It’s that time of year when the leaves are turning golden, there’s a chill in the air and the threat of respiratory viruses like Covid-19, influenza or RSV looms across the country.
The US Centers for Disease Control and Prevention expects the 2025-26 fall and winter respiratory disease season to have a similar number of peak hospitalizations due to Covid-19, flu and respiratory syncytial virus as there were last season.
But there are some steps you can take to reduce your risk of getting seriously ill with any of those circulating viruses this year – and vaccination plays a key role.
“One question or comment I get all the time from my own patients is, ‘Dr. Ren, I got the flu vaccine last year, or I got the Covid vaccine last year, but I still got Covid, or I still got the flu. What gives?’” said Dr. Mike Ren, an assistant professor of family and community medicine at the Baylor College of Medicine.
“What I tell them is, if I get the flu shot and someone with the flu sneezes on me and I’m in direct contact, I may still get sick, but it would be a much lighter version of illness,” he said. “Vaccines are not just disease prevention, but it’s to prevent you from getting a severe form of the disease that sends you to the hospital or worse. Flu every year and Covid every year still cause significant mortality in the country.”
The CDC estimates that about 1 million people were hospitalized with the flu last season, and there were up to 130,000 flu deaths, based on preliminary data from October 2024 through May 2025. Similar CDC estimates suggest that from October 2024 through September 2025, there have been almost 540,000 Covid-19 hospitalizations and up to 63,000 Covid-19 deaths.
Here’s what to know about getting this season’s Covid-19, flu and RSV vaccinations.
The CDC says people 6 months and older – including pregnant people – should consult a health care provider to get an updated Covid-19 vaccine this season. It’s a shift away from the broader push in previous years for most people to get a Covid-19 shot.
“The difference this year is that there’s not an explicit recommendation by the federal government to get the booster,” said Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center.
“This fall, the CDC has not explicitly recommended the Covid-19 vaccine but has made it available to everybody 6 months and older in a process called shared-decision making, which means that people are supposed to talk to a health care provider about the risks and benefits,” he said.
Types of health care providers may include people like physicians, nurse practitioners, pharmacists and physician assistants.
There are three types of Covid-19 vaccines available in the US: Pfizer for ages 5 and older, Moderna for 6 months and older, and Novavax for 12 and older. Pfizer and Moderna’s shots use mRNA technology, and Novavax’s version is a protein-based vaccine.
This year’s vaccines have been updated to target coronavirus strains circulating more recently, and they are available at most pharmacies, some doctors offices and certain public health departments.
“Many pharmaceutical places like your Walgreens or CVS should carry it,” said Dr. Panagis Galiatsatos, pulmonary and critical care medicine physician at Johns Hopkins and a spokesperson with the American Lung Association, who is author of the book “Medicine for the Greater Good.”
Before the CDC finalized the new recommendation this year, access to Covid-19 shots had differed from state to state as pharmacies and providers navigated new federal vaccine policies. CVS, which had previously limited access to Covid-19 shots in some places, said last week that it was “updating our systems to be able to offer the updated COVID-19 vaccines to patients nationwide” and that “prescriptions from outside prescribers will no longer be required in any states.”
For people who may have questions about where to find updated Covid-19 vaccines in their area or how to get their children vaccinated, Galiatsatos suggested directing questions to their local city or county health department or finding a large academic medical center in their area where they may be able to receive the vaccine.
“And what we usually say is to get the updated vaccine that usually comes out in the fall, get it once it’s available, and then talk with your doctor if you should consider getting boosted in about six months,” Galiatsatos said.
Dr. Sarah Dupont, a family medicine physician at Emory Healthcare and assistant professor at Emory University School of Medicine, recommends getting the Covid shot in October or early November.
“At least a few weeks before Thanksgiving, to be sure you are protected over the holidays. If you have had a COVID-19 infection recently, however, you probably want to delay your booster as you already have a boost in immunity,” Dupont said in an email.
For most eligible people with insurance, vaccinations may be covered, but “a COVID booster at a retail pharmacy is about $220 without insurance,” Dupont added.
The nation’s largest trade association for health insurers said its members – which cover more than 200 million Americans – indicated that the new CDC recommendations would not have an impact on policyholders’ coverage through the end of 2026.
AHIP, formerly America’s Health Insurance Plans, said in a statement in September that its members would continue to cover all immunizations that the CDC’s advisory committee recommended as of September 1 at no cost to patients. This includes the updated Covid-19 vaccine.
Last year’s updated Covid-19 vaccines were found to be about 39% effective against Covid-19 hospitalizations and about 64% against Covid-19 deaths, according to a study of US veterans published Wednesday in the New England Journal of Medicine.
“The Covid-19 vaccines do a better job at preventing severe disease than they do preventing mild infection, and so people at higher risk of severe disease benefit the most from the boosters,” Barouch said.
Can you get a Covid vaccine and flu shot at the same time?
The Covid-19 vaccines can be given at the same time as a seasonal flu shot, if people prefer to get both at once.
“There’s no recommendations against it other than just personal preference,” Ren said.
“With a lot of the vaccines, a lot of people may say they feel a little bit of fatigue,” he said of some of the side effects. “So if you’re getting multiple shots all at the same time, that effect could kind of compound.”
Most people 6 months and older should get a flu vaccine every season, according to the CDC.
“For flu, there is no change from prior years in terms of guidelines,” Barouch said. “And according to the CDC, the annual seasonal flu vaccine is recommended universally for everybody 6 months and older.”
Most people need only one dose of the flu vaccine each year. But some children who are getting the vaccine for the first time should get two doses, spaced four weeks apart.
It won’t be clear how effective this season’s flu vaccine is until after the season has ended. The CDC estimates that the vaccine was about 42% to 56% effective in adults during the 2024-25 respiratory virus season.
“Flu has a seasonality. That’s why we update it every year,” Galiatsatos said. “I usually recommend trying to get the vaccine at least two weeks before Thanksgiving, just so you can build up the immunity, because flu really kicks in in November and December and sometimes lingers into January, February, March.”
September and October are considered generally good times to get the flu vaccine, according to the CDC, and ideally eligible people should be vaccinated by the end of October.
“So get the flu vaccine now, if you haven’t already,” Galiatsatos said.
Some public health experts describe this as “flu before boo,” an effort to encourage people to get their flu shots by Halloween.
“It is still okay to get it later than that (you will still get protection),” Dupont wrote in the email. “But it is better to get it before the winter holidays to avoid spreading illness among your loved ones.”
Most people may be able to access flu vaccines at their local pharmacy, doctors office or even through certain public health departments.
But for the first time, many people in the United States who want to protect themselves against the flu can order a nasal spray vaccine to give themselves at home.
AstraZeneca’s FluMist, the only nasal spray flu vaccine in the US that has been approved by the US Food and Drug Administration, is now available for home delivery in 34 states under the brand name FluMist Home. It can be self-administered by adults under 50 and to children as young as 2 with the help of a parent or caregiver.
FluMist has been on the market for more than two decades, receiving initial FDA approval in 2003. In September 2024, the FDA gave the green light for the nasal spray vaccine to be self-administered, but it wasn’t ready to reach the public in time for last respiratory virus season. However, the product is available for this season.
For eligible patients, the flu shot should be covered by almost all insurance programs, but without insurance, “a flu shot at a retail pharmacy may be as low as $30 for a regular dose and up to $130 for a high dose (which is recommended for those over 65),” Dupont said.
The at-home nasal spray flu vaccine option is covered by most commercial insurance, with an $8.99 fee for shipping and handling. The online ordering platform includes a brief medical screening questionnaire to be reviewed by a licensed health-care provider before prescribing the vaccine.
RSV vaccines are recommended for adults 75 and older as well as those ages 50 to 74 who are at increased risk of severe illness, according to the CDC. It’s estimated that one dose of RSV vaccine provides protection against disease in older adults for at least two years.
Separately, to protect infants from severe RSV, immunizations can be given to mothers during pregnancy or to babies after birth as an antibody shot.
“If you’re someone who is pregnant, between 32 and 36 weeks, consider getting it – because when you get that RSV vaccine, you’re going to pass those antibodies to your newborn, and they’ll be protected,” Galiatsatos said.
The RSV vaccine is available for eligible adults at any time, but the best time to get it is typically late summer and early fall, according to the CDC.
For mothers, the RSV vaccine is usually available from September through January, according to the CDC. For infants, the antibody shot is typically recommended from October through March.
“They should start getting it now,” Dupont said. “It is just a one time shot currently.”
For eligible people with insurance, the RSV vaccine may be covered.
Without insurance, “an RSV vaccine may cost $350,” Dupont said. “But there are patient assistance programs that can significantly lower the price if you are paying out of pocket.”
Outside of respiratory viruses, other seasonal vaccines may help reduce the risk of getting sick this fall and winter, Galiatsatos said.
Pneumococcal vaccines help protect against bacterial pneumococcal infections – including pneumonia – in older adults, infants and certain younger adults with underlying health conditions.
“In addition to vaccination, people should stay home when they’re sick to avoid spreading diseases, and if people want to protect themselves further, then they can avoid crowded indoor locations during the wintertime,” Barouch said. “People also always have the option to wear a mask if they wish to do so, both to protect themselves and to protect others.”
Flu, Covid-19 and RSV can spread through respiratory droplets, Ren said.
“Good hand hygiene – so frequent handwashing and hand sanitizing – is really important because if somebody might have sneezed and then touched a door handle or touched that carton of milk that you were going to grab, as gross as it sounds, that’s how illnesses can spread,” Ren said.
It’s also important to cover your mouth when you cough, “get plenty of sleep, eat colorful fruits and vegetables and/or consider a multivitamin to keep your immune system up,” Dupont said.
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