making. Under the current CDC guidance, vaccination is considered for people ages 6 months and older, with the potential benefit generally greater for people at higher risk of severe disease. CDC vaccine recommendations can change as new seasonal guidance is published.

That makes the question of who should get the updated COVID shot a little more complicated than it was a few years ago. Here's what the current FDA and CDC guidance means, who has the most to consider, and how COVID vaccination fits alongside flu and RSV vaccines this fall.

TL;DR: Key Takeaways

• The FDA has approved 2026 to 2027 COVID vaccines for adults 65 and older and for certain younger people with underlying conditions that increase their risk of severe COVID-19. See the FDA's current vaccine information.
• The 2026 to 2027 vaccine formula targets the JN.1-lineage XFG variant.
• Current CDC guidance uses individual-based decision-making for COVID vaccination, with more emphasis on people at increased risk of severe disease.
• People who are moderately or severely immunocompromised may have different dosing recommendations.
• If you've recently had COVID, the timing of your next vaccine dose may be worth discussing with a healthcare professional.
• COVID, flu, and RSV vaccines have different eligibility recommendations, even though they can generally be given during the same visit when each vaccine is indicated.
• Current CDC RSV guidance recommends a single RSV vaccine dose for adults 75 and older and adults ages 50 to 74 who are at increased risk of severe RSV illness.

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What Changed for the 2026 to 2027 COVID Vaccine Season?

COVID vaccine recommendations have changed over the past few years as the virus, vaccine evidence, and federal guidance have changed.

For the 2026 to 2027 season, the FDA selected a new vaccine formula designed to more closely match currently circulating SARS-CoV-2 viruses. The agency advised manufacturers to use a monovalent vaccine targeting the JN.1-lineage XFG variant. The FDA explains the 2026 to 2027 formula here.

The eligibility question is separate from the vaccine formula itself.

Current FDA product approvals for the 2026 to 2027 vaccines include adults 65 and older and certain younger people with underlying conditions that place them at increased risk of severe COVID-19. For example, the current FDA labeling for Moderna's MNEXSPIKE and Novavax's NUVAXOVID covers adults 65 and older and people ages 12 to 64 with at least one underlying condition that puts them at high risk for severe outcomes. See the FDA's MNEXSPIKE information and Novavax's NUVAXOVID information.

For younger children, the specific product and age indication matter, so parents should check the current product labeling and CDC guidance rather than assuming the adult recommendations apply.

Who Should Get the Updated COVID Shot?

The people with the most to consider are those who are more likely to become seriously ill if they get COVID.

Adults 65 and Older

Age is one of the clearest risk factors for severe COVID-19.

Current CDC guidance recommends COVID vaccination for adults 65 and older based on individual-based decision-making. The CDC notes that the potential benefit of vaccination is generally greater for people at higher risk of severe disease. Read the current CDC guidance.

If you're 65 or older, your previous vaccine doses, recent COVID infection, and overall health can all affect when another dose makes sense.

People With Underlying Health Conditions

Some medical conditions increase the risk of severe COVID-19. The CDC's list includes conditions such as chronic lung disease, heart disease, diabetes, obesity, chronic kidney disease, certain neurological conditions, and conditions or treatments that weaken the immune system.

Having one of these conditions does not necessarily mean your vaccination schedule will look exactly like someone else's. Age, previous doses, and the specific condition can all matter.

If you have a chronic condition and haven't discussed your COVID vaccination plan recently, this is a good reason to check the current recommendations with your healthcare professional.

People Who Are Moderately or Severely Immunocompromised

People with moderate or severe immune compromise have separate COVID vaccination considerations.

The immune response to vaccination can be different in this group, which is why the CDC provides separate dosing guidance. The number and timing of doses depend on age, vaccine history, and the person's specific immune status.

If you take medication that suppresses your immune system or have a condition that significantly affects your immune system, don't assume the standard schedule applies to you. CDC's guidance for immunocompromised people provides more specific information.

Pregnant People

Pregnancy is another situation where an individual discussion can be useful.

Pregnancy can increase the risk of severe COVID-19, and CDC guidance supports COVID vaccination during pregnancy. If you're pregnant, trying to become pregnant, or breastfeeding, talk with your healthcare professional about the timing that makes sense for you.

What If You're Under 65 and Otherwise Healthy?

This is where the current rules can be confusing.

The FDA's 2026 to 2027 vaccine approvals are narrower than the broad recommendations people may remember from earlier years. At the same time, the CDC uses individual-based decision-making for COVID vaccination rather than a simple rule that says every person in a particular age group must be vaccinated.

That means you shouldn't assume that being under 65 automatically means you cannot receive a COVID vaccine. Your eligibility depends on the specific vaccine, your age, health status, and the current FDA labeling and CDC guidance.

If you're a healthy adult under 65 and are considering vaccination, ask the pharmacy or healthcare professional whether the vaccine available to you is FDA-approved for your situation and whether vaccination is appropriate based on your individual circumstances.

Insurance coverage can also depend on the vaccine and the circumstances, so check with your health plan if you're concerned about cost.

How Does Shared Clinical Decision-Making Work?

The phrase "shared clinical decision-making" sounds more complicated than it is.

It generally means that you and a healthcare professional consider your individual situation rather than applying the same recommendation to everyone.

The conversation may include:

• Your age
• Your previous COVID vaccination history
• Whether you've recently had COVID
• Underlying health conditions
• Whether you are immunocompromised
• Your risk of exposure to SARS-CoV-2
• Your risk of severe disease
• Any previous reactions to COVID vaccines

Depending on the vaccine and your circumstances, a pharmacist may also be able to assess whether vaccination is appropriate and administer the vaccine during the same visit, subject to applicable requirements.

You don't need to memorize the CDC schedule before making an appointment. Having your vaccination history available is usually much more useful.

What Are the Current COVID Symptoms?

COVID symptoms can still look a lot like other respiratory infections.

Common symptoms can include:

• Sore throat
• Cough
• Congestion or runny nose
• Fatigue
• Fever or chills
• Headache
• Muscle or body aches
• Shortness of breath
• Loss of taste or smell
• Nausea or vomiting
• Diarrhea

The symptoms can vary from person to person, and you cannot reliably tell COVID from flu or another respiratory infection based on symptoms alone.

If you develop COVID symptoms and you're at higher risk of severe illness, contacting a healthcare professional early can be important because some COVID treatments work best when started soon after symptoms begin.

What COVID Variant Is the 2026 to 2027 Vaccine Targeting?

SARS-CoV-2 continues to change, which is one reason the vaccine formula is updated.

For the 2026 to 2027 season, the FDA selected a monovalent vaccine targeting the JN.1-lineage XFG variant. The goal is to make the vaccine's target more closely match viruses currently circulating. The FDA's formula announcement explains the decision.

A variant name doesn't tell you exactly how severe an infection will be for a particular person. Your age, immune status, previous immunity, underlying health conditions, and the virus circulating at the time all matter.

What About Flu and RSV Vaccines This Fall?

COVID isn't the only respiratory vaccine to think about in the fall. Flu and RSV vaccines have their own recommendations.

Flu Vaccine

The CDC recommends annual flu vaccination for everyone 6 months and older, with a few exceptions and special considerations.

For the 2026 to 2027 season, all flu vaccines available in the United States are trivalent. They are designed to protect against three influenza viruses. CDC's current flu vaccine information has the season's vaccine details.

The timing of a flu vaccine can also depend on age, pregnancy, health conditions, and other factors, so it's worth checking the current seasonal recommendation rather than relying on last year's schedule.

RSV Vaccine

RSV vaccination is more targeted than flu vaccination.

Current CDC guidance recommends a single RSV vaccine dose for:

• Adults 75 and older
• Adults ages 50 to 74 who are at increased risk of severe RSV illness

Risk factors can include certain chronic heart or lung conditions, moderate or severe immune compromise, and living in a nursing home or other setting that increases the risk of severe RSV disease. See CDC's current RSV vaccine guidance.

The RSV vaccine is not currently an annual vaccine. If you've already received an RSV vaccine, CDC does not currently recommend another dose. CDC recommends a single dose for eligible adults.

RSV Protection During Pregnancy

Pregnancy has a separate RSV prevention recommendation.

During RSV season, eligible pregnant people can receive the maternal RSV vaccine during the recommended gestational window to help protect their newborn from severe RSV disease. In some situations, an infant may instead receive an RSV monoclonal antibody.

Your obstetric or pediatric healthcare professional can help determine which option is appropriate based on the timing of pregnancy and the RSV season.

Can You Get the COVID, Flu, and RSV Vaccines at the Same Visit?

In general, vaccines that you're eligible to receive can be administered during the same visit.

That doesn't mean everyone needs all three.

Whether you should receive each vaccine depends on your age, health conditions, previous vaccination history, pregnancy status, and the current recommendations for that vaccine.

Some people prefer to separate vaccines because they want to limit the chance of having several short-term side effects at once. Others prefer to get everything they're due for during one appointment.

If you're eligible for multiple vaccines, ask your healthcare professional whether getting them together or spacing them out makes more sense for you.

What If You Recently Had COVID?

Having COVID recently does not necessarily mean you should skip vaccination.

Current CDC guidance says people who recently had COVID may consider delaying vaccination for about three months after symptoms started or, if they had no symptoms, after a positive test.

There isn't one waiting period that works for everyone. Your risk of severe COVID, your risk of exposure, and how much COVID is circulating can all factor into the timing.

If you're older, immunocompromised, pregnant, or have a medical condition that raises your risk of severe disease, ask your healthcare professional before deciding how long to wait.

What If You Don't Want the Vaccine?

Vaccination is one part of respiratory illness prevention, but it isn't the only one.

If you decide not to get an updated COVID vaccine, other steps can still reduce your risk of infection or severe illness, particularly during periods of higher respiratory virus activity.

• Test when you develop symptoms or have a known exposure
• Ask about COVID treatment promptly if you're at higher risk and test positive
• Improve ventilation in shared indoor spaces
• Consider wearing a mask in crowded or high-risk settings
• Stay home when you're sick
• Wash your hands regularly

These steps don't replace vaccination when vaccination is appropriate for you, but they can be part of a broader approach to respiratory illness prevention.

When Should You Talk to a Clinician?

Consider talking with a healthcare professional if you:

• Are 65 or older and want to know whether you're due for an updated COVID vaccine
• Have a medical condition that increases your risk of severe COVID
• Are moderately or severely immunocompromised
• Are pregnant or breastfeeding
• Recently had COVID and aren't sure when to get vaccinated
• Had a reaction to a previous COVID vaccine
• Want to coordinate your COVID, flu, and RSV vaccines
• Are unsure which vaccine is appropriate for your age or health history

Conclusion

The answer to who can get the COVID vaccine in 2026 to 2027 depends on more than age alone.

The FDA has updated the vaccine formula for fall 2026 to target the JN.1-lineage XFG variant. Current FDA approvals cover adults 65 and older and certain younger people with underlying conditions that increase their risk of severe COVID-19. The CDC also uses individual-based decision-making when making COVID vaccination recommendations.

If you're older, immunocompromised, pregnant, or have a medical condition that increases your risk of severe COVID, it's worth reviewing your vaccination history with a healthcare professional.

And don't assume that COVID, flu, and RSV follow the same rules. Flu vaccination is recommended annually for everyone 6 months and older, while RSV vaccination is currently targeted to older adults and certain people at higher risk.

If you're unsure what you're due for this fall, bring your vaccine history to your healthcare professional and ask them to review it against the current recommendations.