Respiratory Vaccine Recommendations

ACHD is providing the following updated 2026-2027 vaccine schedule recommendations for children,  adolescents and adults, to include those who are pregnant and postpartum. They are consistent with those of Washington DOH and guidelines from the American Academy of Pediatrics (AAP), the American Academy of Family Practice (AAFP)    and the American College of Obstetrics and Gynecology (ACOG). Information can be found here. DOH and ACHD advise following these recommendations that are consistent with the above national organizations and are grounded in evidence-based science, decades of research and review, and established safety standards. To summarize ACHD’s recommendations for influenza, COVID-19 and RSV:

All adults ≥19 years should receive an annual influenza vaccine and an updated COVID-19 vaccine.

Adults ≥65 should preferentially receive a high-dose inactivated, adjuvanted inactivated, recombinant influenza vaccine, or mRNA influenza vaccine when available. 

Adults ≥75 years and adults 50-74 years who are at an increased risk should receive a single dose of the respiratory syncytial virus (RSV) vaccine.

Influenza vaccine is recommended for children and adolescents, ages 6 months through 18 years.

COVID-19 vaccine is recommended for all children 6–23 months of age, as well as children 2–18 years old who are at high risk of severe COVID-19 infections, or if the vaccine is desired.

RSV vaccine is recommended  for children under 8 months of age during their first RSV season unless it is demonstrated that the maternal RSV vaccine was administered during pregnancy; and children 8–19 months old in certain risk groups.

For individuals who are pregnant or postpartum influenza vaccination is recommended.

COVID-19 vaccination is recommended for individuals who are pregnant, considering pregnancy or a new or breastfeeding parents.

RSV vaccination is recommended (marketed as Abrysvo) for the first eligible pregnancy, ideally administered between Sept. 1 and March 1.