If you don’t want to take a vaccine, don’t.
Is that a surprising sentiment to read on the blog of the most experienced and celebrated vaccine service provider in our region? It shouldn’t be. Because our express purpose is to provide you with updated vaccinations in a seamless, efficient way — if you want them.
Dr. Neal, founder and holistic pharmacist of Village Apothecary, likens it to selling hot dogs. If you don’t want or like hot dogs, that’s okay! You don’t have to eat them. But we sell hot dogs, so if you do want one, we have you covered.
Now that we have that bit out of the way, let’s take a look at Dr. Neal’s top hot dog recommendations for 2026 — AKA which seasonal vaccines are available at our clinic in Woodstock, New York.
In This Article:
- What you should know first (this part is different this year)
- Dr. Neal’s top 3 for the season: COVID-19, flu, RSV
- Pneumococcal, shingles, and Tdap
Seasonal Vaccine Recommendations: What You Should Know First
About “The Schedule” — and why we’re leaning on it differently this year
In past versions of this post, we pointed you at the CDC Adult Immunization Schedule and said something like: if the smarty pants at CDC and ACIP say you should get a vaccine, Dr. Neal is going to agree.
We have to be straight with you: that shortcut doesn’t work as cleanly in 2026.
The federal advisory committee that writes those recommendations — ACIP — has been without a working quorum since March, when a federal court ruled that most of its recently appointed members were seated improperly. The court also stayed a batch of recommendation changes made over the previous year. The case is still unresolved. So depending on which day you look and which page you land on, federal guidance may be current, reverted, stayed, or simply absent.
Here’s what did not change: the vaccines themselves, and the evidence behind them.
The FDA process — is this vaccine safe, does it work, what strain should it target — ran normally this year. Vaccines got approved on schedule. What’s disrupted is the separate committee that says who should get them.
So this year, our recommendations lean on the pre-disruption standards, the guidance from New York State, and the recommendations of professional societies that never stopped publishing: the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Physicians, and ACOG. Several of these groups now publish their own schedules specifically because of the federal situation.
If that sounds like we’re freelancing, we’re not. We’re doing what pharmacists have always done — following the evidence and the clinical consensus. The letterhead changed. The medicine didn’t.
One piece of good news for our neighbors: New York passed legislation in May 2026 that decoupled state insurance coverage requirements and pharmacist authority from ACIP. We can vaccinate you, and your coverage has a state-level backstop. Last year, that depended on emergency executive orders getting renewed every few weeks. Now it’s law.
And, as always, talk to YOUR healthcare provider before making any decisions.
If you’re too young to talk with your primary care provider directly, you’re likely too young for this blog. The following recommendations are for individuals over 18 — the vaccines adults need after their last round of “pediatric” immunizations.
Understanding Vaccine Functionality
Before you schedule your 2026 vaccinations, it’s important to understand that vaccines aren’t force-fields. Nor are they magic — you can still get sick even after being vaccinated.
“We hope that vaccination prevents illness, but we’re still very happy with the real goals of vaccines: preventing severe complications, hospitalization, and death from a preventable disease.” — Dr. Neal Smoller, PharmD
Dr. Neal himself has had every COVID-19 vaccine that’s been made available and still had a pretty bad spell of COVID at one point. And that’s okay! He got to catch up on movies and his Lego set backlog.
Vaccines are one tool in the health and wellness toolkit. Treat them as such: prioritize timely vaccination, and keep focusing on the practices that keep your immune system strong.
Learn More: Vaccines Do Work, But They’re Not Perfect
Dr. Neal’s Top 3 Vaccine Recommendations for This Season
The three that should be top of mind this time of year: COVID-19, influenza, and RSV.
COVID-19
What’s new for 2026-2027
This year’s vaccines target XFG (nicknamed “Stratus”), a descendant of the Omicron/JN.1 family. FDA approved the updated formulas on August 27, 2026. Four products, all XFG-targeted:
- Comirnaty (Pfizer-BioNTech) — mRNA
- Spikevax (Moderna) — mRNA
- mNEXSPIKE (Moderna) — mRNA, next-gen formulation
- Nuvaxovid (Novavax, commercialized by Sanofi) — protein-based, non-mRNA
The FDA labels for all four are written for adults 65 and older, plus younger people with at least one condition that raises their risk of severe COVID. The qualifying condition list is long and includes things people don’t think of — obesity, diabetes, asthma, heart disease, kidney disease, pregnancy. Ask us if you’re unsure; most adults who wonder whether they qualify do.
Dr. Neal’s COVID-19 Vaccine Recommendations
If you’re eligible and not contraindicated, this shot should be #1 on your list right now — and we mean right now. Two reasons the usual “early September” advice is tighter this year: approval landed August 27, and there’s already a wave. Wastewater levels roughly doubled from July to August nationally.
COVID-19 is endemic at this point. There’s some seasonality — real peaks in summer and fall — but it’s been a constant bother since 2020, and infection risk exists year-round.
Some people avoid COVID vaccines because of side effects, particularly with the mRNA products. Good news for those folks: Nuvaxovid remains the only non-mRNA option, and its side effect profile tends to be milder and more in line with what people are used to — some arm soreness, some fatigue.
“Technically, the ‘highest’ protection comes in this order: Moderna, Pfizer, then Novavax. Moderna is higher dose, but also packs some stronger side effects. Especially local arm pain. We’ll normally promote Moderna as we have ample supply of it and it gives that slight edge, but any one of them are great!” — Dr. Neal Smoller, PharmD
mNEXSPIKE, Moderna’s next-generation formulation, remains our go-to for patients 65+ and those 12-64 at high risk of a severe bout.
Especially important for:
- Patients over 65. The mortality gap versus younger adults is enormous, and this group is squarely inside every product’s label.
- People with comorbidities — obesity, cardiovascular disease, diabetes, asthma or chronic lung disease, sickle cell disease, cancer, kidney or liver disease, or immunocompromised.
- People with other risk factors — long-term care residents, people with disabilities, and anyone whose living situation, work, or access to care raises their exposure or lowers their margin for error.
Adults 65+ and moderately to severely immunocompromised patients are generally eligible for a second dose about 6 months after the first.
The Final Word on 2026-2027 COVID-19 Vaccines
Get one at least once a year, and more often if you’re over 65 or immune-suppressed. Use Nuvaxovid if you’re “anti-mRNA” for any reason or prefer milder side effects. Otherwise, you can’t go wrong with whatever you’ve had before. Never skip getting vaccinated to wait for one brand or another.
Timing this year: as soon as you can get in.
Learn More: 2026-2027 COVID-19 Vaccine Rundown: Everything You Need to Know
Influenza
What’s new for 2026-2027
All three strains were updated from last season. Flu vaccines remain trivalent — two influenza A strains and one B. (B/Yamagata hasn’t been detected in circulation since 2020, so it’s out.)
The genuinely new thing: mFLUSIVA, the first mRNA flu vaccine, is FDA-approved for adults 50 and older. It’s egg-free, and Moderna’s data showed stronger antibody responses than high-dose flu vaccine in adults 65+.
Two caveats we’d rather you hear from us. Approval for ages 50-64 is standard; approval for 65+ came via the accelerated pathway with a confirmatory study still running. And availability may be limited this season while distribution and coverage get sorted.
The standing recommendations
- Everyone 6 months and older should get a flu shot each year.
- Pregnant patients should get vaccinated — it protects the baby for their first several months of life, before they’re old enough for their own dose.
- Adults 65 and older are eligible for “high-dose” or adjuvanted formulations (Fluzone High-Dose, Flublok, Fluad), which contain substantially more antigen and produce a stronger immune response. More protection, slightly more likelihood of side effects.
- Adults 18-64 who’ve had an organ transplant and are on immunosuppressive medications are also eligible for high-dose.
Dr. Neal’s Flu Vaccine Recommendations
Yes, get one. They’re free with most insurance, and unlike COVID vaccines, side effects are pretty mild.
If you’re 65+, we’ll default to a high-dose or adjuvanted product. If you’re curious about the mRNA option, ask — we’ll tell you honestly whether we have it and whether it makes sense for you.
Timing: October or early November. But watch for early seasons. If it looks like flu is coming early, it probably is.
And the rule that matters more than any brand preference: the best flu vaccine is the one you actually get. If your first choice isn’t available, take an appropriate alternative rather than delaying.
Learn More: 2026-2027 Flu Vaccine Rundown: Everything You Need to Know
RSV
Heads up — the eligibility age has changed since our last version of this post.
If we told you a couple of years ago that you were too young for the RSV vaccine, that may no longer be true.
Current recommendations:
- Everyone 75 and up should get a single dose if they haven’t already.
- Adults 50 to 74 at increased risk should get a single dose. That’s the change — the lower bound moved from 60 to 50 in 2025. “Increased risk” means chronic heart or lung disease, diabetes, chronic kidney disease, severe obesity, weakened immunity, or living in a nursing home or long-term care facility.
- Pregnant patients between 32 and 36 weeks, during September through January, to protect their newborns. (Abrysvo is the product used in pregnancy.)
This one is not annual. A single dose appears to provide protection across at least two seasons. Recent CDC network data found roughly 57% effectiveness against RSV hospitalization over two seasons in adults 60 and older. Protection does wane, and researchers are actively studying whether a repeat dose should eventually be recommended — but revaccination isn’t recommended right now. Most people vaccinated in 2023, 2024, or 2025 don’t need another.
Check your records, or let us check them. We’d rather look it up than guess.
RSV Vaccine Brands
Three options: Arexvy (GSK), Abrysvo (Pfizer), and mRESVIA (Moderna, mRNA). None is preferred over the others — except in pregnancy, where Abrysvo is the one.
Dr. Neal’s RSV Vaccine Recommendations
If you’re eligible under the current criteria, get it. And try to get your RSV shot in August, before the COVID and flu crush starts. The vaccines take longer to prepare, availability gets spotty once everyone shows up at once, and frankly you’ll get more of our attention in a quiet week.
Take whatever brand is available. You don’t need to play favorites — though you can absolutely be selective about where you get it done. Experience makes a real difference in how much the shot stings.
Learn More: 2026-2027 RSV Vaccine Rundown: Everything You Need to Know
Dr. Neal’s Recommendations for Pneumococcal, Shingles, and Tdap
Pneumococcal
The pneumococcal vaccine is recommended for all adults 50 and older. That change came in late 2024, moving down from 65, and it still stands. Adults 19-49 with qualifying conditions or risk factors are also recommended.
Simple on its face, tricky in practice. If you got a “pneumonia shot” between 19 and 64, you might need another if your first one was an older formulation — or you might not. This is why our team keeps a reference chart at the counter.
Dr. Neal’s Pneumococcal Vaccine Recommendations
OMG yes, get this one if you’re eligible. Pneumococcal vaccination protects against roughly 20 different strains of pneumococcal disease.
If you’re getting your first pneumococcal shot, you’ll likely get Capvaxive (PCV21), the newest option — it covers the serotypes responsible for about 84% of invasive pneumococcal disease in adults 50+, compared to roughly 52% for Prevnar 20. Prevnar 20 (PCV20) remains a solid option, and depending on your history, may be the right call.
The Final Word: Get a pneumonia shot if you’re eligible and haven’t had one. If you have had one, check with your doctor or us to figure out which one and when. That information determines whether you’re due for a dose of the newer stuff.
Shingles
Recommendations:
- If you’re 50 or older, get 2 doses of the recombinant zoster vaccine (Shingrix), 2 to 6 months apart.
- If you are or will be immunosuppressed, 2 doses are also recommended — and that applies at 19 and up, not just 50.
Dr. Neal’s Shingles Vaccine Recommendations
“I’ve seen the impact of shingles over my 20 years in practice, so I wholeheartedly recommend people RUSH out to get your shingles vaccine series done on your 50th birthday. Okay, fine, maybe you can wait until the day after so you can party a bit.” — Dr. Neal Smoller
Dr. Neal calls this the vaccine with the most tangible benefit. You will experience the downside of skipping it very clearly.
We’ve seen patients young and old struggle with shingles pain. One older — but quite youthful — patient of ours required two epidurals to manage the pain from his outbreak. That’s a lot for someone in their 80s.
The good news: Shingrix is roughly 90% effective. The original shingles vaccine, Zostavax, was comparatively weak. (Don’t get us wrong — Zostavax was great for its time. We’re grateful for the beacon of hope it provided.)
Scheduling pro tip: don’t rush your second dose if the 2-6 month window lands in September or October. Pharmacies are absolute chaos in those months. Wait for a calmer week in November or December and you’ll have a better experience.
Tetanus, Diphtheria, Pertussis (Tdap)
“Most people don’t really have tetanus shots on their radar until after they’ve stepped on a rusty nail. I can barely spell diphtheria, and ‘What the heck is a pertussis?!’ has been said to me more times than I can count over my career. That’s what makes this vaccine one of the most important. It flies under the radar.” — Dr. Neal Smoller
An honest update on whooping cough. Last year we told you pertussis was surging. Right now it isn’t — cases through late spring 2026 were down roughly 69% from the same point in 2025.
We’re telling you that because we’d rather be accurate than alarming. But here’s the part that matters: pertussis is cyclical. It peaks every few years, and the decline after a peak is expected, not a victory. 2025 still saw nearly 29,000 cases, the most since 2012. Two children have died in 2026. And national vaccination coverage sits below target, which is exactly the condition that sets up the next peak.
Whooping cough kills infants, almost exclusively those too young to have completed their own vaccine series. They are protected by the immunity of the adults around them. That’s you.
Also, it’s miserable even when it isn’t dangerous. Dr. Neal had pertussis in his early 20s and coughed for two months straight. Young, fit, and thoroughly wrecked.
Recommendations:
- Tdap is for individuals 7 and older.
- Most people should get a single Tdap in adolescence, around 11-12.
- Adults who have never received a Tdap should get one. Full stop.
- Adults may receive a booster every 10 years (or sooner in some situations) — talk to us.
- Pregnant patients should receive Tdap during every pregnancy, ideally between 27 and 36 weeks, to pass protection to the newborn.
Dr. Neal’s Take: Great vaccine for any adult 19 or older to add to the fold. The whooping cough protection is invaluable even though most people treat it as a tertiary concern. And the tetanus coverage doesn’t hurt either.
Learn More: Vaccine Ingredients in 2026: Less Scary Than You Might Think
Now You Don’t Have to Wonder
Who would’ve thought hot dogs could be so complicated?
This year they’re a little more complicated than usual — not because the science got murkier, but because the paperwork did. Our job is to keep that on our side of the counter so it doesn’t become your problem.
We hope this helped demystify some of the big words and complex facets of modern vaccination. But just because you’re looped in on Dr. Neal’s recommendations for 2026 doesn’t mean you can’t have more questions.
Our team of experienced, certified, and highly sought-after vaccine experts is available year-round to give you answers. So don’t be shy. Reach out if you need clarification or have concerns. We might end up jabbing you — with your consent, of course — but we surely don’t bite.