Washington Flu Cases Surge as Federal Vaccine Guidelines Shift

Rising Cases Amid Policy Turmoil

Washington state is grappling with a sharp spike in flu cases just as the federal government makes unprecedented changes to childhood vaccine recommendations. Influenza cases began to increase here in mid-December, coming a few weeks later than in other parts of the country. But by the week of Christmas, flu emergency and outpatient visits had risen sharply — and continue to remain high, worrying state public health leaders especially following the federal government's unprecedented decision this week to drop some U.S. childhood vaccine recommendations.

Flu activity is currently high in Washington, and proving to be particularly severe for older adults and children. By the end of December, the state's most recent update, 22 people in Washington had died from flu complications. The timing couldn't be more concerning for health officials who now face questions about vaccine access and public confidence.

In the week ending Dec. 27, more than half of flu patients at outpatient clinics were children or young adults. Nearly 21% of clinic patients were infants to 4 years old, while about 37% of patients were between 5 and 24 years old. This surge comes as CDC estimates that there have been at least 11,000,000 illnesses, 120,000 hospitalizations, and 5,000 deaths from flu so far this season nationwide.

Federal Vaccine Policy Overhaul

The Centers for Disease Control and Prevention dramatically altered its childhood vaccination schedule this week, reducing universal recommendations from 18 to 11 vaccines. The new schedule separates vaccines into three categories: universally recommended shots, vaccines for high-risk groups and vaccines recommended based on shared clinical decision-making between patients and doctors. Covid and flu shots, for example, now fall into that third category, while infant RSV shots are only recommended for high-risk groups.

The changes come amid a sharp increase in flu cases across the country. The US Centers for Disease Control and Prevention has reported nine pediatric deaths from flu this season. Public health experts warn the timing is particularly troubling given the severity of the current flu season.

"Despite the changes in federal recommendations, which are really not based in any new science or new data, childhood immunization remains a really important part of public health," said Dr. Tao Sheng Kwan-Gett, the state health officer. Washington officials are working to shield residents from the policy confusion while maintaining access to vaccines.

A Dangerous Strain Dominates

This year's flu season is being driven by a particularly concerning variant. A mutated, potentially severe strain of influenza A called H3N2 "subtype K" is spreading worldwide. It's too soon to predict how the 2025-2026 flu season will unfold in the U.S., but experts are already worried it will be harsh due to the emergence of H3N2 subclade K.

The mutated subclade K strain emerged too late for scientists to include it in this season's vaccine, so there may be a mismatch between the H3N2 strain in the current 2025-2026 flu vaccine and the newly dominant subclade K. However, "The flu shot doesn't always prevent you from getting infected, but it does protect against severe symptoms, hospitalization and deaths. The goal of vaccines is to reduce the severity of illness, and reduce the disease impact on our population," says Hopkins.

When examining rates by age for Week 52, the hospitalization rate among all age groups increased (difference of ≥ 0.2). The highest hospital admission rate per 100,000 population was among those 65 years and older (31.6), followed by children aged 0-4 years (10.8), and adults aged 50-64 years age groups (7.7).

Insurance Coverage Remains Stable

Despite the policy changes, families shouldn't face immediate barriers to vaccine access. The Health and Human Services Department said that private and federal insurance programs will continue to cover all vaccines recommended under the CDC's previous childhood immunization schedule. Three major insurers confirmed to NBC News that such coverage would continue through the end of 2026.

The real challenge may be navigating the new system. The changes may require parents to track their children's immunization schedules more closely, rather than relying on reminders from a pediatrician. Parents will need to have more detailed conversations with healthcare providers about which vaccines their children should receive.

As Washington battles its current flu outbreak, the state's approach may serve as a bellwether for how local health departments nationwide will respond to federal policy shifts while protecting public health. The coming weeks will test whether the new system can maintain vaccination rates during a challenging respiratory illness season.