Under chapter 43.70 RCW, as recently amended by House Bill 2242 (PDF), the Department of Health (DOH) has the authority to issue immunization recommendations and related guidance to health care providers about who should receive certain vaccines, when they should be given, and under what conditions. Certain insurance coverage and funding under the state’s universal Childhood Vaccine Program must be provided for vaccines recommended by DOH.
These recommendations are not vaccine mandates and do not require anyone to be vaccinated. Immunizations required for school attendance are set by the State Board of Health, not the Department of Health. Information on school immunization requirements can be found at our School and Child Care Immunization webpage.
Current DOH Vaccine Recommendations
Vaccine Recommendation Process
In developing recommendations, DOH considers guidance of experts and expert organizations in its process.
Step 1: A need for new or updated immunization guidance is identified.
Step 2: The Washington State Department of Health (DOH) reviews existing evidence-based recommendations, clinical data, and other relevant information from medical and public health organizations. *
Step 3: Vaccine recommendations are drafted.
Step 4: Draft recommendations undergo review by the State Medical Epidemiologist, State Health Officer, and Secretary of Health.
Step 5: Recommendations are finalized and posted on the DOH website.
Step 6: Information regarding the new recommendations is distributed to healthcare providers and the public.
* Sources reviewed may include the CDC’s Advisory Committee on Immunization Practices (ACIP); the Vaccine Integrity Project by Center for Infectious Disease Research and Policy (CIDRAP); West Coast Health Alliance (WCHA); American Academy of Pediatrics (AAP); American College of Obstetricians and Gynecologists (ACOG); American Academy of Family Physicians (AAFP); the DOH Vaccine Advisory Committee (VAC), and other relevant scientific resources.
Frequently Asked Questions
- Do the DOH vaccine recommendations create vaccine mandates?
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No. DOH vaccine recommendations are not vaccine mandates and do not require anyone to get vaccinated, nor do they change consent for immunization. Decisions about vaccines remain between individuals and their health care providers, based on clinical guidance and personal health needs.
- Do the DOH vaccine recommendations change school or child care immunization requirements?
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No. The vaccine recommendations do not change immunization requirements for school or child care entry. These requirements are established in state law and rules adopted by the State Board of Health and are separate from vaccine recommendations.
Vaccine recommendations provide clinical guidance, while school and child care requirements are set by the State Board of Health through a separate legal and rulemaking process.
Washington state law (RCW 28A.210.140) requires the State Board of Health to adopt rules that establish immunization requirements for children attending school and child care in Washington. State law (RCW 28A.210.090) also allows for medical, religious, and philosophical exemptions. The State Board of Health’s rules, in chapter 246-105 WAC, define which immunizations are required for school and child care entry. The rules also outline acceptable documentation, including proof of immunization and exemption forms.
- How are Washington’s immunization requirements for school and child care determined?
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Washington state law (RCW 28A.210.140) requires the State Board of Health to adopt rules that establish immunization requirements for children attending school and child care in Washington. State law (RCW 28A.210.090) also allows for medical, religious, and philosophical exemptions.
The State Board of Health’s rules, in chapter 246-105 WAC, define which immunizations are required for school and child care entry. The rules also outline acceptable documentation, including proof of immunization and exemption forms.
- Does Washington recommend different vaccines than federal authorities?
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Yes. DOH advises that children and adolescents follow the DOH immunization schedule for people ages 18 and younger. For ages 19 and older, we advise following the adult immunization schedule which is based on age, medical conditions, or other risk factors. These recommendations are grounded in evidence-based science, decades of research and review, and established safety standards.
- How will DOH continue to evaluate vaccine safety?
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We continue to monitor vaccine safety through the federal Vaccine Adverse Event Reporting System (VAERS), state-level data systems, and partnerships with health care providers. We will also continue to review the recommendations of and collaborate with the Center for Infectious Disease Research and Policy (CIDRAP) Vaccine Integrity Project, the West Coast Health Alliance, professional medical organizations, and other subject matter experts.
- How does the state make recommendations?
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When a need for new or updated immunization guidance is identified, we review clinical data and guidance from established medical and public health organizations including but not limited to:
- Center for Infectious Disease Research and Policy (CIDRAP) Vaccine Integrity Project
- American Academy of Pediatrics (AAP)
- American College of Obstetricians and Gynecologists (ACOG)
- American Academy of Family Physicians (AAFP)
- West Coast Health Alliance
- Washington State Department of Health Vaccine Advisory Committee (VAC)
- Advisory Committee for Immunization Practice (ACIP)
Once our new or updated recommendations are drafted, they undergo review by the State Medical Epidemiologist, the State Health Officer, and the Secretary of Health. Once approved, recommendations are published on the Department of Health’s website and shared through additional communications. Once issued, DOH's vaccine recommendations are periodically reviewed and updated.
- What happens if state and federal guidance differ?
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State law gives DOH the authority to issue vaccine recommendations for Washingtonians. State recommendations are not dependent on federal guidance and may differ. Certain insurance coverage and funding must be provided under state law based on DOH's recommendations, while some must be provided under federal law based on federal recommendations.
- Will insurance cover vaccines recommended in Washington?
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Coverage may vary by plan. Contact the Office of the Insurance Commissioner for more information about coverage details.
- How can someone without health insurance get DOH-recommended vaccines?
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In Washington, all children ages 18 and younger can receive recommended vaccines at no cost through the state’s Childhood Vaccine Program (CVP). Adults who are uninsured or underinsured may be eligible to receive vaccines at no cost through the Adult Vaccine Program (AVP).
Contact
For questions about Washington’s immunization recommendations, please contact us.