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Peer reviewedOpen accessCOVID-19Influenza

Updated Evidence for Covid-19, RSV, and Influenza Vaccines for 2025–2026

New England Journal of Medicine·

Jake Scott, Michael S. Abers, Harleen K. Marwah, Nicole C. McCann, Eric A. Meyerowitz, Aaron Richterman, Derek F. Fleming, Elise J. Holmes, Leah E. Moat, Sydney G. Redepenning, Emily A. Smith, Clare J. Stoddart, Maria E. Sundaram, Angela K. Ulrich, Christopher Alba, Cory J. Anderson, Meredith K. Arpey, Ethan Borre, Joseph Ladines-Lim, Angela J. Mehr, Katherine Rich, Corey Watts, Nicole E. Basta, Jana Jarolimova, Rochelle P. Walensky, Caitlin M. Dugdale

DOI
10.1056/nejmsa2514268
PMID
41160817
PMCID
OpenAlex
W4415676376
Study type
Systematic review
Publisher
Massachusetts Medical Society
Article type
journal-article
Integrity
current

Why this research matters now

The review addresses disrupted U.S. vaccine advisory processes by providing an independent evidence base to support immunization decisions against major respiratory viruses for the 2025–2026 season.

01

Structured evidence summary

Research question

The review synthesizes current evidence on the efficacy, effectiveness, and safety of U.S.-licensed Covid-19, RSV, and influenza immunizations to inform independent guidance for the 2025–2026 respiratory virus season.

Study design

Systematic review of peer-reviewed literature searched in PubMed/MEDLINE, Embase, and Web of Science, updating prior ACIP Evidence-to-Reviews performed in 2023–2024.

Population and setting

U.S.-licensed vaccine recipients across age and risk groups relevant to the 2025–2026 season, including adults, children, older adults, pregnant persons (for maternal RSV vaccination), and immunocompromised adults.

Main findings

Pooled vaccine effectiveness against hospitalization was 46–50% for Covid-19 mRNA vaccines against XBB.1.5 in adults, 37% in immunocompromised adults, and 68% against KP.2 in one case-control study. Maternal RSV vaccination, nirsevimab, and RSV vaccines in adults ≥60 years showed effectiveness ≥68% against hospitalization. Influenza vaccine effectiveness against hospitalization was 48% in adults 18–64 and 67% in children. Reported safety signals included myocarditis at 1.3–3.1 per 100,000 doses in male adolescents following Covid-19 vaccination, with lower risk at longer dosing intervals, and 18.2 excess Guillain-Barré syndrome cases per million doses with RSVpreF in older adults.

Public-health relevance

The review addresses disrupted U.S. vaccine advisory processes by providing an independent evidence base to support immunization decisions against major respiratory viruses for the 2025–2026 season.

Important limitations

This summary is limited to the supplied single-article abstract and metadata and requires the original full paper for decision-grade interpretation; specific limitations of the systematic review (e.g., heterogeneity, publication bias, and excluded evidence) were not available in the supplied sources.

GIDS interpretation

The article provides independently reviewed vaccine effectiveness and safety evidence that could serve as contextual background for respiratory virus immunization programs; this summary does not link the paper to any live surveillance signal.

02

Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

03

Evidence relationships

This article has 12 auditable classifier relationships to diseases, places, topics, and study design.

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