The Washington State Department of Health (DOH) has released updated immunization schedules for children and adolescents, and for adults.
The recommendations are based on evidence from leading medical and public health organizations.
The updated schedules include Washington-specific guidance for respiratory virus vaccines. The recommendations generally align with guidance released on September 4, 2026, by the West Coast Health Alliance (WCHA).
One important difference: Washington recommends COVID-19 vaccination for all adults age 19 and older, including adults who do not have additional risk factors.
Under chapter 43.70 RCW DOH has the authority to issue immunization recommendations and related guidance to health care providers about who should receive certain vaccines, when they should be given, and under what conditions. Certain insurance coverage and funding under the state's universal Childhood Vaccine Program must be provided for vaccine recommended by DOH.
What changed?
The 2026-2027 DOH immunization schedules include these clinical updates:
- RSV prevention for infants: More high-risk criteria were added for babies ages 8-19 months entering their second RSV season who should get nirsevimab.
- RSV vaccine during pregnancy: The recommended time for maternal RSV vaccination was extended from September through January to September through March 1, based on guidance from the American College of Obstetricians and Gynecologists (ACOG).
- RSV vaccine for adults: An RSV vaccine recommendation was added to immunocompromised adults ages 19 and older.
- Flu vaccine for adults 65 and older: mFlusiva, a recently licensed mRNA flu vaccine, was added to the existing preferred vaccines: Fluzone High-Dise, Fluad adjuvanted, and Flublok recombinant.
- COVID-19 vaccine: 2025-26 COVID-19 vaccine references were removed from the adult schedule, and language was updated to refer more generally to previous doses.
- Meningococcal vaccine: MenACWY recommendations were updated to align with the American Academy of Pediatrics (AAP). The minimum age for the first dose of MenQuadfi is now 6 weeks, instead of 2 years. The indications in the notes section were also updated.
Where to find the current recommendations
Visit the updated Vaccine Recommendations webpage to find:
- Current Washington state immunization recommendations.
- The childhood and adolescent immunization schedule.
- The adult immunization schedule.
- Frequently asked questions.
- Related guidance for health care providers and local health jurisdictions.
Please review the updated schedules and use them when assessing patients and recommending vaccines.
Vaccine access
All vaccines recommended by DOH remain available at no cost for children under age 19 through Washington's Childhood Vaccine Program (CVP) at participating providers.
Uninsured adults ages 19 and older can receive recommended vaccines at no cost through the Adult Vaccine Program (ACP).
For questions about Washington's immunization recommendations, visit Vaccine Recommendations | Washington State Department of Health
Thank you for helping protect Washington communities through vaccination.
Office of Immunization
Washington State Department of Health