Vax Corner: Preparing for the 2025 Fall/Winter Respiratory Season: COVID-19, Influenza, and RSV Immunizations

By Brian Hunsicker | September 15, 2025

By Maria Huang, MD, FAAP, co-chair, Washington Chapter of the American Academy of Pediatrics (WCAAP) Vaccine Committee

Please see the post from Katelyn Jetelina, PhD, MPH (author of the blog Your Local Epidemiologist), for a concise summary of the 2025 fall vaccine options.

Key Updates:

  • COVID-19 Vaccine Labeling: The FDA has limited the COVID-19 vaccine indication to individuals ≥65 yrs and those 6 months – 64 yrs with at least one high-risk condition for severe COVID-19. This is a significant change from prior years, when the vaccine was authorized for all individuals ≥6 months.
  • Professional Organization Recommendations:
    • Pediatrics (AAP): The AAP recommends COVID-19 vaccination for all children 6 months to < 2yrs, and to high-risk individuals 2 yrs – 18 yrs, and those living with high-risk individuals. The guidance also permits vaccination for children outside these groups if parents/guardians desire protection. See the full 2025 AAP Immunization Schedule.
    • Pregnancy (ACOG): ACOG recommends COVID-19 vaccination at any stage of pregnancy, when planning pregnancy, postpartum, or while lactating.
  • Upcoming Federal Guidance: The CDC’s ACIP will issue updated recommendations in mid-September, later than usual, which may impact insurance coverage and implementation.
  • COVID-19 Vaccine Product Availability for Children:
    • Pfizer COMIRNATY: Ages 5 yrs and older
    • Moderna SPIKEVAX: Ages 6 months and older (the only option for <5 yrs)
    • Novavax NUVAXOVID: Ages 12 yrs and older
    • Note: Pfizer will not have a vaccine for children <5 yrs this season; Moderna will be the sole supplier for this age group, so supply may be limited.
  • WA DOH is issuing a statewide standing order for COVID-19 vaccines. This standing order under the direction of the State Health Officer, authorizes qualified health care professionals to vaccinate individuals aged 6 months and older, including pregnant persons, who do not have contraindications to the vaccine.
  • Washington Apple Health (Medicaid) continues to cover the COVID-19 vaccine for members, including children and pregnant individuals, in line with WA DOH recommendations.
  • While the Office of the Insurance Commissioner cannot require all health plans to cover COVID-19 vaccines for everyone, many health plans are still expected to provide coverage. To confirm whether a vaccine is covered, patients should contact their health plan administrator.

Standing Orders: Refer to the attached resources for standing orders for influenza and nirsevimab (RSV) immunizations.

Acknowledgments: Special thanks to the WA DOH Immunization team, WA State Health Officer, Dr. Tao Kwan-Gett, Immunize.org, AAP, and Dr. Katelyn Jetelina & the YLE team for their contributions and resources.

Posted in News, Public Health