Each fall, nurses and doctors brace for an all-too-familiar seasonal surge. Patients struggle to breathe. Older adults lean forward, lips pursed as if trying to drink air through a straw. Infants take more than one shallow breath per second, their wide-eyed panic reflected in their parents’ faces. As an internist, I have cared for too many young, previously healthy patients laid low by infection, some requiring a breathing tube or other intensive care.

More than ever before, much of this suffering is avoidable, particularly because of immunizations for seasonal influenza, respiratory syncytial virus (RSV), and Covid-19.

But changes in federal vaccine guidance are creating confusion about who can get these shots and how. To best serve our patients, the rest of our nation’s health system n

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