ACP Says Adults at Increased Risk Should Get an mRNA-Based COVID-19 Vaccine
The updated 2025-2026 mRNA-based COVID-19 vaccine can protect older adults and others at increased risk from serious illness, hospitalization, or death
PHILADELPHIA, February 24, 2026—The American College of Physicians (ACP) issued updated COVID-19 vaccine practice points for physicians that say adults over age 65 and those aged 18-64 at increased risk for COVID-19 should receive the updated 2025-2026 mRNA-based COVID-19 vaccine. ACP also suggests that those aged 18-64 who are not at increased risk for COVID-19 may consider receiving the vaccine. ACP did not examine evidence or make recommendations for pregnant women or immunocompromised adults. “COVID-19 Vaccines for 2025-2026 in Adults Who Are Not Pregnant or Immunocompromised: Rapid Practice Points from the American College of Physicians” is published in Annals of Internal Medicine.
COVID-19 remains an important population health problem, with more than 20 million cases in the US from October 2024-September 2025 resulting in over 500,000 hospitalizations and 60,000 deaths. Adults aged 65 years and older, adults 18-64 with comorbidities – such as asthma, cancer, cardiovascular disease, or lung diseases – and current or former smokers are at greater risk for severe COVID-19. ACP encourages these individuals at increased risk, which account for over 90% of COVID-related hospitalizations, to be vaccinated against COVID-19. Despite these data, only 17% of adults reported receiving a 2025-2026 COVID-19 vaccine as of January 24, 2026.
ACP’s practice points are based on a rapid review of recent evidence on COVID-19 vaccines. The studies in the review included patients at varying risk for severe COVID-19 and varying personal history of COVID-19 infection and vaccination status. Evidence from the rapid review and epidemiological data showed an association between adults aged 18 or over who received an Omicron adapted mRNA-based vaccine and a reduction in the risk for all-cause mortality and COVID-related hospitalizations compared with those who did not receive the vaccine. The data demonstrated that adults aged 65 or older and those aged 18-64 at increased risk for severe COVID-19 are at highest risk for hospitalization and death. It also showed that incidence of myocarditis resulting from the mRNA-based COVID-19 vaccine is low, most commonly affecting males aged 12-24 years.
“Evidence clearly shows that the 2025–2026 COVID‑19 vaccine significantly reduces the risk of severe illness, hospitalization, and death,” said Jason M. Goldman, MD, MACP, President of ACP. “We strongly urge individuals at higher risk for COVID‑19 complications to receive the vaccine, and we encourage physicians to carefully assess and address the risk factors that make their patients more vulnerable to severe disease.”
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About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 172 countries worldwide. ACP membership includes 163,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on X, Facebook, Instagram, Threads, and LinkedIn, and subscribe to our RSS feed.
Contact: Lori Bookbinder, 215-351-2431, Lbookbinder@acponline.org