Public Health Hot Topic | COVID-19, Influenza, and RSV immunizations in 2025

Answering the top questions about the COVID-19 vaccine, insurance coverage, and preparing for the 2025-2026 respiratory illness season.

||| FROM SAN JUAN COUNTY COMMUNICATIONS |||

We’ve been watching federal and state updates on immunization recommendations closely and are coming to you with an overview of what we know and what we might expect this respiratory illness season.

What’s going on with COVID-19 immunizations? 

Washington State continues to recommend the Coronavirus (COVID-19) immunization to everyone over 6 months old, including pregnant people. On September 4, 2025, the Washington state Department of Health (DOH) issued a statewide standing order for COVID-19 vaccines. This standing order authorizes qualified health care professionals to immunize individuals 6 months and older who do not have contraindications to the vaccine. It supports the recommendations from trusted national medical organizations like the American Academy of Pediatrics (AAP), the American College of Obstetrics and Gynecology (ACOG), and the American Academy of Family Physicians (AAFP).

All individuals 6 months and older who do not have contraindications to the COVID-19 vaccine, including pregnant people, can now receive the updated version of the COVID-19 vaccine in Washington state. 

The release of the Washington State COVID-19 immunization standing orders follows the formation of the West Coast Health Alliance announcement on September 3, 2025. This regional partnership between Washington, Oregon, California, and Hawaii ensures that public health policies will continue to support safety, efficacy, transparency, access, and trust. Other states—including Pennsylvania, Colorado, and Massachusetts—are taking similar steps to ensure individuals will have access to COVID-19 vaccines.

Will health insurance cover the COVID-19 immunization? 

While the standing order gives access to the vaccine, patients may be responsible for the cost of the vaccine. Some pharmacies can bill insurance companies, but not all. Washington Apple Health (Medicaid) continues to cover the COVID-19 vaccine for members, in line with DOH recommendations. 

The Office of the Insurance Commissioner cannot require all health plans to cover COVID-19 vaccines for everyone, but many health plans are still expected to provide coverage. To see if the vaccine is covered with your insurance, contact your insurance directly or reach out to the Office of the Insurance Commissioner.

Where can I get a COVID-19 vaccine? 

San Juan County Health & Community Services (HCS) is not offering the Covid 25-26 currently. Once ordering is available through DOH and we know how much vaccine we can order, we will let the community know when appointments will be available and who is eligible. As a friendly reminder, HCS can only vaccinate children under the age of 19 and adults who do not have insurance.

For those adults who have insurance, please reach out to your primary health care provider to see if they have COVID-19 vaccines available for you. You may also contact your local pharmacy to see if they have availability:

• Friday Harbor Drug on San Juan Island can be reached by calling (360) 378-4421 – you can also schedule a vaccine appointment on their website (if vaccine is available)
• Ray’s Pharmacy in Eastsound can be reached by calling (360) 376-2230 – you can also schedule a vaccine appointment on their website (if vaccine is available)
• Lopez Island Pharmacy on Lopez Island can be reached by calling (360) 468-2616 – you can also schedule a vaccine appointment on their website (if vaccine is available)

Alternatively, you may be able to schedule a vaccine appointment at an off-island pharmacy.

What about Influenza and RSV immunizations? 

The Washington State DOH recommends a yearly influenza (flu) vaccine for everyone 6 months and older, including pregnant and breastfeeding people. It takes two weeks for the flu vaccine to protect you from the flu, so get your flu vaccine in October to ensure you’re protected during the height of respiratory illness season. Most insurances cover the cost of the flu vaccine, including Apple Health (Medicare) and Medicaid. Check with your insurance directly to see if the vaccine is covered.

San Juan County Health & Community Services will be offering flu vaccines in mid- to late-fall for adults without insurance and children under the age of 19 years, on a sliding fee scale. We will announce appointment availability and school-based clinics once those dates have been finalized. We hope to be able to offer both flu and COVID-19 immunizations at these school-based clinics for any child 6 months through 18 years old.

Starting in mid-October we will have regularly scheduled immunization clinics on San Juan, Orcas, and Lopez Islands. These clinics are available by appointment and will be offered to children under the age of 19 years and to adults without insurance. You can make an appointment online at our website or calling 360-378-4474. For those adults who have insurance, please reach out to your primary health care provider to see if they have influenza vaccines available for you. You may also contact your local pharmacy to see if they have availability.

RSV vaccines are available for people who are at higher risk of severe illness:

• Pregnant people should get a one-time dose of the maternal RSV vaccine between 32 and 36 weeks of pregnancy to help protect their baby during respiratory illness season, usually from September through January.
• Infants and some young children should receive monoclonal antibodies to protect them against RSV.
• Adults ages 75 and older, and those who are ages 60 to 74 and are at increased risk for RSV, should get a one-time RSV vaccination.

HCS will be ordering a limited amount of adult and pediatric RSV vaccines. For infants and some young children, and for adults without insurance, please call our office at 360-378-4474 or check our website to inquire about RSV vaccine availability. For those adults who have insurance, please reach out to your primary health care provider to see if they have RSV vaccines available for you. You may also contact your local pharmacy to see if they have availability.

What We Still Don’t Know

There is still a lot we don’t know, unfortunately. We are navigating new waters both nationally and locally in public health. Up until this year, the process for seasonal immunizations was a reliable and transparent process. There have been many disruptions to the process gearing up for the 2025-2026 respiratory illness season so far, so there may be more ahead. However, as your local public health team we will continue to stay vigilant, advocate for equitable vaccine access in San Juan County, stay informed in these changing times, and remain committed to science-based vaccine policy and practices.

If you have questions that weren’t answered or would like to know more, please reach out to your local public health team at hcs@sanjuancountywa.gov.

Relevant URLs:

About San Juan County’s Department of Health & Community Services    

San Juan County’s Department of Health & Community Services is responsible for community and environmental health, mental health and substance abuse programs, senior services, affordable housing projects, and more. The department has staff and offices on Lopez, Orcas, and San Juan Islands. For more information about San Juan County’s Department of Health & Community Services, visit www.sanjuancountywa.gov/1777/Health-Community-Services.