The World Health Organization (WHO) published a new position paper on COVID-19 vaccines on July 31, 2026. The paper replaces earlier interim guidance and directs routine vaccination toward people at the highest risk of severe disease.

The guidance does not produce one answer for every adult. A current decision depends on the national program, time since the last dose or infection, age, health conditions, pregnancy, medicines and the products authorized where vaccination takes place.

Breathing difficulty or chest pressure needs immediate care

WHO lists difficulty breathing at rest, an inability to speak in sentences, persistent chest pain or pressure, confusion, unusual drowsiness, loss of consciousness, cold or clammy skin that turns pale or blue, and loss of speech or movement as severe COVID-19 warning signs. Anyone with these signs needs immediate medical attention through the emergency service or urgent-care facility where they are located.

The US Centers for Disease Control and Prevention says an acute allergic reaction after vaccination can involve widespread hives, throat swelling, wheezing, low blood pressure or shock. Such reactions can begin within minutes, and breathing difficulty, shock or collapse requires immediate emergency help.

An older adult receives a vaccine in the upper arm at a clinic (illustrative image)

WHO separates the highest-risk groups from everyone else

WHO asks countries to consider routine vaccination first for the oldest adults, older adults with major health conditions or severe obesity, residents of care homes and long-term care facilities, and moderately or severely immunocompromised people from six months of age. The agency says countries should set the age thresholds; it suggests 75 or 80 years for the oldest group and 60 years for older adults with major risk conditions.

For these highest-risk groups, WHO recommends at least one dose a year and preferably two about six months apart when the previous dose was more than six months ago. Each country still decides whether to offer one or two doses after considering local epidemiology, cost-effectiveness and delivery capacity.

Countries may also consider routine vaccination for older adults without major risk conditions, younger people with major health conditions or severe obesity, and health or care workers who have direct contact with people at high risk. Healthy adults aged 18 to 59 without those risk factors are not among the routine target groups listed in WHO's 2026 table, although a national program may use broader eligibility.

WHO found only five recent vaccine-effectiveness studies in healthy adults aged 18 to 64, four from the United States and one spanning four Western European countries. The limited and geographically concentrated evidence does not support one worldwide estimate of benefit for a healthy younger adult.

Earlier doses still count, but protection changes

Earlier vaccination remains part of a person's immune history, but it does not create a permanent exemption from later doses. WHO says protection against severe disease and death is highest in the first months after vaccination and then decreases, with immunity declining relatively quickly within six months after vaccination or infection.

WHO's vaccine composition advisers recommended a monovalent LP.8.1 antigen in May 2026 to improve immune responses to circulating variants, while accepting other antigens or approaches that show broad responses or efficacy. The same statement says people at high risk should not delay vaccination while waiting for a newer formulation; a composition recommendation does not establish that a product is authorized or stocked in a particular country.

WHO also says gaps and delays in countries' reporting of cases, hospitalizations and deaths limit comparisons of COVID-19 trends. A rise reported in one country therefore cannot establish that infections are increasing worldwide.

Pregnancy has its own recommendation

WHO recommends one COVID-19 vaccine dose during each pregnancy, at any stage and ideally during the second trimester. The aim is to protect the pregnant person from severe disease, reduce adverse pregnancy outcomes and transfer maternal antibodies to the infant.

WHO's evidence review found no safety concern from COVID-19 vaccination during pregnancy across observational studies, pregnancy registries and vaccine surveillance systems in multiple countries. It also reported no safety concern for breastfeeding people or their infants. Breastfeeding people at higher risk follow the recommendation for their risk group, while the locally authorized product and national schedule still apply.

Immune suppression, chronic illness and medicines change the plan

WHO includes older adults with major cardiovascular, respiratory, kidney, liver or neurological conditions, diabetes or severe obesity among the highest-risk groups. Younger adults with these conditions are an additional group that countries may include, so the same age does not produce the same recommendation for every person.

WHO includes people receiving immune-suppressing treatment in a higher-risk group, so the condition, treatment plan and vaccine record belong in the assessment. WHO says anaphylaxis after a previous dose or to a vaccine component rules out further doses of the same vaccine type, while a history of vaccine-associated myocarditis or pericarditis requires an individual risk-benefit assessment.

Healthy children do not use the adult schedule

WHO does not routinely recommend repeat COVID-19 vaccination for healthy children or adolescents. Countries may consider primary vaccination for previously unvaccinated healthy children aged six to 23 months only when they document a substantial disease burden in that age group.

Moderately or severely immunocompromised children from six months of age fall into a higher-risk group for which WHO asks countries to consider routine vaccination. Pediatric product authorization and schedules vary by country, so an adult interval cannot be applied to a child.

COVID-19 vaccine vials beside a printed vaccination record (illustrative image)

Other vaccines can be given at the same visit

WHO says a COVID-19 vaccine may be given with, before or after other vaccines, including vaccines recommended during pregnancy. Vaccines given during the same visit should use separate injection sites, preferably on different limbs.

Randomized trials, systematic reviews and post-authorization monitoring found no clinically meaningful reduction in immune responses or vaccine effectiveness when COVID-19 and other routine vaccines were given together. Some studies found small, temporary increases in injection-site pain, fatigue or muscle aches, while national product instructions still govern each combination.

Common reactions usually settle within days

WHO lists fever, tiredness, headache, muscle aches, chills, diarrhea, and pain or redness at the injection site among expected reactions. Most resolve within a few days, while serious or long-lasting reactions are possible but extremely rare.

A vaccination check should record the date and product used for previous doses, the date of a confirmed infection, current health conditions and medicines, pregnancy, and any severe reaction after a previous dose. The vaccinating service can then apply the current national schedule and the instructions for products authorized in that country.

APPI News did not verify authorization, supply, price or public coverage market by market at the time of writing. It also could not verify a comparable worldwide percentage for the source article's Taiwan-specific "more than 90 percent" figure, so that number is omitted. A public campaign deadline in one country cannot be used as an eligibility date elsewhere, so those details must come from the applicable national immunization program or an authorized vaccination provider.

Frequently asked questions

Does someone who received several earlier doses still need another?
Possibly. WHO's 2026 schedule focuses on current risk group and time since the last dose, while each country sets eligibility and timing.

Is a six-month interval a universal rule?
No. WHO prefers an interval of about six months for routine vaccination and recommends at least one dose a year, preferably two, for the highest-risk groups, but countries decide the number and timing.

Can COVID-19 and influenza vaccines be given together?
WHO accepts vaccination during the same visit with separate injection sites. The products must still be authorized for the person and used according to the schedule in that country.

Does WHO routinely target a healthy adult under 60?
Not in its July 2026 table if the adult has no major risk condition. A country's program may set broader eligibility based on local epidemiology and delivery priorities.

Should a high-risk person wait for a newer formulation?
WHO says no. Its May 2026 composition statement says vaccination should not be delayed while waiting for an updated antigen, although product authorization and availability vary by country.