New COVID vaccines arrive in Washington as respiratory virus season approaches

Washington state's summer surge of COVID-19 is showing early signs of waning after a particularly infectious couple of months—but don't relax just yet, public health experts say. Respiratory virus season is right around the corner.

Although rates are still nowhere close to where they were during 2022's omicron wave, percent positivity remains high and was higher in late July and August than it had been all year, according to local and state COVID data. In other words, more Washingtonians are testing positive for the virus now than since last winter.

"It's really catching people at a time when they least expect it," said Dr. Eric Chow, King County's chief of communicable diseases. "People don't associate respiratory illnesses with summer weather, during a time when they're traveling, as they're going back to school."

In King County, about 13% to 16% of laboratory tests returned positive for COVID in August, according to Public Health—Seattle & King County's respiratory virus data. About 2% of emergency department visits are COVID-related, still under the county's alert threshold of 3%, but the figure has slowly been ticking up since late May, when it was below 1%.

The rise in cases, which has also emerged the past few summers, is likely due to waning immunity and new variants, as well as increased travel and gatherings, said Dr. Seth Cohen, UW Medicine's medical director of infection prevention.

"We do think [numbers] are plateauing, so we're hoping they'll start to decline," Cohen said.

Staying up-to-date on COVID vaccines

The newest version of the COVID vaccine was approved by the U.S. Food and Drug Administration in August, and already landed in some Washington pharmacies last week. But local public health officials worry that fewer people are returning to doctor's offices and pharmacies for the updated shot.

While millions of Washingtonians once filled stadiums and parking lots to get a highly coveted vaccine, urgency around the shot has faded for many in recent years. Nearly 70% of eligible residents have received their full primary series, but just 19.5% got an updated shot last fall, according to state data.

"I certainly want to see those numbers higher," Chow said.

More older adults have continued to get an updated COVID vaccine (about 46.2% of those 65 and older are up-to-date), but just 10.2% of those between 18 and 24 years old have gotten the most recent shot.

Black, Native Hawaiian/Pacific Islander and Hispanic/Latino communities have the lowest rates of updated vaccination, according to state data.

"Inequities to health care are certainly a big part of it," Chow said. "If we're not able to provide vaccines that are easily accessible ... that is certainly one barrier. We also know the cost of COVID vaccines since it became commercialized could also factor into someone's decision."

In addition, a lot of people "want COVID to be behind them," he added. "It may not be at the forefront of their mind that they should be staying up-to-date with each new vaccine that comes out."

Because the newest shot is updated with protection against more recent variants, and continues to protect against severe illness and death, it's important to take advantage of it, Chow said.

Walgreens, CVS Pharmacy and Rite Aid/Bartell Drugs started offering some appointments to get the updated vaccine last week, though some stores might get the new doses later than others depending on location. But all Walgreens stores nationwide are expected to offer the updated shot by Sept. 6, a corporate spokesperson said Wednesday.

"The sooner people get them, the better matched they'll be against circulating strains," Cohen added.

A rise in whooping cough

While rates of pertussis, or whooping cough, were lower during the height of the pandemic, they've started to pick back up in Washington and throughout the country.

In King County, public health officials have counted at least 114 cases of pertussis this year, which is higher than the annual numbers from 2018 to 2023 combined, Chow said. Twelve of the cases were identified in infants younger than a year old, and four of those babies were hospitalized.

The disease is spread by respiratory droplets and generally starts with coldlike symptoms that develop into a worsening cough.

"There are probably a number of different factors," Chow said. "Some of it is just the epidemiology of pertussis, or the bacteria that causes the infection, and kind of rebounding as a result of all the changes and the effects of the pandemic."

He also encouraged increased rates of vaccination for higher-risk groups, particularly pregnant people, who can offer protection to their newborns by getting a Tdap shot between their 27th and 36th weeks of pregnancy.

DTaP vaccines also protect against whooping cough and are available for preteens and adults.

"In general, for non-COVID illnesses, residents of King County generally do a good job of keeping up with vaccines," Cohen said. "But there's no question we're seeing a slide in childhood vaccination coverage locally, regionally and nationally."

"Some of these trends are very concerning," he added. "Much lower rates of vaccination have put communities at risk of vaccine-preventable conditions."

Back-to-school vaccine routines

As the new school year gets underway, public health experts expect respiratory infections to increase, fueling their push to get kids shots before they return to classrooms.

"This is a great time to start getting primary care appointments on the books to make sure kids are updated with childhood vaccines," Cohen said. It's safe for children to receive COVID, flu, RSV and other vaccines all at once, and is often more convenient to do so, he added.

"As a parent with kids in elementary school, I certainly empathize with people thinking on these decisions," Cohen said. "Children have a lower risk of illness than adults, but are still at risk of medical complications from acute COVID."

Although there's been a slight decline in childhood immunization rates since 2020, last year's numbers stayed fairly stable, said Debra Berliner, King County's program manager of immunizations.

About 91% of students in King County were up-to-date on immunizations last school year, which is about the same as it was during the previous school year, she said.

"I think that's a testament to the excellent work health care providers and schools and families have done to catch kids up on vaccinations," Berliner said.

Rates are also higher than they were before the pandemic. During the 2016-17 school year, about 88% of students were up-to-date on immunizations. The following year, it increased to 89%.

"We were on an upward trajectory before the pandemic, and the pandemic threw a little bit of a wrench in that progression, but our progress hasn't all been lost, and we are actually in a better place than we were, say, seven or eight years ago," Berliner said.

Certain aspects of respiratory virus season are still difficult to predict, especially COVID trends, but local public health experts reminded community members to remember masking, staying home when sick and increasing ventilation in indoor spaces in order to increase protection.

"I can't control all of my children's interactions with the world, nor do I want to," Berliner said.

"I want them to be able to play sports, to socialize, to study, to explore without worrying about whether they're going to come down with a preventable disease. Because my children are fully vaccinated, I feel confident knowing that if they were exposed to measles, their immune systems will almost certainly fight it off without them ever knowing."

King County public health teams will continue to host regular vaccine clinics (free of charge, regardless of insurance status) that offer COVID and childhood immunizations through the end of the year, including in Shoreline, Burien and Renton in the next couple weeks.

The state Department of Health's mobile Care-a-Van clinics will also continue to offer shots at least through September, including in Ferry County, Snohomish County, Pierce County and Mason County this week. More information about Care-a-Van clinics is available at doh.wa.gov.

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