Clark County health officials urge flu, COVID and RSV vaccination as respiratory season nears; Washington issues COVID-19 standing order

Dr. Melnick, speaking for Clark County Public Health during the board’s Sept. 24 meeting, briefed the Board of Health on respiratory viruses and vaccine recommendations ahead of the fall-winter season. Officials highlighted low local vaccination coverage last season and urged eligible residents — including pregnant people, older adults and infants via maternal vaccination or monoclonal antibodies — to get protected.

The presentation summarized current surveillance and vaccine guidance: influenza activity is historically variable but can begin as early as October; Clark County reached “active” influenza season when more than 10 percent of tests were positive in previous years. Dr. Melnick said “now is a good time to get the flu vaccination,” and noted influenza vaccine effectiveness varies by season. The county reported that about 27.9 percent of Clark County residents received a flu vaccine last season, and roughly 18 percent received the COVID-19 vaccine.

On RSV, county staff said activity in Clark County was low at the time of the briefing but emphasized the virus’s threat to infants and older adults. The county discussed the new maternal RSV vaccine recommendation and monoclonal antibodies for infants: county presenters said RSV vaccination for pregnant people (a single dose recommended in pregnancy at about 32–36 weeks to protect newborns) and monoclonal antibodies for eligible infants can prevent severe infant hospitalization. County staff cited RSV vaccine effectiveness estimates of about 73–83 percent at preventing hospitalization in older adults and 70–79 percent effectiveness at preventing infant hospitalization when the mother was vaccinated during pregnancy, and said monoclonal antibodies showed roughly 79–82 percent effectiveness in infants during the prior season.

On COVID-19, the county reported a modest increase in emergency-department visits for COVID-like illness and moderate-to-high levels of SARS-CoV-2 detected in wastewater. County staff described the Washington State Department of Health’s standing order for COVID-19 vaccines (issued Dec. 4 on the state health department’s timeline) as a way to expand access: “a standing order ... enables people to go to a pharmacy and not have to provide a prescription from their doctor,” the presenter said, adding the standing order is not a mandate.

County presenters reviewed who is recommended to receive which vaccine: influenza vaccine is recommended for everyone 6 months and older annually; RSV vaccination in pregnancy is recommended for pregnant people in the specified window to protect newborns and for older adults (a single dose is recommended for many in the 75+ age group); COVID-19 vaccination is recommended for everyone 6 months and older under the statewide standing order, with multiple vaccine platforms available (mRNA and protein-based options). The presenter noted a variety of vaccine products are authorized for different age groups and that vaccine supplies were becoming available at pharmacies and health systems.

The briefing also described the West Coast Health Alliance, a regional alignment of Washington, Oregon, California and—subsequently—Hawaii, formed to coordinate immunization guidance. County staff said the alliance aligns recommendations with major medical organizations such as the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians.

Councilors asked staff to make the standing-order guidance and vaccination resources readily available to providers and the public. A county official said the department had already sent an advisory to providers and that the slideshow and data are posted on the Board of Health web page and broadcast channels. Staff said the county will update emergency-department visit and hospitalization data on its respiratory-illness webpage and provide regular updates via social media.

Public comment during and after the presentation included a range of views. Brianne Scarlett, infection-preventionist at Legacy Salmon Creek and a Public Health Advisory Committee member, supported the resolution earlier in the meeting and urged broad prenatal care and vaccination access; Emily Estes, vice chair of the advisory council, described difficulty accessing prenatal care (supporting the earlier resolution). Other public commenters raised safety concerns about vaccines and asked for evidence supporting claims about transmission and vaccine effectiveness; county staff responded that vaccine-effectiveness studies focus on endpoints such as hospitalization and that medical organizations support current recommendations.

County staff offered to return with additional detail on wastewater surveillance methods and with disaggregated vaccine-uptake numbers if board members requested them. The presentation closed with a reminder of non-pharmaceutical actions — staying home when sick, masking in crowded indoor spaces as appropriate, hand hygiene and keeping sick children home — and that the county will report respiratory illness metrics on its website.