COVID-19 cases and emergency department visits are rising locally, and Jefferson County Health Officer Austin Derry urged residents on Sept. 16 to get the updated COVID-19 vaccine where available while outlining gaps in federal vaccine policy and local workarounds. "For all the rest of us, it's a good idea to go out and get the updated COVID-19 vaccines," Derry said at the Comm County Board of Health meeting.

Derry told the board the county is seeing an end-of-summer surge move into a fall surge, with transmission shifting from adults to school-age children as the school year begins. He said updated vaccines that target current circulating strains are becoming available and are appropriate for people who were not infected in the prior two weeks.

The nut graf: The local health officer said federal decisions have narrowed access at some federal providers even as state and regional actions expand availability, making it important for residents to know where they can receive the updated shots.

Derry outlined three policy developments affecting vaccine access: the U.S. Department of Health and Human Services replaced members of the Advisory Committee on Immunization Practices (ACIP) and the Food and Drug Administration leadership made recommendations that, in practice, limit federal support for broad COVID-19 vaccine access; the federal changes have led some federal providers, including the Department of Veterans Affairs, to follow more restrictive guidance; and the Washington state health officer issued a standing order allowing Washington residents 6 months and older to receive COVID-19 vaccine without an individual prescription.

"Our state health officer... wrote a standing order for all Washington residents to be able to access the vaccine for everyone 6 months and up," Derry said. He added that standing-order recipients can present that order at pharmacies to receive vaccine without a prescription.

Derry said the VA will continue to follow federal guidance and that veterans may see limitations at VA facilities even when vaccines are available elsewhere: "If you're 65 and have no underlying conditions, you're unlikely to be able to get a vaccine at the VA. But you could still get one in Walgreens." He also said Washington's Medicaid will continue to cover COVID-19 vaccines for everyone 6 months and older and that Medicare will continue to cover people 65 and older.

Derry warned of another access limitation: pediatric COVID-19 vaccine doses that come through the federal Children’s Vaccine Program are being held pending the ACIP meeting, delaying distribution to states and local health departments. "We don't currently have pediatric vaccine at the public health department," he said, adding some pharmacies have started to carry pediatric doses but advising callers to check each pharmacy's age limits.

On mitigation, Derry recommended masking in crowded indoor spaces and staying up to date on vaccinations. "You don't have to mask everywhere. You don't have to stay home. But if you're in a crowded space with a lot of other people, it's a good idea to mask," he said.

The health officer also discussed other respiratory threats — influenza, RSV and pertussis — noting limited current activity for flu and RSV in the county but active pertussis transmission: the county has diagnosed 31 pertussis cases so far this year and estimates that represents roughly 10% of actual cases, implying a larger number of unreported infections. "If you're coughing for a long period of time, I would recommend double check, make sure you don't have COVID, and consider seeing a provider to get tested for pertussis," he said.

The meeting included a public comment from resident Ed Bowen, who told the board he is watching vaccine developments and urged that the county consider new vaccine options for older adults. Bowen referenced a new vaccine formulation authorized in August by the FDA and described preliminary data suggesting stronger protection for people 65 and older.

Ending: Derry said the county will continue to provide evidence-based public information and has no plans for mandates, and he encouraged residents to use the state standing order, to check pharmacies for pediatric doses, and to follow masking guidance in crowded indoor settings.

"We are committed to continuing to share accurate evidence with our community so you can make the best decisions about what works for you," Derry said.