Most of my patients receive updated Covid photos regularly, or by shaking them summarily. Sometimes they stop me mid-sentence as I recommend them, frowning, with a look of disgust, as if I had just told them to light a match and smoke. I’m done with Covid shots!
On some level, I understand that. Covid is not what it used to be, and the natural psychology after a pandemic is to move on. Sometimes that involves turning 85-year-old public health heroes into fall guys, or revising what really happened in order to promote a political ideology. But on another level, I think the fear of sleight of hand with Covid injections is just that. People are more willing to get the flu vaccine every year, which is roughly the same paradigm. And while I respect people’s decision not to get another Covid vaccine, especially if they’ve had a bad reaction in the past, I also feel obligated to justify the advice that most doctors continue to give.
Personally, I haven’t had an updated Covid shot yet this season. After some negotiation and consensus building with my family, and after checking how high the local Covid wave is right now, we decided to delay ours until rates go up a bit here in Philly or as the second holiday wave approaches. I’m going to review the numbers very quickly, but first, a new analysis published by JAMA on 2026-2027 Covid shots to be examined.
Why get vaccinated against Covid in 2026?!?
This JAMA systematic review (recently published September 2026) pooled 155 studies from August 2025 to June 2026. Very current, although not an RCT.
The bottom line is that the updated Covid vaccines reduce the risk of serious outcomes by about half and no new safety concerns have emerged.
One caveat applies throughout: no real data yet exists on the 2026-2027 shot itself. The closest evidence comes from last season’s LP.8.1 vaccine. The authors note that in today’s world, XFG and other existing variants are still quite similar.
Elderly (65+) still have the highest hospitalization rates and account for around 88% of Covid deaths. This is the population I strive most to reach. The cliché from last season reduce the risk of hospitalization by 53 to 59% And Emergency room/urgent care visits by 48%. When it comes to how people get sick with Covid, sniffles to hospitalization to death exist along a continuum…so if the updated shots are clearly bending the needle in the right direction, it makes sense to me to reduce the severity of Covid illness with an updated shot. Whether this prevents an individual from getting really sick is anyone’s guess.
In the 2024-2025 data, also updated snapshots reduction in intensive care admissions (57%) and ventilation or death (73%). These are macabre situations. Nursing homes with higher vaccination coverage also had fewer hospitalizations.
Children aged 9 months to 4 years had 76% fewer emergency room visitsand those aged 5 to 17 had 56% less. I like this trend. Less serious illness.
Immunocompromised people obtained more modest but real protection, around 32 to 53% against serious illnesses.
Healthcare workers (that’s me) who have received 3-5 doses since this all started turned out to have fewer infections (41%) and shorter Covids (57%) than those with 2 doses. I lost count, but I think I’ve had seven shots already.
Security showed no new signals. The risk of myocarditis in young men came from studies before the change in dosing intervals in 2022. Covid-related myocarditis is pretty much just something we see with real infections now. Getting vaccinated against Covid and against the flu during the same visit presented no additional risk.
Boundaries: As noted at the top, almost all of the evidence reviewed is observational and many studies carried a risk of bias. This is real-time science. Take it or leave it, but try not to be an RCT absolutist.
My personal bet
If it were up to me, I would have received an updated photo by now…but I’m playing a little with my family. There are usually two waves to jump, and the protection against infection that the updated Covid shots offer gets worse as the months go by. Here in the Northeast, the second wave during the holidays is usually the highest, and we’re stuck inside with the windows closed more often because of the colder weather. This may be why southern states typically have larger late summer surges, stuck indoors as people endure sweltering heat as they also return to school in late August.
Anyway, here are some images and tables that tell a story of the current situation, from Pandemic Mitigation Collaborative and Biobot:
What do you notice in the areas of higher prevalence following the hot summer weather in the south?
There are many variations between states. Good to know if you are also traveling:
See the current year’s red line below. What do you notice?
Not too bad as far as waves go, and if we’re lucky, this line will continue to flatten and might just curve downward until the holidays approach.
I keep an eye on the orange line below that follows the northeast. It just took a jump up, so if it continues to rise by next week (and I did not get Covid during the back-to-school party last night!) I might just ditch the family plan and get my own now.
I’m not really high risk, except I work in healthcare, but if I was high risk I wouldn’t try to mess with this. I would just do it. Most Americans are at high risk for one reason or another, so it’s best to get vaccinated if you’re not happy with the benefits reaffirmed by this JAMA systematic review and are OK with the small risks.
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This article was first published yesterday on my site Examined.
I write about what’s happening in primary care, from evidence to the exam room to political shenanigans.
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Gn Health
