As autumn brings cooler air and children return to school, Covid-19, influenza and RSV are again looming. CDC data show seasonal flu activity remains low nationally, but some measures are rising, particularly in the West.

Since mid-August, health officials in Washington state’s King County have noted an increase in people with flu visiting local emergency departments. Some respiratory illnesses have already arrived even before the traditional season fully begins.

Vaccines intended to prevent illness and reduce the risk of serious infections and hospitalization are now available at most major pharmacies. For some people, health experts say this is the right time to receive them.

The CDC typically launches a fall campaign recommending seasonal immunizations, including flu and Covid-19 vaccines. Following sweeping changes to the agency’s vaccine advisory committee during the second Trump administration and ongoing lawsuits, the CDC recently posted online guidance following last year’s recommendations.

The American Medical Association and the University of Minnesota’s Vaccine Integrity Project separately conducted independent reviews of vaccines for flu, Covid-19 and RSV. Their papers were published in September in the medical journal JAMA.

Those reviews helped inform 2026-27 respiratory virus immunization recommendations from the American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists and Infectious Diseases Society of America.

“For more than 60 years, the United States has benefited from an established federal process for evaluating vaccine evidence and translating that science into recommendations for the American public,” said Dr. Bruce Gellin, board chair of the Vaccine Integrity Project and professor of medicine at Georgetown University.

“Unfortunately today, the federal government is not fulfilling that responsibility in the way that it historically has. But the need for that work has not disappeared. Influenza, SARS-CoV-2 and the RSV viruses will circulate again this fall and winter,” Gellin said.

The US Department of Health and Human Services did not respond to CNN’s request for comment about the groups’ recommendations. Dr. Sarah Nosal, president of the American Academy of Family Physicians, said insurers have indicated to major groups that they will cover the respiratory virus immunizations.

Ordering has also begun through Vaccines for Children, a federal program providing routine immunizations at no cost to children who are uninsured, underinsured or whose families otherwise may not be able to afford them. About half of US children are eligible.

RSV immunizations are recommended for eligible older adults, pregnant people and infants. “People age 50 and older with high-risk conditions, and everyone over 75 years old, should get one dose,” Nosal said.

“This is not an annual vaccine. If you got one before, you do not need a new one this year. Getting one should protect you throughout the entire season,” Nosal said.

Children younger than 8 months should receive an RSV monoclonal antibody unless their mother received an RSV vaccination during pregnancy, according to Dr. Andrew Racine, president of the American Academy of Pediatrics. Immunosuppressed people face a higher risk of severe disease, although vaccines are generally less effective for them than for immunocompetent people, Dr. Dan Barouch said.

Guidance for pregnant people changed slightly this year. The American College of Obstetricians and Gynecologists now recommends one dose of the maternal RSV vaccine Abrysvo from September 1 through March 1, extending the previous window that ended January 31.

Dr. Christina Davidson, the organization’s chief medical officer, said the change reflects an RSV disease season now occurring later in the spring and becoming more severe. The longer eligibility window is intended to provide pregnant patients and their infants with additional protection.

“On average, flu vaccines reduce the risk of needing to go to the doctor by 30% to 60%,” Nosal said. Adults 65 and older should receive an enhanced flu vaccine when available, although Nosal said they should not delay vaccination if that option is unavailable.

For the first time, a vaccine based on mRNA is available against flu for adults 50 and older. October is considered an ideal time for flu vaccination because protection declines through the season, and some providers use the slogan “flu before boo” to encourage vaccination before Halloween.

Nosal recommends Covid-19 vaccination for adults older than 19, especially people 65 and older, those at increased risk of severe infection and people who have never received a Covid-19 vaccine. Adults 65 and older should receive a second updated dose six months after their initial seasonal dose.

Davidson also urged vaccination for people who are pregnant, considering pregnancy, breastfeeding or newly postpartum. Moderna offers two mRNA vaccines, Pfizer and BioNTech offer another, and Sanofi and Novavax provide a more traditional protein based version.

Dr. Sandra Adamson Fryhofer, president elect of the American Medical Association, said the updated Covid-19 vaccine targets the most recent circulating strain. She suggested considering vaccination a couple of weeks before a wedding, trip, birthday party or other gathering to receive the strongest protection during the first few months afterward.