Flu and COVID vaccination in autumn: who needs them and when

Autumn marks the start of the respiratory infection season. Flu and COVID-19 can be serious, especially for older people and people with chronic illnesses. Which vaccine you need depends on your age, your health and the people around you. The recommendations have changed recently, particularly for COVID-19.

Who does STIKO recommend the flu vaccine for?

STIKO recommends the flu vaccine for everyone aged 60 and over and for anyone who is at particular risk from flu or could infect others. The vaccine is given once per season, in autumn or winter [1].

The groups with a vaccination recommendation include [1]:

• People aged 60 and over, as a standard vaccination.
• Pregnant women from the second trimester, or from the first trimester if they have an underlying condition.
• Children from 6 months, adolescents and adults with chronic conditions, such as asthma or COPD, heart, liver or kidney disease, diabetes, severe obesity (BMI 30 or more), neurological diseases such as multiple sclerosis, or a weakened immune system.
• Residents of care homes.
• People who could infect people at risk, for example in the same household or as carers.
• Healthcare workers and people working in facilities with a lot of public contact.

From age 60, STIKO recommends a high-dose vaccine or a vaccine with an adjuvant (MF59). Both work better in older people than standard vaccines and are considered equivalent [1].

The vaccine is given again every year because flu viruses change constantly. For this season, all three virus strains in the vaccine were replaced [7]. Last year's vaccine therefore does not provide adequate protection.

Who needs a COVID booster this autumn?

Since July 2026, STIKO has recommended an annual COVID booster for everyone aged 75 and over and for people from 6 months with certain underlying conditions [5]. Healthy adults under 75 no longer need it under the current recommendation, nor do healthy pregnant women. STIKO explains that most adults are now well protected against severe illness through vaccination and past infections [5].

The recommendation also applies to [5]:

• residents of care homes,
• people with underlying conditions such as chronic lung, heart, liver or kidney disease, diabetes, severe obesity, dementia, cancer, a weakened immune system or long COVID,
• pregnant women with an underlying condition or pregnancy complications, from the second trimester,
• care and healthcare staff with an increased risk of infection or close contact with people at risk,
• close contacts of people in whom the vaccine is not expected to work well.

There should ideally be at least 6 months between your last COVID vaccination or a confirmed infection and the booster [5]. A vaccine adapted to the current virus variant is used.

If you are between 60 and 74 and have had a COVID vaccine every autumn so far, it is worth a short conversation with your GP. They can check whether you have an underlying condition that still makes the vaccine advisable.

When is the best time to get vaccinated?

The best time for the flu vaccine is October to mid-December. It takes 10 to 14 days for full protection to build up [2]. If you miss this window, you can still get vaccinated at the start of or during the flu season [2]. In recent years, the flu season has usually started in December [5].

The COVID booster should preferably be given in late summer or early autumn. If you have not had it yet, you should catch up during the season [5]. Flu and COVID vaccines can be given on the same day, each in a different arm [2]. A joint appointment in October or November therefore saves you a trip.

Against respiratory syncytial virus (RSV), STIKO recommends a one-off vaccination for everyone aged 75 and over and for people aged 60 to 74 with a serious underlying condition or living in a care home [1]. Whether a booster will be needed later is not yet known.

Where can you get vaccinated?

You can get your flu and COVID vaccines at your GP practice and, as an adult, at many pharmacies. After medical training, pharmacists may vaccinate people aged 18 and over with vaccines that do not contain live viruses [9]. Some employers also offer flu vaccination through their company doctor.

Which option suits you depends mainly on whether you need advice. If you have a chronic condition, need several vaccines or are unsure which ones are recommended for you, your GP practice is the right place. Your medical history and vaccination status are on file there.

Who pays for flu and COVID vaccines?

Statutory health insurers cover the cost for everyone STIKO recommends a vaccine for. The condition is that the Federal Joint Committee (G-BA) has added the recommendation to its vaccination guideline [3]. This also applies to the high-dose or adjuvanted flu vaccine from age 60 [2].

Many health insurers also pay for flu vaccines for healthy people under 60, as a voluntary extra benefit [8]. Ask your insurer whether this applies to you. With private health insurance, coverage depends on your contract [3].

For COVID-19, the G-BA decided in September 2026 to adopt the updated STIKO recommendation into its guideline [6]. If you want a vaccine outside the recommended groups, check with your insurer beforehand whether it will pay.

When should you postpone a vaccination?

You should postpone a vaccination if you have a fever of 38.5 °C or higher or an acute serious infection. Get vaccinated as soon as you have recovered [3]. A mild cold without fever, on the other hand, is no reason to cancel your appointment [1]. Chronic conditions or taking antibiotics are usually not a reason against vaccination either [3].

After a flu vaccine, redness, swelling or pain at the injection site may occur, slightly more often with high-dose and adjuvanted vaccines. Tiredness, headache, aching limbs or a mild fever are also possible and usually go away within a few days [3]. The COVID vaccine often causes pain at the injection site, tiredness and headache [5]. The flu vaccine contains no live viruses and cannot give you flu [2].