COVID-19 vaccines for 2026–27: about 53% protection against hospitalisation in older adults

Design

Systematic review of 155 studies (15 RCTs, 84 comparative observational)

Population

Recipients of US-licensed COVID-19 vaccines, studies published Aug 2025 – Jun 2026

Primary outcome

Vaccine effectiveness against hospitalisation and other outcomes; safety

Effect

VE vs hospitalisation 53% (95% CI 37–65%) in ≥65s; paediatric ED visits 76% (58–87%); no new safety signals

This systematic review, prepared ahead of the 2026–27 respiratory season, identified 155 studies published between August 2025 and June 2026: 15 randomised trials, 84 observational studies with a comparator and the rest safety or burden studies. All concerned US-licensed vaccines.

Updated vaccines were associated with 53% lower risk of hospitalisation in adults 65 and over in the 2025–26 season (95% CI 37–65%) and 54% in adults 18–64 in 2024–25, though that estimate was very imprecise (1–78%). Maternal vaccination was associated with 58% fewer COVID-19 emergency or urgent care visits in the mother and 50–54% fewer hospital contacts in the infant's first two months, whatever the trimester. In children aged 9 months to 4 years, vaccination was associated with 76% fewer emergency visits. In immunocompromised adults, protection against ICU admission or death was 32–53%.

No new safety signals were found, and no study under the extended primary-series dosing interval showed raised myocarditis or pericarditis risk. Most of the effectiveness data are observational, so they are associations — but they are consistent across groups and seasons.

• Recommend the updated COVID-19 vaccine this season to adults 65 and over, immunocompromised patients and pregnant women.
• Vaccination in pregnancy protects the infant in the first two months, whatever the trimester.
• Tell hesitant patients that no new safety signal emerged in a year of monitoring, including for myocarditis.
• Expect partial protection — about half against hospitalisation — so antivirals still matter for high-risk patients who get infected.
• Evidence is US-based; Indian availability of updated formulations may differ.

Why it matters

It gives a current, specific figure to quote when patients ask whether this year's COVID-19 vaccine is still worth having.

Don't overread it

Most effectiveness estimates come from observational studies, and the adult 18–64 figure is too imprecise to rely on.

The statistics, in plain English

Vaccine effectiveness of 53% means vaccinated older adults had about half the risk of COVID-19 hospitalisation of unvaccinated ones. A confidence interval of 1–78% for younger adults means the true effect could be almost nothing or very large — too uncertain to quote as a single figure.

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