Vaccine Blurbs Issue #232: Get Ready for Respiratory Season!

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Washington State Department of Health | August 29, 2024


Flu and RSV Vaccine Update

Flu vaccine and RSV products for the 2024-2025 season are available to order. COVID-19 vaccine for the 2024-2025 season is expected to be available to order starting Tuesday, September 3, 2024. Childhood flu orders will be processed weekly initially and more frequently once we receive additional allocation. It can take up to two weeks from the approval date to receive your shipment. Please remember to plan mass vaccination clinics later in September and early October when more flu vaccine is available.

Things to Remember:

  • All respiratory products can be ordered at any time - you do not need to wait for your assigned ordering window to place an order for these products
  • Place smaller orders more frequently, rather than large orders 
  • Orders may be reduced to meet allocation and product availability - the goal is to ensure all providers receive some product 
  • Providers are required to carry and offer all ACIP recommended vaccines for the population they serve. 
    • We expect all providers to have flu and COVID-19 vaccine available. (DOH-authorized specialty providers may not be required to carry flu and COVID vaccines) 
    • If small infants are served, nirsevimab is expected to be available. 

Updated WVA 2024-25 Vaccine Assessment Grid

The Washington Vaccine Association’s (WVA) 2024-25 Vaccine Assessment Grid (“Grid”) has been updated with this season's respiratory season products and has been posted to the WVA’s website in both PDF and Excel format.

The 2024-25 Grid lists vaccines and immunizations and their corresponding CPT codes that are part of the dosage-based assessment (DBA) process. All providers, health insurance carriers, and third-party administrators (TPAs) should complete the DBA each time a CVP product is administered to a commercial/private insured child. In effect, the Grid is the equivalent to a fee schedule. The 2024-25 Grid amounts increased from the 2023-24 Grid amounts. Additionally, there are both new CPT codes and NDC changes in addition to the Grid amounts. The new Grid amounts apply to all listed vaccines and immunizations for dates of service after July 1, 2024, and adjudication fee schedules should be updated, accordingly.


2023–2024 mRNA COVID-19 Vaccines No Longer Authorized

As part of FDA’s actions, the 2023–2024 Moderna and Pfizer-BioNTech COVID-19 vaccines are no longer authorized for use in the United States. To minimize the risk of vaccine administration errors, providers should:  

  • Remove all 2023–2024 mRNA COVID-19 vaccines from storage units immediately, even if they are not expired.
  • Return ALL unused 2023–2024 COVID-19 vaccines to the CDC's centralized distributor. Providers must use the category "Spoiled" and the reason "Expired BUD" to reconcile and submit the return of these vaccines in the IIS. Please do not use the "Recall" category.

COVID-19 Vaccine Ordering Expectation

It is an expectation of enrollment in the Childhood Vaccine Program that providers order COVID-19 vaccine and all other routine vaccines recommended by the ACIP (Advisory Committee on Immunization Practice) for the population they serve. This ensures children receiving care at enrolled sites have access to all routinely recommended vaccines in their medical home without needing to be referred elsewhere. This helps avoid missed opportunities to vaccinate especially in rural areas where health care access is limited. Additionally, there is no special equipment needed to store COVID vaccine and it can be ordered in much smaller quantities than when the vaccine was initially available through the COVID Vaccine Program.  

Making COVID vaccines available at enrolled facilities is especially important now because where patients can receive COVID vaccine changed with the commercialization of this vaccine. For example, Medicaid will not pay for vaccines outside of the Childhood Vaccine Program, so Medicaid (and uninsured patients) may be turned away from pharmacies. It is important that CVP providers have vaccine available for their patients as they may not be able to receive vaccines elsewhere.  

To ensure access to COVID vaccine, it needs to be available at all enrolled facilities even if it’s just ordering the minimum quantity (10 doses) so that you have some vaccine on hand. 


Risk Less, Do More Campaign

Health care providers are the most trusted sources of vaccine information, and a strong recommendation to your patients to get vaccinated can help them feel more confident that vaccines can benefit them and keep them doing the things they love. Resources from this campaign provide messaging you can use in patient outreach, guides for having conversations about vaccines, fact sheets you can give to patients who have questions about flu, COVID-19, and RSV vaccines, and resources to share with other health care provider colleagues.

Clinical Corner

2024-25 Influenza Vaccine Recommendations

The Advisory Committee on Immunization Practices (ACIP) published the 2024-25 Influenza Vaccine Recommendations. Here are the main changes:

  • All influenza vaccines marketed in the United States for the 2024-25 season will be trivalent rather than quadrivalent as in past seasons.
  • Solid organ transplant recipients aged 18 through 64 years who are receiving immunosuppressive medications may get either Fluzone high dose inactivated influenza vaccine or Fluad high-dose inactivated influenza vaccine (no preference by ACIP over other flu vaccines). 
  • Recommendations for children 6 months through 8 years who require 2 doses of influenza vaccine for the season remain the same.

Respiratory Illness Resources

As we prepare for the upcoming respiratory illness season, there are many COVID-19, flu, RSV/nirsevimab resources available for health care providers. Below are a few of the resources to bookmark. For clinical immunization questions, please send an email to immunenurses@doh.wa.gov.


COVID-19 Resources

CDC updated the Interim Clinical Considerations for Use of COVID-19 Vaccines in the United States with guidance for use of the 2024–2025 Moderna and Pfizer-BioNTech COVID-19 vaccines. Here’s a summary of the recommendations:

  • FDA authorized 2024–2025 Moderna and Pfizer-BioNTech COVID-19 vaccines. CDC recommends these vaccines in people ages 6 months and older.
  • The 2023–2024 Novavax COVID-19 Vaccine is authorized but no longer available in the United States since all doses have expired. CDC recommendations for use of Novavax COVID-19 Vaccine have been removed from the Interim Clinical Considerations. This page will be updated if FDA approves or authorizes additional 2024–2025 COVID-19 vaccines.

People who are not moderately or severely immunocompromised

Initial vaccination

  • Ages 6 months–4 years: 2 doses of 2024–­2025 Moderna or 3 doses of 2024–­2025 Pfizer-BioNTech
  • Ages 5 years and older: 1 dose of 2024–2025 Moderna or 1 dose of 2024–2025 Pfizer-BioNTech

Received previous doses of a COVID-19 vaccine

  • Ages 6 months–4 years: 1 or 2 doses of 2024–­2025 mRNA vaccine from the same manufacturer as administered for initial vaccination, depending on the vaccine and the number of prior doses
  • Ages 5 years and older: 1 dose of 2024–­2025 Moderna or 1 dose of 2024–­2025 Pfizer-BioNTech

An additional dose of 2024–­2025 COVID-19 vaccine for people ages 65 years and older who are not moderately or severely immunocompromised is NOT currently recommended.

People who are moderately or severely immunocompromised

Initial vaccination

  • Ages 6 months and older: 3 doses of 2024–­2025 Moderna or 3 doses of 2024–­2025 Pfizer-BioNTech

Received previous doses of a COVID-19 vaccine

  • Recommended mRNA vaccine and number of 2024–­2025 doses are based on age and vaccination history

People who are moderately or severely immunocompromised ages 6 months and older may receive 1 or more age-appropriate doses of a 2024–2025 mRNA COVID-19 vaccine.


Nirsevimab and RSV for Adults Resources


Flu vaccine resources


For questions about the immunization schedule, the Immunization Information System forecast, or any other immunization clinical questions, please send an email to ImmuneNurses@doh.wa.gov. Check out the Immunization Training web page for more resources and training opportunities.


Helpful Hints

Remember to check the Vaccine Advertisements page in the IIS! You may be able to find vaccines on allocation like TD, COVID-19, and RSV available for transfer. 

The Vaccine Advertisement function allows you to post vaccines that your clinic may not be able to use for transfer to other Childhood Vaccine Program providers. You can also find doses your clinic may be able to use. This is a simple and easy way to advertise or locate available vaccines when your facility is in need or has a surplus of vaccine. 

For more details, please see our guide on How to Search for and Advertise Vaccines for Transfer

Please note, you will still need approval prior to transferring vaccine. Review the vaccine transfer checklist and FAQs for additional information and guidelines for transferring vaccines.