What to Know About COVID Vaccine This Fall

Fall is approaching, which means it’s almost time for annual respiratory virus vaccinations. Most people older than 6 months were eligible for a COVID-19 booster shot before, but this year, the vaccination recommendations are a bit more complicated.

Here’s what to know about who should get the updated 2025–26 COVID-19 vaccine and when.

Potential Changes to COVID Vaccine Recommendations

Since 2021, the Centers for Disease Control and Prevention (CDC) has recommended that all adults get the most updated COVID vaccine annually to help protect against seasonal waves of cases.

In a video shared on social media in May, Health Secretary Robert F. Kennedy Jr. said the CDC would stop recommending the COVID vaccine for healthy children and healthy pregnant people. Adults 65 years and older, along with younger people who have an underlying medical condition, are still eligible for the vaccine.

The announcement came after a New England Journal of Medicine article, in which the head of the Food and Drug Administration (FDA) said vaccine makers would need to test their COVID vaccines in clinical trials before they could be approved for other groups.

In May, the FDA chose which strains of the virus this year’s vaccines should target. The updated 2025-26 shots will likely be available in the fall. This year’s updated vaccines won’t need to undergo clinical testing before the FDA considers whether to approve them.

What the CDC Says About COVID Vaccines for Kids

Despite the changes in FDA policy, the CDC still says children can get the vaccine.

The CDC now recommends that children 6 months or older may receive the vaccine if “the parent presents with a desire for their child to be vaccinated” and a healthcare provider recommends it.

William Schaffner, MD, a spokesperson for the National Foundation for Infectious Diseases, said that while the difference in language may seem small, it means that some healthcare providers may not offer the vaccine unless parents ask for it.

Schaffner noted that the specific guidance for how many doses to give a child and when can be confusing. “It gets fairly thorny and involved in pediatric practice,” he said. “As an internist, I say, ‘Listen to your pediatrician or family doctor, do what they say.'”

Schaffner said vaccinating young children is especially important. According to data presented to a CDC advisory committee in June, children younger than 2 accounted for 57% of the COVID-related pediatric hospitalizations last year. Young children are hospitalized with COVID at a similar rate to adults 65 to 74 years old.

FDA’s Limited Vaccine Approval May Reduce Options for Kids

Even if a healthcare provider recommends an updated COVID shot for a child, they may have few options to choose from.

During the pandemic, the FDA granted emergency use authorizations (EUAs) for Moderna’s and Pfizer’s mRNA COVID-19 vaccines for children as young as 6 months. The EUAs allowed for a faster rollout, while full FDA approval requires more data on the manufacturing process and long-term safety. A full approval can boost public confidence in the vaccine’s safety and efficacy and prevent the FDA from pulling it from the market at will.

In July, the FDA granted full approval to Moderna’s COVID vaccine for children aged 6 months to 11 years, but only for those with at least one health condition that raises their risk of severe illness from COVID.

Pfizer’s COVID vaccine is FDA-approved for people 5 years and older, while Novavax’s is authorized for those aged 12 and above. The limited approval of Moderna’s vaccine leaves the youngest children without a fully licensed option.

Robert Hopkins, Jr, MD, medical director of the National Foundation for Infectious Diseases, said that the Moderna approval is a “positive step forward.” However, he added, “limiting the approval to children who have at least one underlying condition creates a barrier for those who want their children to get vaccinated.”

COVID Shot Guidance for Adults

The FDA leaders intend to limit COVID vaccine approval to those older than 65 and younger adults who have at least one health condition that puts them at risk for severe disease. The CDC has yet to update its official recommendation for the 2025-2026 COVID shot.

Those conditions include:

• Asthma
• Cancer
• Diabetes
• Pregnancy
• Depression
• Chronic lung diseases
• HIV

“Come this fall, you should get a dose of COVID vaccine, certainly, if you fit into any of these high-risk groups,” Schaffner said. “If you don’t, but you still want to get the COVID vaccine, have a discussion with your provider. Under shared clinical decision-making, you may still get it.”

Guidance for Immunocompromised People Remains Unchanged

The vaccine recommendations for people with compromised immune systems remain the same: all people older than 6 months should get multiple doses of COVID vaccine if they are moderately or severely immunocompromised.

The CDC says immunocompromised individuals should be fully vaccinated with an initial series and get at least one dose of the updated vaccine. They can consider additional doses of vaccine, as long as they are given at least two months apart.

People with medical conditions or who take medications that dampen their immune system will have different health needs and considerations. It’s best to talk to your physician to figure out a COVID vaccine strategy that works for you.

Confusion Around Vaccine Guidance for Pregnant People

Kennedy stated in a video that the CDC will no longer recommend COVID vaccines for healthy pregnant people.

FDA leaders said that the vaccine would likely be recommended for adults with at least one health condition on the 2025 CDC list of underlying conditions that increase their risk for severe COVID. Pregnancy is listed as one of the qualifying conditions, adding confusion to the recommendation.

The American College of Obstetricians and Gynecologists (ACOG) continues to recommend COVID vaccination during pregnancy. In a statement following the announcement, ACOG President Steven Fleischman said, “We are worried about our patients in the future, who may be less likely to choose vaccination during pregnancy despite the clear and definitive evidence demonstrating its benefit.”

Will Insurance Still Cover COVID Shots?

Most health insurers are only legally required to cover the cost of vaccination if it is recommended by the CDC advisory panel and then greenlit by the CDC Director. That includes private insurers,  Medicare Part D, and Medicaid expansion insurers. Traditional Medicaid and CHIP programs only need an advisory panel recommendation.

Because Kennedy, speaking for the CDC, narrowed the COVID vaccine recommendation, insurers are no longer required to cover the cost of vaccines for healthy adults younger than 65 and healthy pregnant people.

However, health insurers are still required to cover the cost of a child’s vaccine if their healthcare provider recommends it. That’s the rule when the agency recommends shared clinical decision-making.

When and Where to Get the 2025–26 COVID Vaccine

The updated 2025-26 COVID vaccines are expected to become available in the fall, around the same time as the annual flu shot. The U.S. still sees the biggest waves of COVID in the late fall and winter, though there tends to be an uptick in cases during the summer months, too.

Schaffner said people who are at high risk for severe COVID outcomes and have not received a dose of the 2024-25 COVID vaccine may consider talking to a healthcare provider about getting a dose now to stay protected through the end of the summer.

If you’re eligible, you can still get the COVID and flu vaccines during the same visit. Older adults who are due for a respiratory syncytial virus (RSV) vaccine can also get that shot then.

If you were recently sick with COVID, the CDC recommends waiting at least three months for your next COVID vaccine, when your immune response may start to wane again.

“As both a doctor and a dad, I always remind my patients—and my own family—that simple habits can go a long way in helping to prevent the spread of COVID-19 and other respiratory illnesses,” Hopkins said.

That includes getting vaccinated, keeping your distance from people who are sick, staying home when you don’t feel well, wearing a mask in crowded indoor spaces, and practicing good hand washing.