COVID-19 Vaccine Information for Health Care Providers

Statewide Vaccine Standing Order

The Washington State Department of Health (DOH) has issued a statewide standing order, under the direction of the State Health Officer, authorizing qualified health care personnel to vaccinate individuals aged 6 months and older, including pregnant people, who do not have contraindications to the vaccine.

The standing order follows the:

The standing order does not follow the CDC Immunization Schedule published 8/7/25.

Our priority remains ensuring equitable access to COVID-19 vaccines. The COVID-19 virus continues to pose serious health risks in Washington state, including hospitalizations, long COVID, and preventable deaths. These risks are most prominent in pregnant people, young children, older adults, people with chronic conditions, and those who remain unvaccinated.

COVID-19 vaccines remain one of our most effective tools for preventing severe illness. We encourage all eligible Washingtonians to stay up to date on their vaccinations to protect themselves, their loved ones, and the broader community.

 

COVID-19 Vaccine Insurance Coverage:
A guide for health care providers and health system partners (PDF)

  • People who are up to date have lower risk of severe illness, hospitalization, and death from COVID-19 than people who are unvaccinated or who have not completed the doses recommended for them by CDC.
  • Everyone 6 months and older needs one updated COVID-19 vaccine dose to be up to date.
  • People 65 years old and older should receive 2 doses of any updated COVID-19 vaccine 6 months apart. If needed, the second dose can be given as soon as 2 months after the first dose.
  • Children 6 to 23 months may need more than one dose of an updated mRNA COVID-19 vaccine if they didn’t complete the initial series.  
  • People 6 months and older who are moderately to severely immunocompromised should complete a primary series with an age appropriate updated COVID-19 vaccine if not previously vaccinated. Immunocompromised persons may receive additional doses of the updated COVID-19 vaccine at least 2 months after their last dose.  
  • People 6 months and older who have already completed a primary series and are moderately or severely immunocompromised should get at least 2 doses of updated COVID-19 vaccine 6 months apart.

Available COVID-19 Vaccines

There are two types of COVID-19 vaccines available:

  • mRNA vaccines
    • Moderna 2025-2026 COVID-19 vaccine - available for ages 6 months and older
    • Pfizer 2025-2026 COVID-19 vaccine - available for ages 6 months and older
  • Protein subunit vaccines
    • Novavax 2025-2026 COVID-19 vaccine - available for ages 12 years and older

There is no recommendation for any one COVID-19 vaccine over another when more than one recommended and age-appropriate vaccine is available. COVID-19 vaccine can be received at the same time as other recommended vaccines.

COVID-19 Vaccine Resources for Providers

Frequently Asked Questions

Where can I get answers about the COVID-19 Vaccine Standing Orders and my liability in administering this vaccine “off label”?

Please review the FAQs for Health Care Providers for answers to some of your questions. We are continuing to update the FAQs as quickly as possible to add more answers when we have them available.

Who should get an additional dose of the COVID-19 vaccines?

Adults 65 years and older should receive a second dose of the updated COVID-19 vaccine at least 6 months after their first dose. In addition, moderately or severely immunocompromised persons who have previously completed an initial series should receive 2 doses of an updated COVID-19 vaccine, spaced 6 months apart. They may also talk with their health care provider about additional doses based on clinical judgement.

You can find more information on additional doses for immunocompromised adults in the American Academy of Family Physicians (AAFP) COVID-19 Vaccine Guidance. Guidance for immunocompromised children can be found in the American Academy of Family Physicians (AAFP) COVID-19 Vaccine Guidance.

What ages are the vaccines recommended for?

It is recommended the following age groups to receive vaccine: 

  • Pfizer-BioNTech vaccine (Comirnaty): 5 years and older
  • Moderna vaccine (Spikevax): 6 months and older
  • Novavax (Nuvaxovid): 12 years and older

For more details, see the DOH COVID-19 Vaccine Schedule.

Are there any restrictions on who can receive the vaccine?

Generally, the COVID-19 vaccines should not be given to anyone who is under the authorized age or has a history of severe allergic reactions to an ingredient or previous dose of the COVID-19 vaccines.

Pfizer-BioNTech

The Pfizer vaccine (Comirnaty) should not be given to anyone:

  • Under 5 years of age
  • Outside of the appropriate age dose
  • With a history of severe or immediate allergic reactions to an ingredient of the Pfizer-BioNTech vaccine, such as polyethylene glycol or polysorbate
  • Who had a severe or immediate allergic reaction to their first dose of an mRNA COVID-19 vaccine (Pfizer or Moderna)

Moderna

The Moderna vaccine (Spikevax) should not be given to anyone:

  • Under 6 months of age
  • Outside of the appropriate age dose
  • With a history of severe or immediate allergic reactions to an ingredient of the Moderna vaccine, such as polyethylene glycol or polysorbate
  • Who had a severe or immediate allergic reaction to their first dose of an mRNA COVID-19 vaccine (Pfizer or Moderna)

Novavax

The Novavax vaccine (Nuvaxovid) currently should not be given:

  • To anyone under the age of 12 years old until further research can support its use in that age category. 
  • Outside the appropriate age dose.
  • To anyone with a history of myocarditis or pericarditis.
Should I administer the vaccine to patients with a history of allergies?

The COVID-19 vaccines should not be given to people with a known history of severe allergic reaction, such as anaphylaxis, to any ingredient or a previous dose of the COVID-19 vaccines.

People who have had a severe allergic reaction to other vaccines or injectable therapies may still be able to receive this vaccine. However, providers should do a risk assessment and counsel them about the potential risks. If the patient decides to get the vaccine, providers should observe them for 30 minutes to monitor for any immediate reactions. People who report having mild or childhood allergic reactions to medications or vaccines may still get the vaccine.

Can patients receive both COVID-19 and other routine vaccines at the same time on the same day?

Yes. COVID-19 vaccine can be administered at the same time as other recommended vaccines. 

Does the COVID-19 vaccine work against variant strains?

COVID-19 vaccines are working well to prevent severe illness, hospitalization, and death, even against variants. However, public health experts are seeing reduced protection against mild and moderate COVID-19 illness, especially among-high risk populations.

The updated COVID-19 vaccines were created to help boost immunity and provide better protection from the omicron variant. It’s important to get all recommended doses available for best protection. Receiving an updated COVID-19 vaccine can restore protection and provide enhanced protection against the variants currently responsible for most infections and hospitalizations in the United States.

Vaccination is the best protection against COVID-19 illness.

How quickly is someone protected from COVID-19 after receiving the vaccine?

It will take about two weeks after someone receives a COVID-19 vaccine dose to have maximum protection. Protection may wane over time, so it’s important to stay up to date with all doses recommended to you.

What is the recommended dosage and schedule?

Please refer to the following resources for more information:

Can I use any extra doses in the vaccine vials?

You may find that some vials contain extra doses. You can use every full dose you can get from the Pfizer-BioNTech and Moderna vaccine vials. However, you should be sure to:

  • Maintain the dilution concentration of the Pfizer-BioNTech vaccine. See the Pfizer-BioNTech diluent poster (PDF) for more information.
  • Discard any amount of vaccine remaining in the vial that is less than a full dose. Do not pool liquid from multiple vials to create a dose.

If you administer extra doses, you will need to reconcile your inventory in the Washington State Immunization Information System (WAIIS). If you use an electronic health record (EHR) to input data into the WAIIS, you may need to reconcile more often. Instructions are available in the extra dose reconciliation guide (PDF).

Why should minors get vaccinated against COVID-19?

Since the beginning of the pandemic, over 15 million children in the United States have gotten COVID-19. New COVID-19 variants are more dangerous and infectious to children than the original strains and led to peak COVID-19 hospitalizations among youth.

While COVID-19 is often milder in children than adults, children can still get very sick and spread it to friends and family who are immunocompromised or vulnerable in other ways.

Children who are infected with COVID-19 can develop “long COVID-19” or persistent symptoms that often include brain fog, fatigue, headaches, dizziness and shortness of breath. Vaccination is the best way to keep kids healthy and safe.

Children who get infected with COVID-19 may be at greater risk for Multisystem inflammatory syndrome (MIS-C). MIS-C is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. While it is still unknown what causes MIS-C, many children with MIS-C had COVID-19 or had been around someone with COVID-19. MIS-C can be serious, even deadly, but most children diagnosed with this condition have gotten better with medical care.

What can I do as a provider to support COVID-19 vaccinations for youth?

COVID-19 vaccine providers can help youth get their COVID-19 vaccine by:

  • Listening to your patient's concerns and answering their questions with empathy. You can use the COVID-19 mRNA vaccine discussion guide (PDF) and the provider discussion guide: building parental/guardian confidence in COVID- 19 vaccine (PDF) for tips.
  • Clearly stating your available vaccine types during the scheduling process, on the registration form, and at the clinic site.
  • Making your consent process clear during the scheduling process. Provide any necessary forms and let youth know what they need to bring to confirm consent. You should include if your organization:
    • Requires an authorized adult to provide consent in person for the vaccine
    • Applies the Mature Minor Doctrine
    • Accepts consent from school nurses and school counselors for minors who are unhoused through the McKinney-Vento Homeless Assistance Act
  • Offering incentives to compensate youth for their time.
  • Asking youth to outreach to other youth. They'll be more likely to trust and listen to their peers. You can also get their input on how your clinic could better serve youth. If youth have a good experience with a provider, they are more likely to come back and more likely to tell their friends about it.

Questions?

General questions can be sent to covid.vaccine@doh.wa.gov. Any media inquiries can be sent to doh-pio@doh.wa.gov.

You can also subscribe to the bi-weekly Vaccines for Respiratory Illnesses Newsletter.