Flu, COVID and RSV Shots for 2026-27: Who Should Get What
Updated
Who should get flu, COVID and RSV vaccines this fall, the best timing, what Medicare covers at $0, and why federal guidance looks different this year.
Health officials say everyone 6 months and older should get a flu shot, ideally in September or October. COVID-19 vaccines are approved this fall for everyone 65 and older and for younger people at higher risk. Adults 75 and older should get a one-time RSV shot. For people on Medicare, all three are free.
Quick guide
| Vaccine | Who | When | Medicare cost |
|---|---|---|---|
| Flu | Everyone 6 months+ | Now (Sept.–Oct. is best) | $0 (Part B) |
| COVID-19 | 65+, and high-risk people under 65 | This fall | $0 (Part B) |
| RSV | 75+, and ages 50–74 at higher risk | One time only | $0 (Part D) |
Flu shots
- If you're 65 or older, ask for a stronger vaccine: high-dose, adjuvanted or recombinant. They work better for older immune systems.
- Egg allergy? You can get any flu vaccine approved for your age.
- New this year: the FDA approved Moderna's mFLUSIVA, the first mRNA flu shot, for adults 50 and older.
- The nasal spray option is for ages 2 to 49.
COVID-19 vaccines
The FDA approved four updated COVID vaccines in late August, all targeting the current XFG strain. Approval is limited to people 65 and older and younger people with health conditions that raise their risk. The options are Moderna's Spikevax and mNexspike, Pfizer's vaccine, and Novavax's Nuvaxovid, the only non-mRNA option.
Why the guidance looks different this year
The CDC's vaccine advisory committee hasn't met since a federal court in March 2026 paused its 2025 appointments and votes. HHS is appealing. As a result, there's no new federal COVID recommendation for this season. The CDC's interim flu guidance continues last year's schedule, and medical groups like the American Academy of Family Physicians are issuing their own recommendations. Ask your doctor or pharmacist what's right for you.
Will insurance still pay?
Yes, for most people. Major insurers in the industry group AHIP pledged to keep covering routine vaccines at no cost through 2027. Medicare covers flu and COVID shots at $0 under Part B, and RSV at $0 under Part D, including through Medicare Advantage plans with drug coverage at in-network pharmacies.
What to expect this season
Australia's flu season, often a preview for the U.S., started late this year and was still climbing in September. Last year was Australia's worst flu season since 1991. This year's flu vaccine matches most of the viruses circulating so far. No U.S. forecast for season severity has been published.
What to do now
- Get your flu shot this month if you haven't.
- If you're 65+, ask for the high-dose or adjuvanted version.
- If you're 75+ and haven't had an RSV shot, ask about it. It's a one-time shot.
- Bring your Medicare card to the pharmacy.
This page is general information, not medical advice. Talk with your doctor about your own health.
Sources: AHCA/NCAL on CDC interim guidance, Johns Hopkins Medicine, Healio, MLO, Congressional Research Service, Insurance Business, WTOP, AARP, Medical Republic.