As winter draws near, the days shorten, the air thins, and the familiar trio of Covid-19, influenza and respiratory syncytial virus (RSV) return to the stage.
The US Centres for Disease Control and Prevention (CDC) expects peak hospitalisations from these viruses in 2025–26 to be broadly similar to last season in the US, according to CNN.
Last season in the United States, there were about 1 million flu hospitalisations and up to 130,000 flu deaths (October 2024–May 2025). For Covid-19, there were almost 540,000 hospitalisations and up to 63,000 deaths (October 2024–September 2025).
Vaccines won’t block every infection, but they do make illness milder and help keep people out of hospitals.
Doctors emphasise that shots blunt severity. “What I tell them is, if I get the flu shot and someone with the flu sneezes on me and I’m in direct contact, I may still get sick, but it would be a much lighter version of illness,” said Dr Mike Ren of Baylor College of Medicine, speaking to CNN.
Vaccines, he said, are designed to keep you out of hospital or worse, noting that flu and Covid still cause significant mortality annually.
Covid-19
The CDC says people aged six months and older, including those who are pregnant, should consult a healthcare provider about receiving an updated COVID-19 vaccine this season.
Dr Dan Barouch of Beth Israel Deaconess Medical Centre noted a shift from prior years in the US: there is no explicit federal recommendation for everyone to get a booster; instead, the CDC has made the vaccine available to all six months and older via shared decision-making with clinicians such as physicians, nurse practitioners, pharmacists and physician assistants.
Three vaccines are available in the United States: Pfizer (ages 5+), Moderna (6+ months) and Novavax (12+), with Pfizer/Moderna using mRNA technology and Novavax a protein-based platform.
In the United States, updated vaccines targeting recent strains are available at most pharmacies, some doctors’ offices and certain public-health departments; CVS (Consumer Value Stores) has said it now offers updated shots nationwide and no longer requires outside prescriptions.
Dr Panagis Galiatsatos of Johns Hopkins advises contacting local health departments or large academic medical centres for availability, and generally taking the updated vaccine in the autumn, then discussing a possible booster in about six months.
For timing, Dr Sarah Dupont (Emory Healthcare) recommends October or early November, ideally a few weeks before holiday gatherings in the US, and spacing the dose if you recently had Covid-19.
In the United States, a retail-pharmacy Covid booster is about $220 for people without insurance, according to Dupont; most insured patients should have coverage, and AHIP (formerly America’s Health Insurance Plans) said members would continue to cover all immunisations recommended by the CDC’s advisory committee as of September 1 at no cost through end-2026.
On effectiveness, last season’s updated Covid-19 vaccines were about 39% effective against hospitalisation and about 64% against death in a New England Journal of Medicine study of US veterans. Covid and flu shots can be given at the same visit; some people find side-effects feel a bit stronger when multiple jabs are taken together.
Flu
Most people aged six months and older should receive a flu vaccine every season, with no change to guidelines from prior years. Some children getting the vaccine for the first time may need two doses four weeks apart. Effectiveness is only known after the season; for 2024–25, adult effectiveness was estimated at roughly 42% to 56%.
Timing-wise, September and October are generally good months, with protection building over about two weeks. Public-health experts in the US encourage vaccination by Halloween, though later still offer protection ahead of the winter holidays.
For Pakistanis, the National Institute of Health (NIH) Pakistan prioritises seasonal influenza immunisation for high-risk groups—pregnant women (highest priority), young children, older adults, people with chronic medical conditions, the immunocompromised and health-care workers—so these groups should speak with their clinicians about timing and availability locally.
In the United States, access is typically through local pharmacies, doctors’ offices and some public-health departments, and many people can order AstraZeneca’s FluMist nasal-spray vaccine for home delivery in 34 states (FluMist Home), self-administered by adults under 50 or given to children as young as two with a parent or caregiver.
The US Food and Drug Administration (FDA) first approved FluMist in 2003 and authorised self-administration in September 2024. For cost, in the United States, a retail flu shot without insurance may be as low as $30 for a regular dose and up to $130 for a high-dose vaccine (recommended for those over 65).
The at-home FluMist option is covered by most commercial insurance, with an $8.99 shipping fee.
RSV
Vaccination is recommended for adults 75 and older, and for adults 50 to 74 who are at increased risk of severe illness; a single RSV dose is estimated to protect older adults for at least two years.
To protect infants, immunisation can be given to mothers during pregnancy (typically 32–36 weeks) or to babies after birth as an antibody shot.
For adults, the vaccine is available any time, but late summer and early autumn are considered optimal. For mothers, availability is usually September through January; for infants, the antibody shot is typically recommended from October through March.
Dupont said eligible adults should start getting it now, adding that it is currently a one-time shot. In the United States, an RSV vaccine may cost about $350 without insurance, though assistance programmes can reduce out-of-pocket costs.
In line with World Health Organisation (WHO) guidance, countries generally choose one of two routes to shield newborns, either maternal RSV vaccination in late pregnancy (typically weeks 32–36) or a long-acting monoclonal antibody dose for the infant, timed to local seasonality; parents in Pakistan should discuss the most suitable option with their obstetrician or paediatrician.
Beyond vaccines, the same practical steps help: stay home when ill, avoid crowded indoor spaces during peaks if you wish to reduce exposure, consider wearing a mask, and keep up with hand hygiene and cough etiquette.
Dr Ren underscored the role of frequent handwashing and sanitising to break transmission via contaminated surfaces. Dupont added that good sleep and a balanced diet, “colourful fruits and vegetables”, or a multivitamin, support immune health.