- Is the COVID-19 vaccine required?
It will be your choice whether to get the vaccine for COVID-19, but some employers, colleges, and universities may require it.
- How can I get an exemption from the vaccine requirement?
If your employer or college/university requires the COVID-19 vaccine you should contact your employer or college/university to find out how they collect proof of vaccination, if they have an opt-out policy, and what you would need to do to opt out. The Department of Health is not involved in the employer's or college's/university's policy.
You do not need to get an exemption form from the Department of Health (DOH) for the COVID-19 vaccine. DOH does not have exemption forms for the COVID-19 vaccine. The Washington state Certificate of Exemption (COE) is only for parents/guardians who want to exempt their child from the immunizations required for children in K-12 schools, preschools, or child care. Currently, Washington does not require the COVID-19 vaccine for children to attend school or child care, so it is not included on the COE.
- Is there a vaccination requirement for K-12 employees?
The Office of Superintendent of Public Instruction (OSPI) provides COVID-19 guidance and resources for school districts, as well as resources for students and families as appropriate. Past and current vaccination guidance, along with other COVID-19 resources, can be found on the OSPI website.
Administration and Supplies
- Who should get an additional dose of COVID-19 vaccine?
Please review the CDC guidelines for immunocompromised people.
- I am immune compromised. How many COVID-19 vaccines should I get?
Please review the CDC guidelines for immunocompromised people.
- How do I get the vaccine?
Find a vaccine at Vaccine Locator or call 1-833-VAX-HELP (833-829-4357), then press # (language assistance is available). Search or ask for the same type (brand) of the vaccine as you received for the first dose.
You can also text your ZIP code to 438-829 (GET VAX) or 822-862 (VACUNA) for vaccine locations near you.
If you or someone you know is homebound, fill out a secure online form. Your answers will allow us to connect individuals to available County and/or State Mobile Vaccine Teams.
- What do I need to know before I get my vaccine?
Please see the CDC guidelines.
- Do I have to be a U.S. citizen to get the vaccine?
No, you do not need to be a U.S. citizen to get the vaccine. That means you do not need a social security number, or other documents with your immigration status, to get the vaccine. Some vaccine providers might ask for a social security number, but you do not have to give one. Your child does not need to be a U.S. citizen to get the vaccine. Health care providers will not ask for anyone's immigration status. In most cases, parents and guardians will need to give consent to vaccinate youth under age 18. The Department of Health recommends that all people ages 6 months and older get vaccinated.
- Is there a cost for COVID-19 vaccines?
During the COVID-19 pandemic, the U.S. federal government purchased all of the COVID-19 vaccines and made them free to every person who wanted them. Now that the COVID-19 public health emergency has ended, COVID-19 vaccines are expected to follow a similar path as other vaccines, which means they will be purchased by clinics and hospitals directly for adults. COVID-19 vaccines will still be available, but they may cost money for some adults to receive.
Like other vaccines, COVID-19 vaccines will likely be covered by most insurance plans. COVID-19 vaccines will continue to be available at no cost to all children in Washington state until their 19th birthday through the Vaccines for Children program. There are also programs for adults that can help cover costs of getting vaccinated if they don’t have health insurance or their plan doesn’t cover the vaccine. Visit HHS.gov for more information on these programs.
COVID-19 vaccines will continue to be available at no cost for all, as long as the supply of federally purchased vaccines lasts.
- Why am I being asked to show my insurance card?
When you get the vaccine, your vaccine provider may ask if you have an insurance card. This is so they can get reimbursed for giving you the vaccine (vaccine administration fee). Let your provider know if you do not have insurance. You will still be able to get the vaccine at no-cost.
- What if I don't have an insurance card?
If you do not have insurance coverage, tell your provider. You will still get the vaccine at no-cost.
- What about office visit fees?
You should not be charged for an office visit if you only receive the vaccine. If other services are performed along with the administration of the vaccine, it may be billed as an office visit. Seek clarification from your provider beforehand and from your insurance company if you are charged an office visit fee.
- I received a bill from my provider for the COVID-19 vaccine or the vaccine administration fee. What do I do?
If you have health insurance, contact your insurance plan first. If this doesn't address the issue, you can also file a complaint with the Office of the Insurance Commissioner. If you do not have health insurance, remember that providers are not allowed to charge you for the vaccine and therefore may be violating the requirements of the COVID-19 vaccine program. Please email firstname.lastname@example.org.
- When am I considered up to date with COVID-19 vaccination?
You are up to date with your COVID-19 vaccination if you have received the most recent dose recommended for you by the CDC.
- What is a vaccination record card?
You should receive a paper vaccination record card when you get your first dose of COVID-19 vaccine. This card will tell you which type of vaccine you got (Comirnaty/Pfizer-BioNTech, Spikevax/Moderna, or Johnson & Johnson) and the date you received it. Keep this card with you so your vaccine provider can complete it with additional dose information.
COVID-19 vaccination is required by many businesses, events and employers. Go to the COVID-19 Vaccination Verification page to learn more about the types of proof accepted in Washington.
- Do vaccine doses go to waste if people don't show up for their appointments?
It's common for some vaccine appointments to open up again after a clinic is fully booked. Sometimes people reschedule their vaccine appointments or they find an option at a different clinic that works better for them. These unfilled appointments do not mean that vaccine is going to waste. Unused doses can be given at a later date if properly stored. Vaccine wastage has been very minimal in Washington state.
- I got vaccinated as part of a U.S.-based clinical trial. Am I considered up to date?
U.S. trial participants, along with non-U.S.-based participants in the same trial, who received all recommended doses of a vaccine that has gone through a U.S. data and safety monitoring board or equivalent are considered up to date with their COVID-19 vaccines when they have received one bivalent mRNA vaccine dose. At this time, only the Medicago COVID-19 vaccine in people ages 18 years and older and Sanofi-GSK COVID-19 vaccine in people ages 18–59 years meet these criteria.
Safety and Effectiveness
- What does it mean when a vaccine is fully licensed?
For full approval, the FDA evaluates data over a longer period of time than for an emergency use authorization. For the vaccine to be given full approval, the data must show a high level of safety, effectiveness, and quality control in vaccine production. The purpose of emergency use authorization is to ensure that people can get lifesaving vaccines prior to a longer-term analysis of data. However, EUA still requires a very thorough review of clinical data—just over a shorter period of time.
- How do we know the vaccines are safe?
To make sure that COVID-19 vaccines are safe, CDC expanded and strengthened the country’s ability to monitor vaccine safety. As a result, vaccine safety experts can monitor and detect issues that may not have been seen during the COVID-19 vaccine clinical trials.
- How will a COVID-19 vaccine work in my body?
The COVID-19 vaccine teaches your immune system to recognize the coronavirus. When you get the vaccine, your immune system makes antibodies (“fighter cells”) that stay in your blood and protect you in case you are infected with the virus. You get protection against the disease without having to get sick.
When enough people in the community can fight off the coronavirus, it has nowhere to go. This means we can stop the spread quicker and get a little closer to ending this pandemic.
Watch this video on how vaccines work in your body.
- How are COVID-19 vaccines made?
This short video explains how COVID vaccines are made.
- What is an mRNA vaccine?
A messenger RNA, or mRNA vaccine is a new type of vaccine. mRNA vaccines teach your cells how to make a harmless piece of the “spike protein.” The spike protein is what you see on the surface of the coronavirus. Your immune system sees that the protein doesn't belong there, and your body will start to build an immune response and make antibodies. This is similar to what happens when we “naturally” get a COVID-19 infection. Once it does its job, the mRNA quickly breaks down and the body clears it away in a few days.
Although we have used mRNA for other types of medical and veterinary care in the past, creating vaccines using this method is a huge leap forward in science and may mean future vaccines can be created more easily.
You may read more about how mRNA vaccines work on CDC's website, or watch this video from Dr. Paul Offit at the Children's Hospital of Philadelphia.
- What is a viral vector vaccine?
This type of vaccine uses a weakened version of a different virus (the “vector”) that gives your cells instructions. The vector enters a cell and uses the cell's machinery to create a harmless piece of the COVID-19 spike protein. The cell displays the spike protein on its surface, and your immune system sees that it doesn't belong there. Your immune system will start to make antibodies and activate other immune cells to fight off what it thinks is an infection. Your body learns how to protect you against future infection with COVID-19, without you having to get sick.
- What is a protein subunit vaccine?
One of the COVID-19 vaccines authorized by the FDA is a protein subunit vaccine. Protein subunit vaccines contain pieces of the virus (proteins) that causes COVID-19 (made without using any live virus) with an additive intended to help the vaccine work better in the body. Once your immune system knows how to respond to the spike protein, it will then be able to respond quickly to the actual virus and protect you against COVID-19. Subunit vaccines cannot cause infection with the virus that causes COVID-19 and do not interact with our DNA.
- What is an adjuvant?
The adjuvant in the Novavax is the additive intended to help strengthen the body’s immune response.
- What types of symptoms are normal after receiving the vaccine?
Like other routine vaccines, the most common side effects are a sore arm, fatigue, headache, and muscle pain.
These symptoms are a sign that the vaccine is working. In the Pfizer, Moderna and Novavax trials, these side effects occurred most often within two days of getting the vaccine, and lasted about a day. For all vaccines, people over age 55 were less likely to report side effects than younger people.
- What ingredients are in the vaccines?
You may see some rumors and untrue ingredients listed online or in social media. These are generally myths. The ingredients in the COVID-19 vaccines are pretty typical for vaccines. They contain the active ingredient of mRNA or modified adenovirus along with other ingredients like fats, salts, and sugars that protect the active ingredient, help it work better in the body, and protect the vaccine during storage and transport.
The Novavax COVID-19 vaccine is a protein subunit-based vaccine that contains an additive, along with fats and sugars to help the vaccine work better in the body. This vaccine does not use mRNA.
Pfizer, Moderna, Johnson and Johnson, and Novavax vaccines do not contain human cells (including fetal cells), the COVID-19 virus, latex, preservatives, or any animal by-products including pork products or gelatin. The vaccines are not grown in eggs and do not contain any egg products.
See this Q&A; webpage from the Children's Hospital of Philadelphia for more information about ingredients. You can also find the full ingredients lists in the Pfizer, Moderna, and Johnson & Johnson fact sheets.
- Can I get the COVID-19 vaccine if I'm pregnant, lactating or planning to become pregnant?
Yes, data show that COVID-19 vaccines are safe during pregnancy. The Centers for Disease Control and Prevention (CDC), American College of Obstetricians and Gynecologists (ACOG), and Society for Maternal-Fetal Medicine (SMFM) recommend the COVID-19 vaccine for people who are pregnant, lactating, or planning to get pregnant.
Some studies show that if you are vaccinated, your baby may even get antibodies against COVID-19 through pregnancy and lactation. Unvaccinated pregnant people who get COVID-19 are at increased risk of severe complications like preterm birth or stillbirth. In addition, people who get COVID-19 while pregnant are two to three times more likely to need advanced life support and a breathing tube.
For more resources about getting the COVID-19 vaccine while pregnant and breastfeeding, please see up to date information on the One Vax, Two Lives website.
- What is an Emergency Use Authorization (EUA)?
An EUA allows the FDA to make a product available during a declared state of emergency before it has a full license. The purpose of emergency use authorization is to ensure that people can get lifesaving vaccines prior to a longer-term analysis of data. EUA still requires a very thorough review of clinical data—just over a shorter period of time. Any EUA granted by the FDA is further vetted by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.
- What is the Western States Pact?
In October, 2020 Washington joined Oregon, Nevada, Colorado and California to form the Western States Scientific Safety Review Workgroup (Western States Pact) to review the safety and efficacy of COVID-19 vaccines after they were authorized by the FDA. This workgroup provided another layer of expert review around vaccine safety.
The panel included experts appointed by all member states, and nationally recognized scientists with expertise in immunization and public health. To act in close coordination and collaboration with western states when COVID-19 was declared a health emergency, this panel reviewed all publicly available data concurrently with federal reviews for the four vaccines we currently have available in Washington state. As we move into a new recovery phase of the pandemic, the Western States Pact has disbanded and all vaccine use authorization in western states will be determined by the FDA and vaccine recommendations will come from the CDC.
Read the findings of the Western States Scientific Safety Review Workgroup:
- Is it COVID-19 or a vaccine reaction?
After getting a COVID-19 vaccine, you may have some side effects. These are normal signs that your body is building protection against COVID-19. Your arm may hurt where you got your vaccine or you may have redness or swelling. You may be tired or have a headache, muscle pain, chills, fever, or nausea. They may affect your ability to do daily activities but should go away in a few days. Some people have no side effects. Learn more about possible side effects after getting a COVID-19 vaccine.
If the symptoms do not go away after a few days, you should seek medical advice. If there’s a possibility you have COVID-19 or were exposed, please stay away from others as a precaution. If you experience a medical emergency after getting the COVID-19 vaccine, call 9-1-1 immediately.
- Can I get the COVID-19 vaccine if I've had an allergic reaction to a vaccine in the past?
The vaccine should not be given to people with a known history of severe allergic reaction, such as anaphylaxis, to a previous dose of an mRNA or viral vector vaccine, or to any ingredient of the Pfizer-BioNTech/Comirnaty, Moderna/Spikevax, Novavax or Johnson & Johnson–Janssen COVID-19 vaccines.
People who have had a severe allergic reaction to other vaccines or injectable therapies may still be able to receive the vaccine. However, providers should do a risk assessment and counsel them about potential risks. If the patient decides to get the vaccine, the provider should observe them for 30 minutes to monitor for any immediate reactions.
The Advisory Committee on Immunization Practices (ACIP) recommends that providers observe all other patients for at least 15 minutes after receiving the vaccine to monitor for an allergic reaction. See ACIP's interim clinical considerations for vaccines for more information.
- What happens if I get sick after getting the COVID-19 vaccine?
It's normal to have some side effects after getting the vaccine. This can be a sign that the vaccine is working. If you experience a medical emergency after getting the COVID-19 vaccine, call 9-1-1 immediately.
If you get sick after getting the vaccine, you should report the adverse event to the Vaccine Adverse Event Reporting System (VAERS). An “adverse event” is any health problem or side effect that happens after a vaccination.
For more information about VAERS, see "What is VAERS?" below.
- What is VAERS?
VAERS is an early warning system led by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). VAERS can help detect problems that may be related to a vaccine. Anyone (health care provider, patient, caregiver) can report possible adverse reactions to VAERS.
There are limits to the system. A VAERS report does not mean the vaccine caused the reaction or outcome. It only means that the vaccination happened first. VAERS is set up to help scientists notice trends or reasons they should investigate a possible problem. It is not a list of verified outcomes of vaccination. When you make a report to VAERS, you help the CDC and the FDA identify possible health concerns and make sure vaccines are safe. If any issues arise, they will take action and notify health care providers about potential issues.
- What is a COVID-19 variant?
Viruses mutate (change) as they spread from person to person. A ‘variant' is a mutated strain of virus. Some variants disappear over time and some continue to spread in communities.
The Centers for Disease Control and Prevention (CDC) identifies the virus variants that are concerning. Currently, several variants are concerning because they spread quickly and more easily, causing more COVID-19 infections.
- Why should I get the COVID-19 vaccine if most people survive having the disease?
Death is not the only risk from having COVID-19. Many people who get COVID-19 only have mild symptoms. However, the virus is extremely unpredictable, and we know some COVID-19 variants are more likely to make you really sick. Some people can get very sick or die from COVID-19, even young people with no chronic health conditions. Others, known as “COVID long-haulers” may get symptoms that last for months and affect their quality of life. We also don't know yet all the long-term effects of COVID-19 since it's a new virus. Getting vaccinated is our best protection against the virus. Even if you're young and healthy, you should get a COVID-19 vaccine.
- What is the difference between vaccination and immunity?
Natural immunity from infection does offer some level of immunity against reinfection but it is important to stress that initial infection among unvaccinated persons increases risk for serious illness, hospitalization, and death. While some people may develop antibodies after COVID-19 infection, others may not. For those that develop some immunity after infection, there is no way to tell how strong that protection is, how long it will last or even which variant the immunity is for.
Because we cannot rely on natural immunity to prevent reinfection or severe illness from COVID-19, being up to date on vaccination remains the best protection and primary strategy to prevent SARS-COV-2 infections, associated complications, and onward transmission.
For more information on immunity and COVID-19, please review these helpful resources.
Timeline and Availability
- I’m up to date with the COVID-19 vaccines. If I'm exposed to COVID-19, do I need to quarantine?
Please refer to our Isolation and Quarantine for COVID-19 page for isolation and quarantine guidelines.
- Can people under age 18 get the vaccine?
Yes, the Pfizer-BioNTech (Pfizer) vaccine and Moderna COVID-19 vaccine brands are authorized for children ages 6 months and older. The Novavax vaccine is available for ages 12+ under an EUA. Youth who are under 18 years of age may need consent from a parent or guardian to get the vaccine, unless they are legally emancipated.
Check with the vaccine clinic about their requirements for showing proof of parental consent or legal emancipation.
- I've had COVID-19. Can I get the vaccine?
Yes, the Advisory Committee on Immunization Practices (ACIP) recommends anyone who previously had COVID-19 to get the vaccine. Data shows it is uncommon to be re-infected with COVID-19 in the 90 days after you were infected, so you might have some protection (called natural immunity). However, we don't know how long natural immunity might last.
People who currently have COVID-19 or who have been recently exposed to COVID-19 should wait to get vaccinated until they feel better and their isolation/quarantine period is finished, if possible. If there is a high risk they could infect others, they may be vaccinated during their quarantine period to prevent spreading the disease.
For isolation and quarantine-specific guidance documents, please visit our Isolation and Quarantine for COVID-19 webpage.
- Can I get the COVID-19 vaccine when I get routine vaccinations?
Yes. The Advisory Committee on Immunization Practices (ACIP) changed their recommendations on May 12, 2021. You can now get a COVID-19 vaccine at the same time that you get other vaccines.
You do not need to schedule your child's required school vaccinations or other recommended vaccines separately from COVID-19 vaccination. A COVID-19 vaccine appointment is another opportunity to get your child caught up on all of their recommended vaccines.
School and Child Care
- Will the state require COVID-19 vaccination for K-12 school entry?
The Washington State Board of Health, not the Department of Health, has the authority to create immunization requirements for children in K-12 schools RCW 28A.210.140. There is no school or childcare requirement for COVID-19 vaccine at this time.
- Will there be any flexibility in school immunization requirements for the 2021-2022 school year given the COVID-19 pandemic?
The Washington State Board of Health determines if there should be any changes to school immunization requirements. At this point, school immunization requirements will remain the same. Children will need to meet vaccination requirements before they can attend the first day of school. Find out what vaccines are required for school at www.doh.wa.gov/scci.
- How will vaccine distribution work?
The CDC primarily manages the distribution of COVID-19 vaccines. Providers enrolled in the COVID-19 Vaccine Program can order vaccines through the Washington State Department of Health at any time or request vaccine from local vaccine depots. Vaccine orders and transfers are approved throughout the week.
If vaccine doses are limited, the federal government and the state consider many factors such as prioritization of high-risk groups, vaccine supply and distribution, logistics, safety, and clinical guidance. Vaccine distribution adjusts over time as the number of available doses increases.
- Who are your partners in Washington state?
We coordinate with tribal nations, local government, community leaders, and other partners to develop and implement vaccination efforts.
- How have you planned for the COVID-19 vaccine?
We worked with the federal government and local partners within Washington to plan for the distribution of a COVID-19 vaccine. We turned in our interim vaccine distribution plan to the CDC on October 16, 2020.
On October 29, 2020, the CDC released version 2 of the COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations. The second update of our plan included changes guided by the CDC's new playbook along with other sources of feedback.
Please find the latest version of the plan on our vaccine distribution page.
- Has DOH received federal funding for COVID-19 vaccine distribution?
Yes. We received $5 million in federal funding for COVID-19 vaccine response preparation. This funding has been used to support partnerships with local health jurisdictions and tribal entities, mass vaccination clinics, vendor contracts, and staffing. The department has redirected some current staff to this program and is hiring additional positions to support this work.
- What other kinds of information are you gathering?
We've conducted focus groups and key interviews with disproportionately impacted communities, workers, and business sectors. Key groups include African American/Black communities, Latinx community, Pacific Islander communities, immigrant and refugee communities, older adults, people experiencing homelessness, farmworkers, people with underlying health conditions, and individuals with disabilities.
We have also engaged with communities and sectors who are at higher risk for getting or spreading COVID-19. This includes essential workers and businesses, health care workers and providers, college students, youth, early learning providers, and parents.
We've gathered feedback using interviews, focus groups, community conversations, and surveys. Learn more about engagement efforts.
- What are other states doing?
Learn what other states and territories are doing here.
Vaccine Tracking and Records
- How will the state track COVID-19 vaccine?
The department is using various tools to track and administer vaccine. The federal government is developed a tool called the Vaccine Administration Management System (VAMS) to support COVID-19 vaccine work. DOH has decided not to use VAMS and is instead using a program called PrepMod, along with our state's Immunization Information System (IIS).
The IIS is a lifetime registry that keeps track of immunization records for people of all ages. The system is a secure, web-based tool for health care providers and schools. The IIS connects people who receive, administer, record, and order vaccines in Washington. One of our planning areas is to ensure that the system can meet the demands of a COVID-19 vaccine program, and ensure the registry connects with any federal systems.
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