Several leading medical organizations have released updated recommendations for flu, COVID-19, and respiratory syncytial virus (RSV) vaccines for the 2026-27 respiratory season. The guidance, available through the Vaccine Integrity Project, can help people with paroxysmal nocturnal hemoglobinuria (PNH) discuss respiratory-virus protection with their healthcare teams.

PNH is a rare blood disorder in which part of the immune system, called the complement system, damages red blood cells. PNH itself does not necessarily mean a person has a weakened immune system.

Vaccines train the immune system to recognize and fight specific viruses. This can help your body respond more quickly if you’re exposed.

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There isn’t one vaccine plan that’s right for everyone with PNH. Your age, treatment plan, immune function, vaccination history, and other health conditions can all influence which vaccines are recommended and when you should receive them.

The Vaccine Integrity Project, working with the American Medical Association, reviewed the latest evidence on flu, COVID-19, and RSV immunizations for the 2026-27 respiratory season. The findings helped inform recommendations from several leading medical organizations, including:

• American Academy of Family Physicians
• American Academy of Pediatrics
• American College of Obstetricians and Gynecologists
• Infectious Diseases Society of America (IDSA)

The review included 299 studies published mostly between August 2025 and June 2026. It found that flu, COVID-19, and RSV immunizations continued to provide meaningful protection against hospitalization, severe illness, and death.

The amount of protection can vary based on the virus, the vaccine or immunization, the season, and a person’s health. For people with PNH, vaccination decisions should take into account factors such as age, treatment, immune function, and other health conditions.

For the 2026-27 respiratory season, COVID-19 and flu vaccines have updated formulations. There are also three RSV vaccines for adults. These vaccines differ in how they are made and which age groups or risk groups they are approved for.

COVID-19 Vaccines

The U.S. Food and Drug Administration (FDA) has approved four COVID-19 vaccine options. All four vaccines are given by injection.

The IDSA recommends that people with conditions that increase their risk of severe COVID-19 discuss a second vaccine dose with their healthcare team. This dose may be given two to six months after the first.

Flu Vaccines

All U.S. flu vaccines for the 2026-27 season are trivalent, meaning they are designed to protect against three influenza viruses.

Most people need one flu vaccine dose each season. Some children may need a second dose based on their age, vaccination history, or individual health circumstances. For people with PNH, ask your healthcare team whether flu vaccination needs to be coordinated with your treatment.

People who are immunocompromised (have weakened immune systems) shouldn’t receive the live-attenuated nasal flu vaccine FluMist, which contains weakened live flu viruses. Their immune systems may have difficulty controlling these viruses. This is based on guidance from the U.S. Centers for Disease Control and Prevention (CDC) and IDSA.

RSV Vaccines

There are three FDA-approved adult RSV vaccines.

The CDC recommends a single dose of RSV vaccine for everyone age 75 and older and for adults ages 50 through 74 who are at increased risk of severe RSV illness. For adults with weakened immune systems, the IDSA recommends RSV vaccination starting at age 18.

Having PNH does not automatically mean you qualify under this recommendation. Ask your healthcare team whether your immune status or other health conditions affect eligibility. The RSV vaccine isn’t currently given every year.

For people who are immunocompromised, the benefits of vaccination generally outweigh the risks. Current evidence shows that flu, COVID-19, and RSV immunizations can reduce hospitalization, severe illness, and death. People with weakened immune systems may not respond as strongly to vaccines, but vaccination can still provide protection.

Vaccines can cause side effects, but serious side effects are uncommon. Your healthcare team can explain what to expect and help you weigh the benefits and risks based on your:

• Treatment plan
• Immune function
• Age
• Previous reactions
• Other health conditions

The right vaccine and timing can vary for people with PNH. PNH itself does not necessarily weaken the immune system, but other health conditions or treatments may affect vaccination decisions.

Ask your doctor not only which products are available, but which type, dose, and timing make sense for you.

Your healthcare team may consider:

Some vaccine types may not be appropriate for people with weakened immune systems. For example, the nasal spray flu vaccine is a live vaccine and should not be used by people who are immunocompromised. PNH alone does not establish that someone is immunocompromised.

Timing Around Treatments

Timing may also matter. People receiving complement inhibitors need MenACWY and MenB vaccines, ideally completed or updated at least two weeks before starting treatment when possible.

If treatment needs to begin sooner, your healthcare team can advise you on vaccination and other precautions. These vaccines are separate from the seasonal COVID-19, flu, and RSV vaccines discussed here.

For COVID-19, flu, and RSV vaccines, timing decisions should take into account your age, immune function, vaccination history, and other health conditions.

Your hematology team can help determine which vaccines you need and when to receive them. Don’t delay, skip, or change PNH treatment to get vaccinated unless your healthcare team recommends it.

People with weakened immune systems may not develop as strong a response to vaccines as people with healthy immune systems. That doesn’t mean vaccination has no benefit.

The Vaccine Integrity Project found that respiratory-virus immunizations continued to reduce severe outcomes among people with immunocompromising conditions, although protection varied.

In many cases, COVID-19, flu, and RSV vaccines can be given at the same visit.

Whether that makes sense for you may depend on your treatment schedule, previous vaccinations, expected side effects, and other health needs. Ask your hematology team whether getting more than one vaccine at the same appointment is appropriate.