A COVID-19 and influenza vaccine on Thursday, Sept. 28, 2023 in Everett, Washington. (Olivia Vanni / The Herald)

A COVID-19 and influenza vaccine on Thursday, Sept. 28, 2023 in Everett, Washington. (Olivia Vanni / The Herald)

As flu season rises, a quarter of Washingtonians are vaccinated

“Flu is just getting started,” Snohomish County’s health officer said. COVID cases were below an “alert threshold,” but it remains the deadliest virus.

EVERETT — Flu season is about to hit its peak, health officials say. But it’s not too late to get vaccinated.

Earlier this month, local hospitals and clinics tightened mask policies to prevent spread of the “big three” respiratory viruses: COVID, influenza and respiratory syncytial virus, or RSV. Snohomish County saw a rate of 27 new COVID cases last week, continuing a trend of low-to-medium transmission in the county. But rates for flu and RSV — the leading cause of infant hospitalization — are rising.

“Flu is just getting started,” county Health Officer James Lewis said. “It will likely peak in the next few weeks.”

Just over 15% of people in Washington have been vaccinated with the latest COVID shot. About 16% of seniors have been vaccinated against RSV. And the flu vaccination rate was 27%, as of Friday.

Snohomish County’s vaccination rates are comparable to those statewide. In general, fewer people have been vaccinated this flu season — lasting from about October to March — than the previous three. Nationwide, adult flu vaccinations are around 8 million doses behind last season’s rate, insurance claim data show. Flu shots in children are down around 5% from last season.

The Centers for Disease Control and Prevention issued a health advisory last week regarding low vaccination rates and a strain on hospitals across the United States. Hospital stays for respiratory virus infections increased nationwide over the past month: 200% for flu, 51% for COVID and 60% for RSV.

In Snohomish County, people with COVID were visiting the emergency department at a rate of 1.7%, below a “transmission alert threshold” of 3%. Flu and RSV emergency visits were above the thresholds for those viruses. The latest flu rates were recorded at 2.2%, compared to an alert threshold of 1%. RSV rates were at 0.9%, with a threshold of 0.3%. These visit rates resemble statewide trends.

Providence Regional Medical Center Everett saw flu and RSV cases double over the past two months, hospital records show.

“Providence Swedish recommends that everyone remain vigilant in protecting themselves and their loved ones from respiratory viruses through vaccination,” spokesperson Erika Hermanson said.

Hospitals in the county have worked at high capacity for years, Lewis said, but it gets worse during flu season. People can reduce hospital strain by getting vaccinated, masking in crowded indoor spaces and limiting emergency visits when possible. Nurse call lines can help people determine if they need to visit the emergency room. The Everett Clinic, Providence and most health insurance companies have nurse lines.

Though COVID case rates in the county have remained lower than last year, the virus remains more deadly than flu or RSV. Since October, 297 people have died from COVID in Washington. Fewer than 10 people in the state have died from the flu or RSV.

“Folks want to say the pandemic is over,” Lewis said. “Whatever terminology you use, the pathogen is still around. It’s a strain on our health care system, and it’s causing mortality.”


The fastest-growing COVID variant in the United States is JN.1, a descendant of the BA.2.86 variant, known as Pirola. JN.1 made up 29% of infections nationwide in the past two weeks, up from 8.8% in November, according to the CDC. This year’s COVID vaccine, designed to protect against variants EG.5 and BA.2.86, is also said to be effective against JN.1.

People may avoid a vaccine because they think it can cause illness, Lewis said. That’s a myth.

“It’s impossible,” he said. “The vaccine does not contain the whole virus and can’t cause disease. But someone may get sick with another virus around the same time they get their vaccine.”

The risk of severe illness and death is much higher for those who are unvaccinated, said Yuan-Po Tu, medical director for disease and outbreak response at Optum Pacific Northwest. In addition, vaccines are better at protecting against severe illness than immunity from a “natural infection,” he said.

This year marks the first available RSV child immunizations and vaccines recommended for pregnant people and seniors. The United States has seen a shortage of child immunizations due to underestimated demand and supply chain issues, Lewis said, but more are on the way.

The flu and COVID vaccines, recommended for everyone 6 and older, are safe to get at the same time. The latest COVID vaccine can cost over $100, but most insurance companies cover it. Free vaccines for adults can be found through the federal Bridge Access Program. Vaccines for Children providers vaccinate under- or uninsured children.

Lewis said testing and treatment resources for COVID at the county and state level have all but dried up.

“They’re really going away unfortunately,” he said. “I recommend people check costs with providers ahead of time.”

People can still apply for free tests from the federal government. Under- or uninsured people can apply for free Paxlovid treatment.

Tu, who worked on the original COVID nasal swabs for testing, said he trusts the accuracy of home tests. The federal Food and Drug Administration has found home tests consistently detect COVID regardless of the variant. Since home tests are less sensitive to the virus than more expensive tests, Tu said, they may show a false negative at the very onset of an infection. If someone thinks they may have COVID but test negative, they should test again.

Amid a recent spread of respiratory illness in dogs, some may be concerned about infecting their pets with COVID. While this can happen, Tu said it’s uncommon.

“We don’t typically test Snoopy,” Tu said. “But Charlie Brown would say, ‘If you’re sick, don’t kiss your dog.’”

Flu season resources:

• State vaccine locator;

• Federal vaccine search by zip code. Text zip code to GETVAX (438829);

Personal vaccination records;

Bridge Access Program for adult vaccines;

Vaccines for Children providers;

Free tests from the federal government;

Paxlovid for the under- or uninsured;

• State testing and treatment resources; and

• County reports on flu, COVID and RSV.

Sydney Jackson: 425-339-3430; sydney.jackson@heraldnet.com; Twitter: @_sydneyajackson.

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