Flu and Covid this autumn (2026-2027): should you get vaccinated, and when?

Daniel Platteau

In short: in Belgium, the Superior Health Council recommends the flu vaccine mainly from age 65, for people with a chronic disease, pregnant women and healthcare workers, and the Covid booster mainly from age 65 and for vulnerable people. The right time is now: from mid-October to the end of November, so you are protected before the epidemic, which usually starts in December. Both vaccines can be given on the same day, one in each arm, at the pharmacy or the doctor's. The Covid vaccine is free; the flu vaccine costs about €4 if you belong to a risk group (just under €8 for the enhanced vaccines after 65). Vaccines do not protect 100%, but they reduce the risk of severe illness and hospitalisation in older people.

Updated 14 October 2026.

Does it apply to me this year?

Every year, the Superior Health Council (SHC), the scientific body that advises the Belgian government, publishes its recommendations. For this winter: advisory report No. 9897 for flu (February 2026) and advisory report No. 9934 for Covid (6 October 2026). The target groups have not changed since last year.

The chronic diseases concerned are those of the lungs (severe asthma, COPD), heart, liver or kidneys, diabetes and other metabolic diseases, neurological or neuromuscular diseases, weakened immunity (due to a disease or a treatment), and severe obesity (body mass index of 40 or more) (SHC, 2026a, 2026b).

Why target older people first? Because that is where flu kills: in Belgium, about 97% of flu deaths occur after age 65 (Sciensano, n.d.).

When should you get vaccinated?

• Flu: from mid-October. Flanders advises the period from mid-October to the end of November (Departement Zorg, 2026); other Belgian sources mention mid-October to mid-December (Vaccination-info, n.d.).
• Covid: the campaign started in September, but the SHC prefers October (SHC, 2026b).

Why not earlier? Because the protection from the flu vaccine wanes over the months, and the epidemic arrives late: last season it started at the end of December 2025 and ended on 18 March 2026, according to the press (VRT NWS, 2025, 2026); in 2024-2025 it lasted 13 weeks, from mid-December to early March (Sciensano, 2025). Why not too late? Because the body needs about two weeks to build its protection after the injection. If you missed November, getting vaccinated is still worthwhile as long as flu is circulating.

As of 14 October 2026, flu and RSV are still circulating at low levels in Belgium, while the Covid virus is rising in wastewater (Sciensano, 2026).

Both vaccines on the same day: is that possible?

Yes. The SHC considers co-administration (two vaccines at the same visit) “safe and effective” and also allows it with the RSV, pneumococcal or shingles vaccines (SHC, 2026a, 2026b). In practice, you get one vaccine in each arm.

This is not just an opinion: a British trial gave 679 adults the Covid vaccine together with either the flu vaccine or a placebo. There were no safety concerns, and the immune response to each virus was as good as with a single vaccine (Lazarus et al., 2021). Minor, short-lived effects (sore arm, tiredness) were sometimes slightly more frequent, but not serious.

Where to get vaccinated, and how much does it cost?

At the pharmacy or at the doctor's

You can get vaccinated by your GP, at a community health centre, by a home nurse, in a nursing home and, increasingly, at your pharmacy. Trained pharmacists have been allowed to vaccinate against Covid since 2022 and against flu since 2023, and the law made this permanent at the end of 2025 (Chamber of Representatives, 2026). The pharmacist can even write the flu vaccine prescription: no need to see the doctor first.

At the pharmacy, the injection costs you nothing: the pharmacist is paid directly by health insurance (NIHDI, n.d.-b). At the doctor's, the consultation is billed as usual.

Vaccine prices (2026-2027 season)

Source: NIHDI (n.d.-a) for flu; BCFI (2026b) for Covid. Only one flu vaccine is reimbursed per person per season. Increased reimbursement is a status that entitles you to better reimbursement (depending on income or certain situations); your health insurance fund can tell you whether you qualify.

There is no invitation letter for Covid: it is up to you to make an appointment.

Do these vaccines really protect?

Understanding “vaccine effectiveness”

When you read that a vaccine is “40% effective”, it does not mean that 40% of vaccinated people fall ill. It means that the risk is reduced by 40% in vaccinated people compared with unvaccinated people. If 100 out of 1,000 unvaccinated people are hospitalised, there will be about 60 out of 1,000 among the vaccinated.

The flu vaccine: partial protection that varies from year to year

The flu virus changes every year. Vaccines are updated every year to target the strains expected to circulate the following winter, and the forecast is not always perfect.

• In the United States, effectiveness ranged from 19% to 60% depending on the season between 2009 and 2024 (CDC, 2026).
• In Europe, last season was dominated by a strain that had drifted somewhat from the vaccine strain (“subclade K” of the H3N2 virus). Effectiveness against influenza A remained at 25 to 45%, similar to other years, and 47 to 72% in children (Lucaccioni et al., 2026).
• In people aged 65 and over, the Cochrane review of placebo-controlled trials found 2.4% confirmed flu cases among the vaccinated versus 5.7% among the unvaccinated, with a level of certainty rated as low (Demicheli et al., 2018).

For people aged 65 and over: “enhanced” vaccines

With age, the immune system responds less well. Two vaccines are designed to compensate:

• the high-dose vaccine (Efluelda®), which contains more antigen, the part of the virus the body learns to recognise;
• the adjuvanted vaccine (Fluad®). An adjuvant is a substance added to boost the immune response.

The SHC prefers them to the standard dose after 65, with stronger evidence for the high dose (SHC, 2026a). The benefit is real but modest: in a large analysis of 466,320 older people in Denmark and Spain, 515 people had to receive the high dose rather than the standard dose to prevent one hospitalisation (Johansen et al., 2025). If your pharmacy has run out, the standard dose is still a good choice: a standard vaccine now is better than an enhanced vaccine too late.

The Covid booster: mainly against severe illness, and for a few months

This autumn's Covid vaccine is adapted to the XFG variant, a descendant of the Omicron JN.1 family that dominated worldwide at the end of 2025 (EMA, 2026). Last year's boosters reduced the risk of hospitalisation by about 40 to 50% in older people:

• 52% in people over 65 in Belgium (Sciensano, 2025);
• 42% in people aged 60 and over in European hospitals, within two months of the injection, after which protection declined and was no longer measurable after about six months in that study (Rojas-Castro et al., 2025);
• 45% in people aged 65 and over in the United States (Link-Gelles et al., 2025).

That is why there is a booster every autumn: the aim is to get through the winter protected.

Side effects: what is common, what is rare

• Common and harmless: a sore, red or swollen arm for a day or two; sometimes a slight fever, tiredness or aching muscles.
• Very rare, flu: Guillain-Barré syndrome, a nerve disorder that causes weakness in the legs, usually reversible. If there is a vaccine-related risk, it is in the order of 1 to 2 additional cases per million doses. Flu itself can also cause this syndrome (CDC, 2024b).
• Very rare, mRNA Covid vaccines: myocarditis (inflammation of the heart muscle), mainly in young men and mainly after the second dose of the primary vaccination in 2021, usually with a favourable outcome (EMA, 2021). These figures relate to the 2021 vaccination; today's boosters are mainly given to older people, in whom this risk is much lower.
• Severe egg allergy: there is an egg-free flu vaccine (Flucelvax®); tell the person vaccinating you.

Common myths

“The vaccine gives you flu.” False. Injectable vaccines contain an inactivated virus, that is, a killed one, or just a protein from the virus. It cannot multiply, so it cannot give you flu (CDC, 2024a). The tiredness for a day or two after the injection is the immune system reacting, not the disease.

“I still got flu.” That can happen: protection takes two weeks to build up, it is only partial, the strain may have changed, and many “flus” are actually other viruses (colds, RSV) that the vaccine does not protect against. Studies do, however, show that illness is on average less severe in vaccinated people.

“I’m healthy, I don’t need it.” At 30, that is true according to the SHC. At 70, even in great shape, it is not: age alone increases the risk of complications.

“Two vaccines on the same day is too much for the body.” False. The immune system responds to thousands of microbes every day; the British trial mentioned above showed no safety problems and no loss of effectiveness.

Flu shot myths: can the vaccine give you the flu? Sutter Health (US hospital network).

And RSV, the third winter virus?

Respiratory syncytial virus (RSV) causes bronchiolitis in babies, but also severe pneumonia in older people. Protection exists against it too:

• Adults: the SHC recommends one dose for everyone aged 75 and over, and from 60 in case of chronic disease, weakened immunity or living in a nursing home (SHC, 2024; BCFI, 2026b). A single dose protects for at least two seasons, with no booster for now. Since 1 August 2026, one of the two vaccines (Arexvy®) has been reimbursed for people aged 65 and over living in a nursing home or with a risk factor. Note: this vaccine is given at the doctor's; the pharmacist can neither prescribe nor administer it (BCFI, 2026b). Talk to your GP.
• Babies: either the mother is vaccinated between 28 and 36 weeks of pregnancy, or the baby receives a monoclonal antibody (nirsevimab, Beyfortus®), that is, “ready-made” antibodies that protect immediately for about six months (Vaccination-info, 2026). This protection reduced RSV hospitalisations in young children in Belgium by 86% in 2024-2025 (Sciensano, 2025).

Further reading

How does an mRNA vaccine work?

The most widely used Covid vaccines (Comirnaty®, Spikevax®) contain messenger RNA (mRNA): a kind of temporary “instruction manual” that makes our cells produce a protein from the virus, the “spike” protein. The immune system learns to recognise this protein, and the mRNA is then quickly broken down by the body. It does not enter the cell nucleus and does not alter DNA. A protein-based vaccine, of more conventional design, will also be offered in a few university hospitals (BCFI, 2026b).

A bit of history: the first flu vaccine

The first flu vaccine was developed in the United States during the Second World War by Thomas Francis Jr. and his young colleague Jonas Salk at the University of Michigan. It was already a killed-virus vaccine. Tested on 12,500 recruits in 1943-1944, it was given to the entire US Army in the autumn of 1945 (University of Michigan, n.d.). Ten years later, Salk developed the polio vaccine.

Why a new vaccine every year?

Flu and Covid viruses mutate: small changes in their proteins allow them to partly escape our defences. Every year, the World Health Organization (for flu) and the European Medicines Agency (for Covid, in May this year) choose the strains to target for the following winter. When the circulating strain drifts away from the vaccine strain, as with subclade K last winter, effectiveness drops, without disappearing.

Test yourself

Sources

Belgian Centre for Pharmacotherapeutic Information (BCFI). (2026a, March 19). Vaccination antigrippale : un nouvel avis du CSS pour la saison 2026-2027. CBIP. https://www.cbip.be/fr/vaccination-antigrippale-un-nouvel-avis-du-css-pour-la-saison-2026-2027/

Belgian Centre for Pharmacotherapeutic Information (BCFI). (2026b, September 10). Prévention des infections virales des voies respiratoires chez les adultes : hiver 2026-2027. CBIP. https://www.cbip.be/fr/prevention-des-infections-virales-des-voies-respiratoires-chez-les-adultes-hiver-2026-2027/

Centers for Disease Control and Prevention. (2024a, September 6). Misconceptions about seasonal flu and flu vaccines. https://www.cdc.gov/flu/prevention/misconceptions.html

Centers for Disease Control and Prevention. (2024b, September 17). Guillain-Barré syndrome and flu vaccine. https://www.cdc.gov/flu/vaccine-safety/guillainbarre.html

Centers for Disease Control and Prevention. (2026, March 16). CDC seasonal flu vaccine effectiveness studies. https://www.cdc.gov/flu-vaccines-work/php/effectiveness-studies/index.html

Chamber of Representatives of Belgium. (2026, February 18). Proposition de résolution visant à renforcer le rôle des pharmaciens d'officine dans les politiques de vaccination (DOC 56 1381/001). https://www.dekamer.be/FLWB/Pdf/56/1381/56K1381001.pdf

Demicheli, V., Jefferson, T., Di Pietrantonj, C., Ferroni, E., Thorning, S., Thomas, R. E., & Rivetti, A. (2018). Vaccines for preventing influenza in the elderly. Cochrane Database of Systematic Reviews, (2), CD004876. https://doi.org/10.1002/14651858.CD004876.pub4

Departement Zorg. (2026, October 12). Herfstcampagne 2026-2027. Vlaamse overheid. https://www.departementzorg.be/nl/alles-over-vaccineren/herfstcampagne-2026-2027

European Medicines Agency. (2021, July 9). Comirnaty and Spikevax: Possible link to very rare cases of myocarditis and pericarditis. https://www.ema.europa.eu/en/news/comirnaty-spikevax-possible-link-very-rare-cases-myocarditis-pericarditis

European Medicines Agency. (2026, May 29). ETF recommends updating COVID-19 vaccines to target XFG variant. https://www.ema.europa.eu/en/news/etf-recommends-updating-covid-19-vaccines-target-xfg-variant

Johansen, N. D., Modin, D., Pardo-Seco, J., et al. (2025). Effectiveness of high-dose influenza vaccine against hospitalisations in older adults (FLUNITY-HD): An individual-level pooled analysis. The Lancet. https://doi.org/10.1016/S0140-6736(25)01742-8

Lazarus, R., Baos, S., et al. (2021). Safety and immunogenicity of concomitant administration of COVID-19 vaccines (ChAdOx1 or BNT162b2) with seasonal influenza vaccines in adults in the UK (ComFluCOV): A multicentre, randomised, controlled, phase 4 trial. The Lancet, 398(10318), 2277–2287. https://doi.org/10.1016/S0140-6736(21)02329-1

Link-Gelles, R., et al. (2025). Interim estimates of 2024–2025 COVID-19 vaccine effectiveness among adults aged ≥18 years — VISION and IVY Networks, September 2024–January 2025. MMWR, 74(6), 73–82. https://doi.org/10.15585/mmwr.mm7406a1

Lucaccioni, H., et al. (2026). Influenza vaccine effectiveness from nine studies during drifted A(H3N2) subclade K predominance, Europe, September 2025 to January 2026. Eurosurveillance, 31(7), 2600109. https://doi.org/10.2807/1560-7917.ES.2026.31.7.2600109

National Institute for Health and Disability Insurance (NIHDI). (n.d.-a). Remboursement du vaccin contre la grippe saisonnière. INAMI. Retrieved October 14, 2026. https://www.inami.fgov.be/fr/themes/soins-de-sante-cout-et-remboursement/les-prestations-de-sante-que-vous-rembourse-votre-mutualite/medicaments/remboursement-d-un-medicament/remboursement-du-vaccin-contre-la-grippe-saisonniere

National Institute for Health and Disability Insurance (NIHDI). (n.d.-b). Quels honoraires pour la vaccination contre la grippe ou la COVID-19 ? INAMI. Retrieved October 14, 2026. https://www.inami.fgov.be/fr/themes/covid-19/quels-honoraires-pour-la-vaccination-contre-la-grippe-ou-la-covid-19

Nobel Prize Outreach. (2023). Press release: The Nobel Prize in Physiology or Medicine 2023. NobelPrize.org. https://www.nobelprize.org/prizes/medicine/2023/press-release/

Rojas-Castro, M., et al. (2025). COVID-19 vaccine effectiveness against hospitalization in older adults, VEBIS Hospital Network, Europe, September 2024–May 2025. Influenza and Other Respiratory Viruses, 19(11), e70191. https://doi.org/10.1111/irv.70191

Sciensano. (2025, December 1). Surveillance des infections respiratoires aiguës : rapport épidémiologique saison 2024-2025. https://hdl.handle.net/20.500.14493/4184

Sciensano. (2026, October 14). Bulletin infections respiratoires aiguës, semaine 41-2026. https://hdl.handle.net/20.500.14493/13151

Sciensano. (n.d.). Influenza. Retrieved October 14, 2026. https://www.sciensano.be/en/topics/flu-and-other-acute-respiratory-tract-infections/influenza

Superior Health Council. (2024, December 19). Vaccination against RSV (adults) – revision 2024 (Advisory report No. 9837). https://www.hgr-css.be/en/report/9837/vaccination-against-rsv-adults-revision-2024

Superior Health Council. (2026a, February 26). Vaccination against seasonal influenza (season 2026–2027) (Advisory report No. 9897). https://www.hgr-css.be/en/report/9897/vaccination-against-seasonal-influenza-season-2026-2027

Superior Health Council. (2026b, October 6). Vaccination against COVID-19 (2026-2027 season) (Advisory report No. 9934). https://www.hgr-css.be/en/report/9934/vaccination-against-covid-19-2026-2027-season

University of Michigan. (n.d.). The first flu shot. Heritage Project. Retrieved October 14, 2026. https://heritage.umich.edu/stories/the-first-flu-shot

Vaccination-info. (2026, September 18). Bronchiolites et pneumonies 2026-2027 : vacciner contre le VRS peut faire baisser les hospitalisations ! https://www.vaccination-info.be/bronchiolites-et-pneumonies-2026-2027-vacciner-contre-le-vrs-peut-faire-baisser-les-hospitalisations/

Vaccination-info. (n.d.). Grippe saisonnière : vaccinez-vous entre la mi-octobre et la mi-décembre. Retrieved October 14, 2026. https://www.vaccination-info.be/grippe-saisonniere-vaccinez-vous-entre-la-mi-octobre-et-la-mi-decembre/

VRT NWS. (2025, December 23). Griepepidemie is officieel in het land, slechts helft van risicopatiënten laat zich vaccineren. https://www.vrt.be/vrtnws/nl/2025/12/23/griep-epidemie-belgie/

VRT NWS. (2026, March 18). Gevreesde "supergriep" bleef uit, epidemie officieel voorbij. https://www.vrt.be/vrtnws/nl/2026/03/18/griepepidemie-officieel-voorbij/