Vaccine season 2026–27 is here: California says three shots for anyone 65 and up, Orange County starts free flu shots Sept. 21 — and Medicare pays $0

What's happening

Every fall, health agencies publish their vaccine recommendations for the winter. This year California did not wait for the federal government. On September 4, 2026, the California Department of Public Health (CDPH) released its guidance jointly with Oregon, Washington and Hawaii — a four-state group called the West Coast Health Alliance.

CDPH says the recommendations follow three major medical societies: the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Family Physicians (AAFP). Dr. Erica Pan, the State Public Health Officer, said the goal is to make sure communities are "well prepared and protected" for the 2026–27 season.

For older adults in Bolsa, it comes down to this: three shots, two of them yearly, and close to nothing out of pocket if you have Medicare or Medi-Cal.

Three shots for adults 65 and older

From the West Coast Health Alliance table dated September 4, 2026, "Adults" row — which shot, who should get it, how often:

Flu. Who: all adults. How often: every year.

COVID-19. Who: everyone 65 and older; adults 19–64 with risk factors, those in close contact with people at risk, and anyone who wants to lower their risk of severe illness. How often: every season.

RSV. Who: everyone 75 and older; adults 50–74 with risk factors. How often: once, not yearly.

RSV, short for respiratory syncytial virus, is a common cause of pneumonia in older adults. If you got the RSV vaccine in 2024 or 2025, you do not need it again — the WCHA table says it is "currently recommended once rather than annually."

What counts as a "risk factor," and do you have one? The WCHA table does not list them. Medicare.gov says the same thing: talk to your doctor or other health care provider to find out whether you are at increased risk. That question belongs to your family doctor or your pharmacist.

What's new with this year's flu shot

Two things.

First, the stronger shot for 65+ is still the standard. On September 1, 2026, the Centers for Disease Control and Prevention (CDC) posted its flu guidance for 2026–27 and said the recommendations from its July 2025 schedule remain in effect. For adults 65 and older, CDC says to preferentially get one of three vaccines: high-dose (Fluzone High-Dose), recombinant (Flublok) or adjuvanted (Fluad). All three produce a stronger response than the standard shot. At the pharmacy counter, you can simply ask: "Do you have the 65-plus flu shot?" CDC also says September or October is the ideal time. And according to CDC, all three virus components in this year's vaccine were updated from last year's.

Second, the first mRNA flu vaccine now exists. On August 5, 2026, the FDA approved Moderna's mFLUSIVA for people 50 and older. For the 65-and-older group, the FDA approval letter calls it an accelerated approval — granted on immune-response data, with a confirmatory study still to come. Moderna says it will have doses this season. But CDC's 2026–27 flu guidance does not mention it, and Pharmacy Times reported on August 6 that without a CDC recommendation, insurance coverage remains uncertain. If you want the new shot, ask the pharmacist two questions: is it in stock, and does my plan pay for it?

Where to get vaccinated

If you have insurance: major pharmacies (CVS, Walgreens, supermarket pharmacies), your family doctor's office, or your plan's clinic. According to CDPH, California pharmacists can give any CDPH-recommended vaccine to anyone 3 and older without a prescription. For RSV, the money flows through Part D — your drug plan — so before you go, ask your drug plan which pharmacies are in its network. You can search for a clinic on the state's My Turn site (myturn.ca.gov) or on a pharmacy's website.

If you have no insurance and no doctor: the Orange County Health Care Agency gives free flu shots starting Monday, September 21, 2026, for everyone 6 months and older. Hours: Monday through Friday, 8 to 11:30 a.m. and 1 to 4 p.m.
Clinic: Family Health Clinic, 1725 W. 17th Street, Santa Ana
Appointments: 1-800-914-⁠4887
The county's page has a Vietnamese version. The FluMist nasal spray is not offered here. The county lists only this one site — nothing yet in Westminster or Garden Grove.

If you have Medi-Cal / CalOptima Health: according to the state Department of Health Care Services (DHCS), state law AB 144 requires Medi-Cal to cover every vaccine CDPH recommends. Shots given at a pharmacy are billed to Medi-Cal Rx, Medi-Cal's drug program. CalOptima Health members with questions can call the member line, which has Vietnamese-speaking staff:
1-888-587-⁠8088 (TTY 711)

What it costs

According to medicare.gov:

- Flu: Medicare Part B covers it. "You pay nothing" if the provider accepts assignment — that is, takes Medicare's payment as payment in full. Usually one shot per flu season.
- COVID-19: Part B covers FDA-approved and FDA-authorized vaccines. Also $0 if the provider accepts assignment.
- RSV: Medicare Part D covers it. "You pay nothing for the RSV vaccine if you have Part D." Medicare Advantage plans that include drug coverage also cover it.

If you have private insurance or a Covered California plan: CDPH says every vaccine it recommends will "continue to be covered by health insurance regulated in California." CDPH's page on AB 144 specifies plans overseen by the Department of Managed Health Care (DMHC). There is one exception. Plans that large employers fund themselves — "self-funded" plans — fall under federal law, and according to KFF, the health-policy research group, they are exempt from state insurance rules. If you get a bill, call the number on your insurance card, ask what kind of plan you have, and cite CDPH's statement.

The bigger picture

This year California issued its own guidance with three other states instead of waiting for the federal government. For people in Bolsa, what stayed the same matters more than what changed. Flu is still yearly. CDC still prefers the stronger shot for 65+. Medicare still pays. What's new is a vaccine nobody on the block has tried yet — and a county clinic opening its doors for free on September 21.

Translation assisted by AI and reviewed by an editor.