Independent Review Supports Safety and Effectiveness of COVID-19, RSV, and Influenza Vaccines for 2025–2026

The systematic review and meta-analysis were published in The New England Journal of Medicine in October 2025.

Disruptions in the United States (U.S.) vaccine advisory processes have highlighted the need for independent clinical evidence assessment to guide immunization decisions. Consequently, Dr. Jake Scott of the Division of Infectious Diseases and Geographic Medicine at the Stanford University School of Medicine, Stanford, California, and his team synthesized data on epidemiology, vaccine efficacy (VE), and safety to equip clinicians with clear, data-driven immunization guidance for the upcoming respiratory virus season.

The systematic review and meta-analysis screened 17,263 references, identifying 511 studies on United States (U.S.) licensed vaccines since the last Advisory Committee on Immunization Practices (ACIP) review. Researchers stratified findings by pregnancy, immune status, and age—specifically, infants, children, adults, and seniors aged 60–65+—to evaluate effectiveness against laboratory-confirmed hospitalizations within six months.

Key Findings of the Analysis:

• COVID-19 Vaccination Efficacy: The Current XBB.1.5-adapted mRNA vaccines provide 46% to 50% protection against hospitalization in adults, while the newer KP.2-adapted formulation demonstrates an even higher effectiveness of 68%.
• RSV Prevention Impact: Maternal vaccination and nirsevimab administration achieve over 80% effectiveness against infant hospitalizations, while RSV vaccines for adults aged 60 and older maintain a robust 79% pooled effectiveness.
• Influenza Vaccine Performance: Seasonal influenza vaccines show 67% effectiveness against hospitalization in children and 48% in younger adults, with high-dose and adjuvanted versions providing significantly improved protection for the elderly.
• Maternal and Neonatal Safety: The analysis data confirms that Coronavirus Disease 2019 (COVID-19) vaccination during pregnancy is not associated with miscarriage or congenital anomalies and may reduce preterm birth risk, while RSV Vaccination at 32–36 weeks shows no increased risk of preterm birth.
• Strategic Coadministration: Clinicians can safely implement single-visit strategies for all three respiratory vaccines, as the concurrent administration of COVID-19, RSV, and influenza vaccines maintains immunogenicity and safety profiles comparable to separate dosing

The review concludes that ongoing peer-reviewed evidence supports the continued use of COVID-19, RSV, and influenza vaccines as the most effective tools for preventing severe respiratory disease during the 2025–2026 season. The findings highlight the importance of updated COVID-19 vaccine formulations and reinforce the role of routine immunization in reducing hospitalizations among vulnerable populations.

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