Your guide to fall vaccines: Flu, COVID & RSV

This story has been updated for the 2025–2026 flu season.

We've now heard the expression “tripledemic” — driven by simultaneous surges of RSV, influenza, and  new COVID-19 variants — which instances have tested our healthcare system. While respiratory activity is currently low, the CDC warns that the 2025–26 season could bring a similar wave if preventive steps aren’t taken.

This year’s flu vaccine has been updated with newly recommended strains, COVID-19 vaccines are expected by September, and RSV immunizations remain critical for the most vulnerable. Here’s what you need to know.

Influenza vs COVID-19 vs RSV

According to the CDC, both the flu and COVID-19 are highly contagious viral infections that affect the respiratory system. Symptoms of the flu and COVID-19 are similar but they are caused by two very different viruses. Both the flu and COVID-19 can be more severe than the common cold for people. In fact, the CDC notes that out of 9 million cases of influenza viruses in the 2021-2022 season, there were 4 million flu-related medical visits, 100,000 flu-related hospitalizations, and 5,000 flu-related deaths. The numbers are even more dismal for COVID-19, with over 2 million COVID-19-related hospitalizations and 244,000 COVID-19-related deaths in the United States.

Each of these viruses can be spread through exposure to a contaminated surface or respiratory droplets that are expelled into the air when an infected person coughs, sneezes, or talks, notes the CDC.

Influenza, COVID-19 and RSV Symptoms Compared

Symptoms of RSV, influenza, and COVID-19 can be similar. Our symptom tracker (based on information from the Mayo Clinic) can help guide you this season.

When does flu season start?

Flu activity in the U.S. typically starts in October, peaks between December and February, and can last through May. Cold temperatures and indoor gatherings during winter drive transmission. CDC surveillance reports low activity as of June 2025, but historic trends suggest things will escalate by late fall.

What’s new for the 2025–26 flu season?

New vaccine strains

The FDA has approved a trivalent flu vaccine for 2025–26, including:

• A/Victoria/4897/2022 (H1N1)pdm09-like (egg-based) or A/Wisconsin/67/2022 (H1N1)pdm09-like (cell/recombinant)

• A/Croatia/Y10136RV/2023 (H3N2)-like (egg-based) or A/District of Columbia/27/2023 (H3N2)-like (cell/recombinant)

• B/Austria/1359417/2021 (B/Victoria lineage)-like virus

Manufacturers have already begun shipping doses.

Pediatric mortality warning

The 2024–25 season ended with 256 pediatric flu deaths — the highest for any non-pandemic year since 2004. Most children who died were not fully vaccinated, underscoring the importance of timely immunization.

When should I get vaccinated?

The CDC recommends getting vaccinated by the end of October to ensure protection before respiratory viruses peak. This includes:

• Flu shot (ages 6 months and older)

• COVID-19 vaccine (expected Sept. 2025)

• RSV immunization (see eligibility below)

Vaccines take about 2 weeks to become effective. Children under age 9 receiving the flu shot for the first time may need two doses spaced 4 weeks apart.

Flu Vaccine Overview

Types of flu vaccines

• Standard-dose flu shot

• High-dose flu shot (ages 65+)

• Adjuvanted vaccine (ages 65+)

• Egg-free (cell-based) vaccines (ages 18+ with egg allergy)

• Recombinant vaccine (no candidate virus needed)

• Nasal spray (LAIV) for eligible children and adults under 50

Who should get it?

Everyone 6 months and older without contraindications. Especially important for:

• Adults 65+

• Children under 2

• Pregnant people

• Immunocompromised individuals

• People with chronic diseases

• Residents of long-term care facilities

• American Indians and Alaska Natives

Cost of flu shots

• Usually free with insurance

• Uninsured? Prices range from $0–$50, depending on provider, with discounts available.

COVID-19 vaccine for 2025–26

What’s new?

A reformulated COVID-19 vaccine targeting current variants is expected to be released in September 2025, according to the FDA.

Who should get it?

• Everyone 6+ years old who has not received a vaccine in the last 4 months or had COVID-19 in the last 3 months

• This guidance will be updated upon official CDC release

Cost of COVID vaccines

• Still free as of mid-2025 due to federal funding

• Future cost may depend on insurance

RSV immunization: Who should get it?

Eligibility

• Infants under 8 months entering their first RSV season

• Toddlers (8–19 months) with heart/lung disease or prematurity

• Adults aged 50+ for individuals at high-risk
  

• All Adults aged 75+

• Pregnant people between 32–36 weeks gestation (to protect infants)

Cost of RSV vaccines

• Covered as preventive care under most insurance plans (ACA, Medicaid, Medicare)

• Uninsured? May cost $180–$295, per Kaiser Family Foundation

Is the RSV vaccine an annual shot?

No. RSV vaccines offer longer-lasting protection than flu or COVID-19 shots. Most adults won’t need yearly doses, but pregnant people and infants will continue to benefit from seasonal immunization.

Can I get all my fall vaccines at once?

Yes — the flu shot and COVID-19 vaccine can be administered together. For RSV immunization, early data suggest it’s safe to co-administer but may result in increased side effects (e.g., fever, soreness) or slightly reduced immune response. Ask your doctor if you qualify for and should combine doses.

Common Side Effects

Mild reactions typically go away in a few days:

• Soreness or redness at injection site

• Headache

• Fatigue

• Muscle aches

• Mild fever or chills

• Nausea

Rare but serious reactions may include:

• Breathing difficulty

• Hives or swelling

• Facial numbness or tingling

Seek immediate medical attention if you experience serious symptoms.

Benefits of immunization

Per CDC research, fall vaccines help:

• Prevent severe illness and hospitalizations

• Protect infants, pregnant people, and seniors

• Reduce the spread of respiratory viruses

• Lower risk of flu-related complications, like heart issues or pneumonia

• Lessen symptom severity even if you get sick