The 2026-2027 Influenza (Flu) and COVID-19 Vaccines

Following scientific review and advice from external experts, the Food and Drug Administration (FDA) has recommended strains for the 2026-2027 influenza (flu) and COVID-19 vaccines.[1],[2] Federal health officials will continue to monitor the safety and effectiveness of COVID-19 vaccination.

From 2023 to 2026, uptake of the influenza vaccine was between 49% and 54% for children, 35% and 38% for adults aged 18-49 years, 45% and 49% for adults aged 50-64 years, and 69% and 70% for people 65 years or older, according to the Centers for Disease Control and Prevention (CDC). COVID-19 vaccination rates have been substantially lower —in the 10%-14% range for children, the 11%-14% range for adults aged 18-49 years, the 17%-24% range for adults aged 50-64 years, and 34%-43% for people 65 years or older.[3],[4],[5],[6]

The influenza virus and the SARS-CoV-2 virus, which causes COVID-19, can mutate and circulate rapidly; each year, vaccine strains must be selected and updated.[7],[8] Strain selection identifies the key amino acid sequences that match each vaccine’s composition to predicted viral threats. The updates consider (1) surveillance data about population and clinical trends, including assessments of viral variant “fitness,” an indicator of which strains will become the greatest threat in the next year; (2) serology studies using human and other animal blood samples that identify the amino acid sequences, frequency and geographic distribution of virus strains; and (3) vaccine effectiveness studies and information on previous viral variants, including the availability of “candidate” viruses that may serve as vaccine templates. The World Health Organization leads most of these international data collection and analytic efforts, coordinating laboratory and other public health resources across 135 countries.

Influenza

As of February 2026, the 2025-2026 influenza season ranked as the third-worst season for hospitalizations since 2010-2011. There were 90 pediatric deaths; approximately 85% of those children were not fully vaccinated.

The 2025-2026 influenza vaccination reduced the risk of outpatient visits and hospitalizations across 16 states sampled for a national evaluation, although the vaccine’s effectiveness was lower than in previous seasons. Three recent studies in adults showed vaccine effectiveness ranging from 22% to 34%.

In March 2026 the FDA’s Vaccine and Related Biological Products Advisory Committee (VRBPAC) met to make recommendations on the strain composition of the 2026-2027 influenza vaccine.[9] Most laboratory-confirmed influenza cases in the United States from mid-November 2025 through February 2026 were the alpha (A) strain,[10] according to FDA, CDC and other analyses discussed at the meeting. The A/H3 subvariant was dominant. During the first two months of 2026, the beta (B) strain (principally the Victoria subvariant or unspecified) became more prevalent.

The VRBPAC voted unanimously to recommend an updated trivalent (two A and one B strains) influenza vaccine formulation for the 2026-2027 season.[11]

COVID-19

From October 2025 to May 2026, there were approximately 25 COVID-19 hospitalizations per 100,000 people in the United States.[12] These rates were markedly lower than in prior years. Hospitalization rates at the extremes of age were higher (96 per 100,000 for infants and about 71 per 100,000 for adults 64 years of age or older). Adults with one or more underlying conditions had two to five times the risk of hospitalization compared with age-matched adults without comorbidities. Three-quarters of infants who were hospitalized had no underlying medical conditions.

In May 2026 the VRBPAC met to make recommendations about the composition of the 2026-2027 COVID-19 vaccine. In the four weeks ending on June 7, 2025, the COVID-19 JN.1/LP.8.1 variant represented about 50% of all cases in the United States, according to information discussed at the meeting. By Sept. 27, 2025, the new JN.1/XFG variant accounted for over 70% of cases, almost completely replacing the LP.8.1 variant.[13] As of April 11, 2026, XFG variants were approximately 60% of all circulating COVID-19 viruses.

Four COVID-19 vaccines are approved in the United States; three are mRNA vaccines (COMIRNATY, MNEXSPIKE, SPIKEVAX) and one is a protein vaccine (NUVAXOVID).[14] Vaccine effectiveness was confirmed by several studies during the L.P. 8.1 strain phase of the 2025-2026 season, including one study showing 54% effectiveness in preventing outpatient visits and 57% effectiveness in preventing urgent-care or emergency-department visits.

The VRBPAC voted 9 to 0 with one abstention to recommend the monovalent, JN.1/XFG COVID-19 vaccine for 2026-2027.[15] The committee member who abstained said that although targeting the XFG variant was acceptable, it might have been better to add one or two other viral variants to broaden the vaccine’s scope.

What You Can Do

Absent limited medical exceptions such as documented severe allergic reactions, Public Citizen’s Health Research Group recommends that all eligible children and adults receive and stay up to date on influenza and COVID-19 vaccination, including people who are pregnant.[16] The 2026-2027 influenza and COVID-19 vaccines should be widely available in pharmacies, health centers and doctors’ offices. Both vaccines can be administered at the same visit. The best time for annual influenza vaccination is September or October.
 

References

[1] U.S. Food and Drug Administration. Influenza vaccine composition for the 2026-2027 U.S. influenza season. March 13, 2026. https://www.fda.gov/vaccines-blood-biologics/vaccines/influenza-vaccine-composition-2026-2027-us-influenza-season. Accessed July 6, 2026.

[2] U.S. Food and Drug Administration. COVID-19 vaccines (2026-2027 formula) for use in the United States beginning in fall 2026. May 29, 2026. https://www.fda.gov/vaccines-blood-biologics/industry-biologics/covid-19-vaccines-2026-2027-formula-use-united-states-beginning-fall-2026. Accessed June 30, 2026.

[3] Centers for Disease Control and Prevention. FluVaxView: influenza vaccination coverage and intent for vaccination, adults 18 years and older. March 4, 2026. https://www.cdc.gov/fluvaxview/dashboard/adult-coverage.html. Accessed July 13, 2026.

[4] Centers for Disease Control and Prevention. FluVaxView: influenza vaccination coverage, children 6 months through 17 years, United States. December 3, 2025. https://www.cdc.gov/fluvaxview/dashboard/children-vaccination-coverage.html. Accessed July 13, 2026.

[5] Centers for Disease Control and Prevention. COVIDVaxView: COVID-19 vaccination coverage and intent for vaccination, adults 18 years and older, United States. March 4, 2026.  https://www.cdc.gov/covidvaxview/weekly-dashboard/adult-vaccination-coverage.html. Accessed July 13, 2026.

[6] Centers for Disease Control and Prevention. COVIDVaxView: COVID-19 vaccination coverage and the intent for vaccination, children 6 months through 17 years, United States. December 3, 2025. https://www.cdc.gov/covidvaxview/weekly-dashboard/child-coverage-vaccination.html. Accessed July 13, 2026.

[7] Uzer F, Erendor F, Sanlioglu S. SARS-CoV-2 variants and immune Evasion: Mapping the future of vaccine design. Rev Med Virol. 2026 May;36(3):e70157.

[8] World Health Organization. Recommended composition of influenza virus vaccines for use in the northern hemisphere 2026-2027 influenza season and development of the candidate vaccine viruses for pandemic purposes. February 27, 2026. https://cdn.who.int/media/docs/default-source/vcm-northern-hemisphere-recommendation-2026-2027/b.-27-feb-2026-frequently-asked-questions.pdf?sfvrsn=66208818_7. Accessed July 6, 2026.

[9] U.S. Food and Drug Administration. Center for Biologics Evaluation and Research. Summary Minutes. 191^st Vaccines and Related Biological Products Advisory Committee Meeting. March 12, 2026. https://www.fda.gov/media/192383/download. Accessed July 6, 2026.

[10] Grohskopf L. U.S. influenza surveillance and preliminary vaccine effectiveness estimates, 2025-2026 season. FDA Vaccines and Related Biological Product Advisory Committee meeting. March 12, 2026. https://www.fda.gov/media/191522/download. Accessed July 6, 2026.

[11] U.S. Food and Drug Administration. Center for Biologics Evaluation and Research. Summary Minutes. 191st Vaccines and Related Biological Products Advisory Committee Meeting. March 12, 2026. https://www.fda.gov/media/192383/download. Accessed July 6, 2026.

[12] Thornburg NJ. Updates on epidemiology of COVID-19 and SARS-CoV-2 genomics. Centers for Disease Control and Prevention. Presentation to the VRBPAC. May 28, 2026. https://www.fda.gov/media/192772/download. Accessed July 6, 2026.

[13] Ibid.

[14] U.S. Food and Drug Administration. Briefing document: Selection of the 2026-2026 formula for COVID-19 vaccines. Vaccines and Related Biological Product Advisory Committee. May 28, 2026. https://www.fda.gov/media/192693/download. Accessed July 8, 2026.

[15] U.S. Food and Drug Administration. VRBPAC May 28, 2026, Meeting Videorecording. https://www.youtube.com/watch?v=3wU0NWzXvZY&t=21680s. Accessed July 6, 2026.

[16] Worst Pills, Best Pills Newsletter. Newsbrief: updated evidence supports COVID-19, RSV and influenza vaccines for 2025-2026 season. February 2026. https://www.worstpills.org/newsletters/view/1709. Accessed July 6, 2026.