Several leading medical organizations have released updated recommendations for flu, COVID-19, and respiratory syncytial virus (RSV) vaccines for the 2026-27 respiratory season.

The guidance, available through the Vaccine Integrity Project, is especially important for people with lupus, whose disease or treatments may increase the risk of serious infections.

Lupus is an autoimmune disease in which the immune system attacks healthy tissues. It can affect many parts of the body, including the joints, skin, and kidneys.

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Some lupus treatments, including immunosuppressive medicines, can weaken immune defenses or reduce vaccine responses. Infection risks and vaccination needs can vary depending on disease activity, treatment, and other health conditions.

Vaccines train the immune system to recognize and fight specific viruses. This can help your body respond more quickly if you’re exposed to them.

There isn’t one vaccine plan that’s right for everyone with lupus. Your age, treatment plan, immune function, vaccination history, and other health conditions can all influence which vaccines are recommended and when you should receive them.

The Vaccine Integrity Project, working with the American Medical Association, reviewed the latest evidence on flu, COVID-19, and RSV immunizations for the 2026-27 respiratory season. The findings helped inform recommendations from several leading medical organizations, including:

The review included 299 studies published mostly between August 2025 and June 2026. It found that flu, COVID-19, and RSV immunizations continued to provide meaningful protection against hospitalization, severe illness, and death.

The amount of protection can vary based on the virus, the vaccine or immunization, the season, and a person’s health. For people with lupus, vaccination decisions should take into account factors such as age, lupus treatment, and immune function.

For the 2026-27 respiratory season, COVID-19 and flu vaccines have updated formulations. There are also three RSV vaccines for adults. These vaccines differ in how they’re made and which age groups or risk groups they are approved for.

COVID-19 Vaccines

The U.S. Food and Drug Administration (FDA) has approved four COVID-19 vaccine options. All four vaccines are given by injection.

The IDSA recommends that people with weakened immune systems talk to their healthcare provider about receiving a second dose of the COVID-19 vaccine two to six months after the first dose.

Flu Vaccines

All U.S. flu vaccines for the 2026-27 season are trivalent, meaning they are designed to protect against three influenza viruses.

Most people need one flu vaccine dose each season. Some children may need a second dose based on their age, vaccination history, or individual health circumstances.

For people with lupus, the American College of Rheumatology recommends influenza vaccination even during active disease or immunosuppressive treatment. However, the timing of certain medicines may need to be discussed with a rheumatologist.

People who are immunocompromised shouldn’t receive the live-attenuated nasal flu vaccine FluMist, per guidance from the U.S. Centers for Disease Control and Prevention (CDC) and IDSA.

RSV Vaccines

There are three FDA-approved adult RSV vaccines.

For adults, the CDC recommends a single dose of RSV vaccine for everyone age 75 and older and for adults ages 50 through 74 who are at increased risk of severe RSV illness.

For people with lupus whose treatment substantially weakens immune defenses, the IDSA recommends RSV vaccination starting at age 18. Having lupus does not automatically mean someone is immunocompromised.

For people who are immunocompromised, the benefits of vaccination generally outweigh the risks. Current evidence shows that flu, COVID-19, and RSV immunizations can reduce hospitalization, severe illness, and death.

People with weakened immune systems may not respond as strongly to vaccines, but vaccination can still provide protection.

Vaccines can cause side effects, but serious side effects are uncommon. Your healthcare team can explain what to expect and help you weigh the benefits and risks based on your:

• Treatment plan
• Immune function
• Age
• Previous reactions
• Other health conditions

The right vaccine and timing can vary for people with lupus. Some lupus treatments suppress the immune system or reduce how strongly the body responds to vaccines.

It’s important to ask not only which products are available, but which type, dose, and timing make sense for you.

Your healthcare team may consider:

Some vaccine types may not be appropriate for people with lupus who take immunosuppressive medicines. For example, the nasal spray flu vaccine is a live vaccine and should not be used in people with weakened immune systems.

Timing Around Treatments

Timing may also matter. The American College of Rheumatology conditionally recommends discussing a two-week pause in methotrexate after flu vaccination if lupus activity allows. Decisions to pause treatment should be made with your rheumatology team.

For people receiving rituximab, the American College of Rheumatology recommends getting the flu vaccine on schedule and coordinating the timing of other nonlive vaccines with treatment when possible.

Your rheumatology team can recommend the best timing based on your treatment and immune function. Don’t delay, skip, or change lupus treatment to get vaccinated unless your healthcare team recommends it.

People with weakened immune systems may not develop as strong a response to vaccines as people with healthy immune systems. That doesn’t mean vaccination has no benefit.

The Vaccine Integrity Project found that respiratory-virus immunizations continued to reduce severe outcomes among people with immunocompromising conditions, although protection varied.

In many cases, COVID-19, flu, and RSV vaccines can be given at the same visit.

Whether that makes sense for you may depend on your treatment schedule, previous vaccinations, expected side effects, and other health needs. Ask your rheumatology team whether getting more than one vaccine at the same appointment is appropriate.