Vaccines are an important and effective way to protect against severe illness and keep communities safe. This respiratory virus season, Maryland is protecting vaccine access for Marylanders of all ages. As federal government actions around vaccine policy have raised questions for many, Maryland's public health officials will continue to use science-based guidance to be a trusted resource for people to keep themselves and their families safe and healthy. Information below relates to vaccines for the most common seasonal respiratory virus:
COVID-19, influenza (flu) and
Respiratory Syncytial Virus Infection (RSV).
Updated September 19, 2025
How can I best prevent respiratory illness including COVID-19, flu or RSV?
These strategies can help prevent common respiratory viral illnesses:
- Stay up to date with all recommended immunizations.
- Practice good hygiene, including washing your hands frequently with soap and water, and covering coughs and sneezes.
- Take steps for cleaner air, such as gathering outdoors, opening a window, wearing a mask, or improving indoor air quality through HVAC or a portable air filter.
If you have a respiratory virus:
- Stay home and away from others (including people you live with who are not sick). Children should follow guidance from schools.
- You can go back to your normal activities when both are true:
- Your symptoms are getting better overall, and
- You have not had a fever (and are not using fever-reducing medication) for at least 24 hours.
- When you return to normal activities, take added precaution over the next 5 days, such as practicing good hygiene described above to prevent spread, wearing a well-fitted mask, physical distancing, and/or testing when you will be around others. This is especially important to protect people with higher risk of severe illness from respiratory viruses.
Why is it important to get vaccinated this respiratory season?
Vaccines are one of the best tools we have to help protect against three respiratory viruses that circulate each year: COVID-19, influenza and RSV. These viruses continue to cause significant illness and death in the community. During the 2024-2025 respiratory virus season, there were nearly 5,000 Maryland residents hospitalized with COVID-19, over 8,000 hospitalized with influenza, and more than 2,600 hospitalized with RSV. More than 1,200 of those hospitalized patients died. The Maryland Department of Health encourages all Marylanders to stay up to date on all vaccines recommended for them.
What vaccines are recommended for me this respiratory virus season?
COVID-19 VACCINE
Are COVID-19 vaccines safe and effective? Do they have any side effects?
COVID-19 vaccines continue to be a safe and effective way to prevent serious illness due to COVID-19. The vaccines teach our immune systems how to recognize and fight the virus that causes COVID-19. The safety of these vaccines have been well-studied in clinical trials and continue to be monitored through post-marketing surveillance systems. After the COVID-19 vaccination, you may have some side effects. The most common reported side effects include soreness at the injection site, fatigue, headache, muscle aches, joint aches, fever and nausea. If you do have any of these, they should go away in a few days. Talk with your doctor or healthcare provider for more information.
What are the current recommendations for who should get the COVID-19 vaccine?
Maryland's clinical vaccine guidance for the 2025-26 respiratory virus season is based on an assessment of population risks, a review of scientific literature and consultation with medical associations. The guidance aligns with updated guidance released by the
American Academy of Pediatrics (AAP),
American Academy of Family Physicians (AAFP), and the
American College of Obstetricians and Gynecologists (ACOG).
Can any Marylander who wants a COVID-19 vaccine get one?
Maryland residents have a wide variety of ways to obtain vaccines for themselves and their children, and should speak to their health care provider about what is best. Right now, Marylanders should have access to a COVID-19 vaccine if they want one - and we are taking additional actions to help ensure that doesn't change. Please note that recent actions at the federal level have increased the complexity of the vaccination process, and could create access and supply issues for Marylanders looking for a COVID-19 vaccine. The Maryland Department of Health is working closely with our partners to ensure the vaccine is widely accessible across Maryland.
Do you need a prescription to get a COVID-19 vaccine?
Marylanders do not need a prescription for a COVID-19 vaccine. Immunizations are available from many providers statewide, including pharmacists who are authorized under Maryland law to give vaccines without a prescription to individuals 3 years and older. As a further step,
the Maryland Department of Health has issued a statewide COVID-19 vaccination standing order that authorizes qualified health care professionals to 1) follow the most current evidence-based guidelines developed by the
AAP,
AAFP, and
ACOG as standards, and 2) exercise reasonable medical judgement in vaccinating their patients. (Note: authorization does not require providers to offer vaccines and does not mandate individuals to receive vaccines.)
The specific processes to determine vaccine eligibility may still vary by provider. For instance, some pharmacies or health care practices may ask people to attest to having a
high-risk condition (such as diabetes, obesity, cancer, disabilities, physical inactivity, current or former smokers, pregnancy, or mental health conditions). Additionally, some pharmacies or health care practices may not have the vaccine in stock. Contact your pharmacy or health care provider prior to making an appointment to ask about vaccine availability and requirements.
What should I do if I want a COVID-19 vaccine but am turned away from a provider or pharmacist's office?
Right now, Marylanders 6 months and older should have access to a COVID vaccine if they want one. A
2024 Maryland law allows pharmacists to administer flu and COVID vaccines without a prescription to anyone 3 years and older. Additionally,
the Maryland Department of Health has issued a statewide COVID-19 vaccination standing order to help ensure access. Pharmacies or health care providers may ask people to confirm that they have a high-risk condition, or ask other questions to understand if the vaccine is right for you. Contact your pharmacy or healthcare provider prior to making an appointment to ask about vaccine availability and eligibility. The Maryland Department of Health will work closely with our partners to ensure the vaccine is widely accessible across Maryland.
Will the Maryland Department of Health be communicating with pharmacies about the law?
Yes. The Maryland Department of Health is consulting closely with all of our partners, including the Board of Pharmacy and pharmacy associations, about current legal authority. On September 19,
the Maryland Department of Health issued a statewide COVID-19 vaccination standing order that authorizes qualified health care professionals, including pharmacists, to 1) administer vaccinations using the most current evidence-based guidelines developed by the
AAP,
AAFP, and
ACOG as standards, and 2) exercise reasonable medical judgement in vaccinating their patient. (Note: authorization does not require providers to offer vaccines and does not mandate individuals to receive vaccines.)
Does private insurance cover the COVID-19 vaccine?
Yes, in most cases. The Maryland Department of Health is working closely with partners, including the Maryland Insurance Administration. Maryland law requires regulated insurers to cover the COVID-19 vaccine. Maryland is unable to regulate self-funded health insurance plans, Medicare, Medicare Advantage, Tricare, or Veterans Administration benefits under federal law. However,
America's Health Insurance Plans recently announced a commitment by health plans to continue coverage of COVID vaccines at zero cost-share through 2026.
Does Medicaid cover the COVID-19 vaccine?
Yes. Maryland Medicaid, both the HealthChoice Maryland managed care and fee-for-service programs, covers the COVID-19 vaccine for its participants. As federal vaccine policy evolves, Maryland Department of Health will provide updates about any changes to the way Maryland Medicaid customers access vaccines.
Parents and guardians of children enrolled in Medicaid should discuss vaccines with their health care provider.
Can non-Maryland residents get the COVID-19 vaccine in Maryland?
Residents from outside of Maryland can get vaccinated in Maryland, but the vaccine location may have its own residency requirements or may not be taking new clients. Contact the provider's office, pharmacy, local health department, or clinic location to ask if you're eligible based on your residency.
How can parents get their children vaccinated against COVID-19 right now?
Immunizations are available from a variety of providers statewide. Pharmacists are authorized to vaccinate children over 3 years old. Based on recent actions at the federal level, access to vaccines may vary by location. Parents and guardians should speak to their pediatrician or health care provider about options for their children. Maryland will continue to work with partners to address the availability of COVID-19 vaccine for children.
How can kids under age 3 get a COVID-19 vaccine?
Parents and guardians should speak to their pediatrician or health care provider about COVID-19 vaccine recommendations for their child.
INFLUENZA (FLU) VACCINE
What is the current influenza (flu) vaccine guidance?
Everyone aged 6 months and older should receive the 2025-26 seasonal influenza vaccine to protect against severe flu infection.
Should kids get the flu vaccine? Should older adults?
Yes, children and older adults are at especially high risk for severe flu illness. These individuals, and those who live and work with them, should be vaccinated. The flu is highly contagious, especially in group settings like schools, and potentially fatal. The 2024-25 flu season was particularly severe, leading to at least 47 million illnesses, 610,000 hospitalizations, and 26,000 deaths. At least 216 of those deaths were children, marking the deadliest non-pandemic flu season on record for children in the United States.
Should I get the flu vaccine every year?
Yes, individuals should get a flu vaccine every year. New variants of the flu emerge every year; Scientists are continuously updating the flu vaccine to ensure it offers the best protection from new strains of the virus. Studies on effectiveness show that flu vaccination, on average, reduces the risk of serious illness by 40- 60%.
Does private insurance cover the flu vaccine?
Yes, in most cases. Maryland state law requires that most private health plans cover preventive services, including vaccinations recommended by the CDC's Advisory Committee on Immunization Practices (ACIP) as of December 31, 2024. This includes the flu shot. In addition,
America's Health Insurance Plans recently announced a commitment by health plans to continue coverage of flu vaccines at zero cost share through 2026.
Does Medicaid cover the flu vaccine?
Medicaid covers all recommended vaccines, including flu vaccines. Parents and guardians of children enrolled in Medicaid should talk with their health care providers about appropriate vaccinations. Adults with Medicaid coverage can receive the flu vaccine through pharmacies or their primary care providers.
RSV VACCINE
What is the current RSV vaccine guidance?
RSV vaccines are recommended for several populations.
There are two immunizations recommended to protect infants from severe RSV: a maternal RSV vaccine (Pfizer's Abrysvo) given during pregnancy or an infant RSV antibody (Nirsevimab or Clesrovimab given to infants after birth). Nirsevimab is also recommended to some young children 8-19 months of age who are at increased risk for severe RSV, including children who have chronic lung disease of prematurity who required medical support any time during the 6-month period before the start of the second RSV season, children with severe immunocompromise, children with cystic fibrosis who have severe disease, and American Indian and Alaska Native children .
RSV vaccines are recommended for all previously unvaccinated adults ages 75 and older and adults ages 50–74 who are at increased risk for severe RSV (those with certain chronic medical conditions, such as chronic lung or heart disease, those with weakened immune systems, and those living in long-term care facilities like nursing homes).
Does private insurance cover the RSV vaccine?
Yes, in most cases. Maryland state law requires that most private health plans cover preventive services, including vaccinations recommended by the CDC's Advisory Committee on Immunization Practices (ACIP) as of December 31, 2024. This includes RSV vaccines. In addition, America's Health Insurance Plans recently announced a commitment by health plans to continue coverage of vaccines recommended by ACIP as of September 1, 2025 at zero cost share through 2026.
Does Medicaid cover the RSV vaccine?
Yes, Medicaid covers all recommended vaccines, including the RSV vaccine. Parents and guardians of children enrolled in Medicaid should discuss vaccines with their health care provider. Adults with Medicaid coverage can access the RSV vaccine at pharmacies or from their primary care providers.
OTHER
What are the current vaccine requirements for school-aged children? Have these changed?
Students in public preschool and K-12 schools remain subject to Vaccine Requirements For Children, by Maryland law, available on the
Maryland Department of Health Vaccine Requirements webpage. COVID-19, flu and RSV vaccines are not required for students to attend school, but MDH continues to encourage that children stay up to date on all vaccines recommended for them.
Is vaccination against respiratory viruses (i.e., COVID-19, flu, RSV) recommended during pregnancy?
Yes, all three vaccines are recommended. ACOG
recommends an updated COVID-19 vaccine at any point during pregnancy, when planning to become pregnant, in the postpartum period, or when lactating. ACOG
recommends an inactivated or recombinant influenza vaccine for all individuals who are or will be pregnant during influenza season,as soon as it is available, during any trimester of pregnancy. FluMist (a nasal spray) is NOT recommended during pregnancy.
ACOG recommends the bivalent RSV PreF (Abrysvo) vaccine for pregnant patients during RSV season in order to protect their infants after birth.
How is Maryland working with other states/partners to improve vaccine access?
Collaboration with regional and nationwide partners is an important aspect of public health. As part of this effort, Maryland will participate in the Northeast Public Health Collaborative with several other states and jurisdictions to help protect the public's health, safety and well-being, using information based on science, data, and evidence, and to ensure equitable access to vaccines, medications and services.
