Four FDA-approved COVID vaccines for the 2026–27 season

Clinical takeaway: Prioritize updated vaccination for adults aged 65 years or older and younger patients at increased risk for severe COVID-19. Select an age-appropriate product based on availability and preference, including Nuvaxovid for patients who prefer a non-mRNA option.

FDA has approved four monovalent COVID-19 vaccines for the 2026–27 season. All target XFG, a JN.1 descendant selected to better match circulating SARS-CoV-2 variants.

All four vaccines are approved for adults aged 65 years or older. Younger patients must have at least one condition that increases their risk for severe COVID-19. The CDC’s broad risk list includes asthma, diabetes, cardiovascular disease, overweight or obesity, pregnancy, immunocompromise, and mood disorders.

The available products are:

• Spikevax, Moderna’s full-spike mRNA vaccine, is approved beginning at age 6 months.
• Comirnaty, the Pfizer-BioNTech mRNA vaccine, is approved beginning at age 5 years.
• mNexspike, Moderna’s newer mRNA vaccine, is approved beginning at age 12 years. It encodes two key regions of the spike protein rather than the full spike and can be stored under standard refrigeration.
• Nuvaxovid, approved beginning at age 12 years, uses recombinant spike protein with an adjuvant and remains the only non-mRNA option.

No specific product is currently recommended over another. Age, availability, contraindications, previous reactions, and patient preference can guide selection.

CDC recommendations for the 2026–27 season, including the number and timing of doses, are not yet available.

Medical organizations have issued their own guidance. ACP recommends vaccination for everyone aged 65 years or older and younger adults at increased risk; lower-risk adults may consider it. AAFP recommends vaccination for all adults and children aged 6 through 23 months, with a risk-based approach for older children and access for families desiring protection. ACOG recommends vaccination during pregnancy and lactation, and IDSA recommends it for immunocompromised patients. AAP’s 2026–27 guidance is expected September 2; last season, it recommended vaccination for all children aged 6 through 23 months and for older children at increased risk or whose families wanted protection.

Sources: US Food and Drug Administration. Coronavirus (COVID-19) | CBER-Regulated Biologics. Accessed 2026 Aug 28; US FDA. (2026 May 29). COVID-19 vaccines (2026–2027 formula) for use in the United States beginning in fall 2026