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Medical groups continue to diverge from CDC on fall vaccine schedule
AAFP, AAP and peer groups' vaccine recommendations remain consistent with previous years, but they now diverge from the CDC's advisories calling for shared decision-making before annual COVID vaccination.
Leading medical groups, including the American Academy of Family Physicians and American Academy of Pediatrics, are making waves with their recently updated fall immunization schedule, which includes vaccines for COVID-19 and the flu.
However, it's not because these groups have changed their recommendations. Rather, it's because government agencies, like the CDC, have changed theirs.
Now, the groups -- which joined the American College of Obstetricians and Gynecologists and the Infectious Diseases Society of America to create the Vaccine Integrity Project -- diverge with government agencies, something they hadn't done until last year.
"As federal guidance evolves, the science behind vaccines remains strong," Sarah Nosal, M.D., AAFP president, said in a press release. "These recommendations are grounded in the latest evidence, informed by public health experts and shaped by what family physicians are seeing every day in their patients."
For the fall of 2026, the societies continue to recommend that all adults receive a COVID-19 vaccine, whether it is their first dose or an annual dose. The organizations also said kids aged 6-23 months should be vaccinated against COVID-19, and kids aged 2-18 years should follow a risk-based approach for a single-dose annual shot.
This is one of the key areas where the groups in the Vaccine Integrity Project diverge from the CDC. Some resources show the CDC issuing a universal recommendation for all adults to get their initial dose of the COVID-19 vaccine. However, the CDC has also published literature recommending that people aged 6 months to 64 years get vaccinated based on shared clinical decision-making.
The medical societies also recommended that all adults over age 75 get a one-time RSV vaccine, which aligns with CDC recommendations. The Vaccine Integrity Project groups and the CDC both also recommend adults aged 50-74 at increased risk for RSV get the vaccine.
However, the Vaccine Integrity Project groups further recommended adults and adolescents who are immunocompromised get the vaccine.
Finally, the medical societies and the CDC both issue universal flu vaccination for anyone six months and older. However, the Vaccine Integrity Project groups added that adults over age 65 should get an enhanced flu vaccine, such as a high-dose, adjuvanted or recombinant or mRNA shot when available. But older adults should not delay vaccination simply to get one of these enhanced vaccines, they said.
Medical societies push back on fed guidelines
These recommendations aren't exactly revelatory. They align with what medical groups have previously advised. And although they stray somewhat from CDC recommendations, the differences are mostly related to the COVID-19 vaccine.
Still, there have been changes to CDC recommendations for other vaccines, including the MMR vaccine. The CDC, through its Advisory Committee on Immunization Practices, has also issued shared clinical decision-making advisories for certain vaccines and groups.
Groups like AAFP say the science behind vaccines hasn't changed, indicating that changes from CDC and ACIP aren't necessarily warranted.
"Vaccines are one of medicine's greatest success stories," Nosal said in the statement. "They prevent serious illness, reduce hospitalizations and long-term complications and save lives."
However, changing guidance from government agencies like the CDC and its departure from leading medical groups have sown some confusion among patients. Indeed, patients aren't entirely sure of what certain vaccines are designed to prevent, and mixed public health messaging has made it hard to know what is and is not recommended.
Other data has shown that patients don't know what shared clinical decision-making entails. Although the CDC says shared clinical decision-making amounts to a conversation with one's physician or clinician about getting a vaccine, a 2026 Annenberg Public Policy Center survey found that patients don't know this.
About a fifth of respondents said shared clinical decision-making means it's a patient's choice whether they want to talk to their doctor about the vaccine. This could potentially lead some individuals to forego medical advice. Another quarter of respondents were unaware that a healthcare professional should even be part of the shared decision-making process. Rather, they thought it could happen with just their family members.
Still, a promising 68% of respondents correctly said shared decision-making entails a medical history review with a provider. Nosal said healthcare professionals need to be ready to have conversations about vaccines with their patients this fall and be equipped with up-to-date recommendations to help patients parse fact from fiction.
"Physicians know that patients may have questions about vaccines and are ready to have conversations about why they are important and how they help protect you and your loved ones," Nosal explained. "At a time when patients and physicians are navigating changing guidance, the AAFP is committed to providing clear, trusted recommendations based on the best available evidence."
Sara Heath is an executive editor at Xtelligent Healthcare Media, where she covers patient engagement, healthcare policy and health IT.
