🕷️ Crawler Inspector

URL Lookup

Direct Parameter Lookup

Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 175 (from laksa044)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa175.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://health.hawaii.gov/docd/disease-types/respiratory-viruses/\')), getAhrefsUnparsedNoserviceFromURL(\'https://health.hawaii.gov/docd/disease-types/respiratory-viruses/\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/health.hawaii.gov\/docd\/disease-types\/respiratory-viruses\/","crawl_time":1775881824,"first_indexed_time":1555915182,"http_code":200,"src_unparsed":"gov,hawaii!health,\/docd\/disease-types\/respiratory-viruses\/ s443","src_root_hash":"17892012007036080175","history_drop_reason":null,"meta_title":"Respiratory Viruses | Disease Outbreak Control Division","meta_descriptions":[],"attrs_boilerpipe_text":"Report a Case\nDisease Reporting Line:\n(808) 586-4586\nAs part of the\nWest Coast Health Alliance (WCHA)\n, Hawaii Department of Health (DOH) issued immunization recommendations for the 2025–2026 respiratory virus season. This page aligns with these immunization recommendations.\nView Immunization Recommendations\nImmunization Recommendations\nCOVID-19\nCOVID-19 Vaccine Timing 2025-26 – Routine Schedule (\nView PDF\n)\nPopulations at Increased Risk Recommended for Vaccination Against COVID-19\nA. Due to Population Characteristics\nDOH especially recommends vaccination against COVID-19 for the following persons:\nThose with increased occupational or residential risks:\nHealthcare workers\nResidents of long-term care facilities or other congregate settings\nThose with household contacts who are at high risk for severe COVID-19\nThose who have never been vaccinated against COVID-19\nInfants and children 6 through 23 months of age\nAdults over 65 years of age\nB. Due to Medical Conditions That Increase the Risk of Severe COVID-19\nDOH especially recommends vaccination against COVID-19 for persons with underlying medical conditions that increase their risk of severe COVID-19 disease. These tables provide examples of such underlying medical conditions but are not meant to be complete lists.\nChildren and Adolescents – in accordance with\nAAP guidance\nCategory\nExamples\nBlood diseases\nSickle cell disease\nCancers or other immunosuppressive conditions\nLeukemia, Receipt of immunosuppressive therapy, Primary immunodeficiency, HIV infection, Transplant Receipt (hematopoietic cell or solid organ)\nCardiovascular diseases\nCongenital heart disease\nChronic lung diseases\nAsthma or reactive airway disease, Chronic lung disease of prematurity, Compromised respiratory function, e.g., airway abnormality, tracheostomy, or ventilator dependent)\nGastrointestinal or liver disorders\nFeeding tube dependent, Inflammatory bowel disease, Chronic liver disease\nMetabolic disorders\nDiabetes mellitus\nNeurologic or neurodevelopmental disorders\nCerebral palsy, Epilepsy. Intellectual developmental disorder. Compromised mobility (e.g., wheelchair dependent)\nObesity\nPregnancy\nRheumatologic or autoimmune diseases\nSystemic lupus erythematosus, Juvenile idiopathic arthritis\nAdults\nCategory\nExamples\nCancers or other immunosuppressive conditions\nHematologic malignancies, Receipt of immunosuppressive therapy, Primary immunodeficiency, HIV infection\nTransplant Receipt (hematopoietic cell or solid organ)\nCardiovascular disease\nHypertension, coronary artery disease, cardiomyopathies, congestive heart failure, atrial fibrillation, aortic stenosis\nChronic kidney disease\nChronic kidney disease at any stage\nChronic lung disease\nAsthma, bronchiectasis, COPD, cystic fibrosis, OSA, interstitial lung disease, pulmonary embolism, pulmonary hypertension, oxygen dependency\nChronic metabolic disease\nDiabetes mellitus, type 1 or type 2\nDisabilities\nAny type of disability including but not limited to ADHD, intellectual and developmental disabilities, learning disabilities, compromised mobility\nGastrointestinal and liver disease\nAlcoholic liver disease, non-alcoholic fatty liver disease, cirrhosis, autoimmune hepatitis, ulcerative colitis, Crohn’s disease, chronic liver disease\nHematologic disease\nSickle cell disease, thalassemia\nMental Health\nMood disorders including depression and schizophrenia spectrum\nNeurologic disorders\nDementia, Alzheimer’s disease, Parkinson’s disease, seizure disorders, cerebral palsy, cerebrovascular disease, spinal cord injury\nOverweight and obesity\nPhysical inactivity\nPregnancy\nPregnancy, postpartum, lactating, or planning pregnancy\nRheumatologic and autoimmune disorders\nRheumatoid arthritis, lupus erythematosus, vasculitis\nSmoking\nCurrent or former\nSubstance use disorders\nRespiratory Syncytial Virus (RSV)\nDOH recommends year-round RSV immunization in the State of Hawaii for all infants through either maternal RSV vaccination or administration of long-acting RSV monoclonal antibody (nirsevimab or clesrovimab) to the infant.\nRSV immunization guidance:\nChildren\nAll younger than 8 months*\nAll 8-19 months with risk factors\nRefer to the\nAmerican Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule\nfor Ages 18 Years or Younger\nPregnancy\nBetween 32-36 weeks gestation*\nAdults\nAll 75 years and older**\nAll 50-74 years with risk factors\n*\nProtect infants with either prenatal RSV vaccine or infant dose of RSV monoclonal antibody (nirsevimab or clesrovimab)\n**\nAdult RSV vaccination recommendations are currently for a single lifetime dose. Those who have previously received a dose do not need a second dose\nInfluenza (Flu)\nInfluenza immunization guidance:\nChildren\nAll 6 months and older\nRefer to the\nAmerican Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule\nfor Ages 18 Years or Younger\nPregnancy\nAll who are planning pregnancy, pregnant, postpartum or lactating\nAdults\nAll adults\nStaying Safe from Respiratory Viruses\nRespiratory viruses circulate throughout the year in Hawaii. They can cause symptoms like runny nose, cough, and sometimes fever, often thought of as “flu-like” or “common cold” symptoms. They can also cause severe disease in some people. We can all help prevent the spread of respiratory viruses.\n\nStay up to date on your flu, COVID-19, and RSV immunizations.\n\nStay home until fever-free for 24 hours without using fever reducing medication AND other symptoms are mild and improving.\n\nWearing a mask when you are indoors with other people is a precaution you can take at any time. Wearing a mask helps protect you and those around you.\n\nCover your coughs and sneezes, clean frequently touched surfaces, and wash your hands often.\n\nOpen doors or windows to bring in fresh outside air, purify indoor air or gather outdoors.\n\nIf you have cold or flu symptoms, and are at higher risk for severe disease, knowing what illness you have can help get you the right treatment. Antiviral medications for COVID-19 and flu work best when taken as soon as possible and are recommended for those at higher risk.\nRespiratory Virus Q & A\nShould I wear a mask?\nWearing a mask is usually a personal decision (it may be required in some settings). Here are some things that can help you decide whether to wear a mask:\nWearing a well-fitted mask that fully covers your nose and mouth helps protect you from breathing in other people’s germs.\nWearing a mask helps protect others from breathing in your germs.\nYou can be contagious before you feel sick. Wearing a mask helps prevent accidental spread to others even when you feel well.\nWearing a mask helps protect someone else’s loved one, who may be at\nhigher risk of severe disease\n.\nWhen should I wear a mask?\nHere are some circumstances in which a mask is a good idea:\nWhen you are around others if you have cold or flu symptoms (e.g., runny nose, sore throat, cough) or are recovering from respiratory illness.\nIf you test positive for COVID-19, wear a mask for 5 days after your fever is gone and you start to feel better. Masking for 10 days after a positive COVID-19 test is recommended if you have regular contact with someone who is at higher-risk.\nIf you or someone you live with, care for, or spend time with is at higher-risk, consider wearing a mask in crowded indoor spaces or when you may not be able to maintain distance from others.\nIf you were exposed to someone with cold and flu symptoms, consider masking if you are in a crowded indoor space or if you are in contact with someone who is higher risk.\nEveryone should consider masking in indoor public spaces when respiratory viral disease rates are high in your\ncommunity\n.\nWhat mask should I wear?\nThe most effective mask is one you can wear comfortably and correctly:\nChoose the most protective one that fully covers your nose and mouth and that you can comfortably wear for extended periods of time.\nThe\ntype of mask\nand how well it fits your face affects how well it reduces the number of germs you breathe in or out.\nN95, KN95, or KF94 masks can be purchased at drugstores, hardware stores, and online. They offer more protection than surgical masks or cloth face covering.\nIs there anyone who should not wear a mask?\nMasks are not recommended for:\nChildren under 2 years\nPeople with sensory, cognitive, or behavioral issues for whom wearing a mask might be difficult\nAnyone having trouble breathing or who is unconscious, incapacitated, or unable to remove a mask without help\nWhat if I’m at higher risk for severe disease?\nThose at higher risk for severe disease (including kūpuna, those with weakened immune systems, and pregnant people) can take additional steps to protect themselves.\nGet vaccinated!\nSome vaccinations have specific guidelines for people in high risk groups.\nVaccine\nPopulations with specialized guidelines\nCOVID-19\nAll 2-18 years with risk factors or never vaccinated against COVID-19\nAdults younger than 65 with risk factors, and all 65 years and older\nImmunocompromised people\nPregnant people\nRSV\nAdults 50-74 years with risk factors and all 75 years and older\nInfants younger than 8 months and all 8-19 months with risk factors\nPregnant people between 32-36 weeks of gestation\nInfluenza\nAdults 65 and older\nChildren aged 6 months through 8 years receiving the flu vaccine for the first time\nPregnant people\nWear a mask\nany time you are in crowded indoor spaces, especially when you cannot maintain physical distancing.\nIf you start having symptoms,\nget tested.\nKnowing what illness you have can help get you the right treatment. If you are sick with COVID-19 or influenza, antiviral treatments can help you feel better faster and reduce the risk of complications. Antiviral medications for COVID-19 and influenza work best when taken as soon as possible.\nWho is at higher risk for severe disease?\nKūpuna\nOlder adults are at higher risk for hospitalization, complications, and death from many respiratory viral diseases, including COVID-19, influenza, and RSV.\nYoung keiki\nInfants under 6 months of age have similar COVID-19 hospitalization rates to older adults.\nChildren under 5 years old, and especially infants, are at higher risk of hospitalization or complications from\ninfluenza\nand\nRSV\n.\nPeople with weakened immune systems\nPeople with weakened immune systems (also referred to as immunocompromised) may not be able to fight off infections as well as others and may not have developed strong immunity against infections from vaccinations.\nThis group includes, but is not limited to, people undergoing cancer treatment, people who have received organ transplants, and people with chronic immune deficiencies.\nPeople with certain medical conditions such as:\nCancer\nDiabetes\nChronic lung disease\nHeart disease\nDisabilities that increase risk\nPeople who live in congregate facilities, such as:\nSkilled nursing facility\nCorrectional facility\nShelter\nPregnant people\nPregnancy can cause changes to the immune system, heart, and lungs, placing pregnant people at higher risk for severe disease.\nWhat if I live with, care for, or have regular contact with someone who is at high risk for severe disease? How can I protect them?\nTake preventive measures: Get vaccinated, practice good hygiene, take steps for cleaner air, and wear a mask when you are in indoor crowded places or unable to physically distance.\n \nIf you have been exposed to someone with cold and flu symptoms:\nWear a well-fitted mask when you are indoors with the higher risk person. It can take as long as 4-6 days for symptoms to develop after an exposure, so it’s a good idea to wear a mask for at least that long after you’ve been exposed.\nIf you develop cold and flu symptoms:\nStay away from those at high risk.  If you’re unable to avoid higher risk individuals, wear a well-fitted mask, wash your hands frequently, and open doors and windows to increase air flow as much as possible. Continue to wear a mask for at least 5 days after symptoms are improving and you have not had a fever for 24 hours without use of a fever-lowering medication. Take a COVID-19 test.\nIf you test positive for COVID-19:\nFollow all of the above guidelines for a\nfull 10 days\n. You can stop after 5 days\nIF\nyou test negative on two home tests in a row taken at least 24 hours apart.\nIs RSV immunization for you?\nInfants should receive an RSV monoclonal antibody if younger than 8 months old and their mother was not vaccinated during that pregnancy\nPregnant people between 32-36 weeks gestation to protect their newborn. The RSV vaccine is given only once, so for future pregnancies the infant can receive an RSV monoclonal antibody\nAdults 75+, and adults 50-74 years with risk factors such as chronic heart or lung disease, a weakened immune system, other medical conditions, or living in a nursing home\nMore Information on Specific Respiratory Viruses\nHawaiʻi Reports and Dashboards","attrs_markdown":"- [For Providers](https:\/\/health.hawaii.gov\/docd\/for-healthcare-providers\/news-updates\/)\n- [Contact Us](https:\/\/health.hawaii.gov\/docd\/contact-us\/)\n- [Archive](https:\/\/health.hawaii.gov\/docd\/advisories\/)\n\n[![SOH DOH logos](https:\/\/health.hawaii.gov\/docd\/files\/2021\/11\/SOH-DOH-logos.png)](https:\/\/health.hawaii.gov\/docd\/)\n\nState of Hawaii, Department of Health \\| Ka ʻOihana Olakino  \n*Disease Outbreak Control Division*\n\n- [Home](https:\/\/health.hawaii.gov\/docd\/)\n- [Vaccines & Immunizations](https:\/\/health.hawaii.gov\/docd\/vaccines-immunizations\/)\n  - [Recommendations by Age](https:\/\/health.hawaii.gov\/docd\/vaccines-immunizations\/recommendations-by-age\/)\n    - [Infants & Toddlers](https:\/\/health.hawaii.gov\/docd\/vaccines-immunizations\/recommendations-by-age\/infants-toddlers\/)\n    - [Preteens & Adolescents](https:\/\/health.hawaii.gov\/docd\/vaccines-immunizations\/recommendations-by-age\/preteens-adolescents\/)\n    - [Adults](https:\/\/health.hawaii.gov\/docd\/vaccines-immunizations\/recommendations-by-age\/adults\/)\n  - [School Health Requirements](https:\/\/health.hawaii.gov\/docd\/vaccines-immunizations\/school-health-requirements\/sy-20-21\/)\n  - [Vaccine-Preventable](https:\/\/health.hawaii.gov\/docd\/disease-types\/vaccine-preventable\/)\n  - [Seasonal Flu](https:\/\/health.hawaii.gov\/docd\/disease_listing\/influenza-flu\/)\n  - [Traveler’s Health](https:\/\/health.hawaii.gov\/docd\/resources\/travelers-health\/)\n  - [Hawaii State Immunization System (HiSIS)](https:\/\/health.hawaii.gov\/docd\/about-us\/programs\/hawaii-immunization-information-system-hisis\/)\n  - [Stop Flu at School (SFAS)](https:\/\/health.hawaii.gov\/docd\/about-us\/programs\/stop-flu-at-school\/)\n  - [Vaccines for Children (VFC) Program](https:\/\/health.hawaii.gov\/docd\/vaccines-immunizations\/vaccines-for-children-vfc-program\/)\n- [Diseases](https:\/\/health.hawaii.gov\/docd\/diseases-a-z\/)\n  - [Diseases A-Z](https:\/\/health.hawaii.gov\/docd\/diseases-a-z\/)\n  - [Disease Types](https:\/\/health.hawaii.gov\/docd\/disease-types\/)\n    - [Animal-Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/animal-transmitted\/)\n    - [Bioterrorism-Related](https:\/\/health.hawaii.gov\/docd\/disease-types\/bioterrorism-related\/)\n    - [Bloodborne](https:\/\/health.hawaii.gov\/docd\/disease-types\/bloodborne\/)\n    - [Common Infections](https:\/\/health.hawaii.gov\/docd\/disease-types\/community-infections\/)\n    - [Environmental](https:\/\/health.hawaii.gov\/docd\/disease-types\/environmental\/)\n    - [Foodborne](https:\/\/health.hawaii.gov\/docd\/disease-types\/foodborne\/)\n    - [Healthcare & Hospital-Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/healthcare-hospital-transmitted\/)\n    - [Influenza](https:\/\/health.hawaii.gov\/docd\/disease-types\/influenza\/)\n    - [Mosquito-Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/mosquito-transmitted\/)\n    - [Pest-Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/pest-transmitted\/)\n    - [Recreation-Related](https:\/\/health.hawaii.gov\/docd\/disease-types\/recreation-related\/)\n    - [Respiratory Viruses](https:\/\/health.hawaii.gov\/docd\/disease-types\/respiratory-viruses\/)\n    - [Sexually Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/sexually-transmitted\/)\n    - [Travel-Related](https:\/\/health.hawaii.gov\/docd\/disease-types\/travel-related\/)\n    - [Vaccine-Preventable](https:\/\/health.hawaii.gov\/docd\/disease-types\/vaccine-preventable\/)\n    - [Waterborne](https:\/\/health.hawaii.gov\/docd\/disease-types\/waterborne\/)\n- [Prevention](https:\/\/health.hawaii.gov\/docd\/prevention\/)\n  - [Vaccines](https:\/\/health.hawaii.gov\/docd\/prevention\/vaccines\/)\n  - [Handwashing and Hand Hygiene](https:\/\/health.hawaii.gov\/docd\/prevention\/handwashing-and-hand-hygiene\/)\n  - [Using Antibiotics Wisely](https:\/\/health.hawaii.gov\/docd\/prevention\/using-antibiotics-wisely\/)\n  - [Mosquito Bite Prevention](https:\/\/health.hawaii.gov\/docd\/prevention\/mosquito-bite-prevention\/)\n  - [Traveler’s Health](https:\/\/health.hawaii.gov\/docd\/resources\/travelers-health\/)\n  - [Natural Disasters and Pandemics](https:\/\/health.hawaii.gov\/docd\/prevention\/natural-disasters\/)\n  - [Bioterrorism, Chemical, Radiological, and Nuclear Emergencies](https:\/\/health.hawaii.gov\/docd\/prevention\/bioterrorism\/)\n- [Reporting an Illness](https:\/\/health.hawaii.gov\/docd\/reporting-an-illness\/restaurant-related\/)\n  - [Restaurant-Related](https:\/\/health.hawaii.gov\/docd\/reporting-an-illness\/restaurant-related\/)\n  - [Individual](https:\/\/health.hawaii.gov\/docd\/reporting-an-illness\/individual\/)\n  - [School-Related](https:\/\/health.hawaii.gov\/docd\/reporting-an-illness\/school-related\/)\n  - [Long-Term Care-Related](https:\/\/health.hawaii.gov\/docd\/reporting-an-illness\/long-term-care-related\/)\n  - [For Healthcare Providers](https:\/\/health.hawaii.gov\/docd\/for-healthcare-providers\/reporting-an-illness-for-healthcare-providers\/)\n- [Resources](https:\/\/health.hawaii.gov\/docd\/resources\/)\n  - [Traveler’s Health](https:\/\/health.hawaii.gov\/docd\/resources\/travelers-health\/)\n  - [Wastewater Surveillance](https:\/\/health.hawaii.gov\/docd\/wastewater-surveillance\/)\n  - [Disaster Preparedness](https:\/\/health.hawaii.gov\/docd\/resources\/disaster-preparedness\/)\n  - [Reports](https:\/\/health.hawaii.gov\/docd\/resources\/reports\/)\n    - [School Assessment Forms and Instructions](https:\/\/health.hawaii.gov\/docd\/resources\/reports\/school-assessment-reports\/)\n    - [Influenza and Respiratory Reports](https:\/\/health.hawaii.gov\/docd\/resources\/reports\/influenza-reports\/)\n    - [Healthcare Associated Infections (HAIs) Reports](https:\/\/health.hawaii.gov\/docd\/resources\/reports\/healthcare-associated-infections-hais-reports\/)\n    - [Summary of Reported Cases of Notifiable Diseases](https:\/\/health.hawaii.gov\/docd\/resources\/reports\/summary-of-reported-cases-of-notifiable-diseases\/)\n  - [Conferences](https:\/\/health.hawaii.gov\/docd\/resources\/conferences\/)\n  - [Print Materials](https:\/\/health.hawaii.gov\/docd\/resources\/print-materials\/)\n  - [Video\/Digital Materials](https:\/\/health.hawaii.gov\/docd\/resources\/videodigital-materials\/)\n  - [Disease Factsheets](https:\/\/health.hawaii.gov\/docd\/resources\/disease-fact-sheets\/)\n  - [CDC National Notifiable Diseases Surveillance System (NNDSS)](https:\/\/www.cdc.gov\/nndss)\n  - [News Archive](https:\/\/health.hawaii.gov\/docd\/news\/)\n- [Lab Reporting](https:\/\/health.hawaii.gov\/docd\/for-healthcare-providers\/reporting-an-illness-for-healthcare-providers\/reportable-diseases-laboratory\/)\n- [Schools](https:\/\/health.hawaii.gov\/docd\/schools\/)\n  - [Reporting COVID-19, Influenza, and Gastrointestinal Illness](https:\/\/health.hawaii.gov\/docd\/reporting-an-illness\/school-related\/)\n  - [Outbreak Reporting Tool for DOE Schools](https:\/\/health.hawaii.gov\/docd\/doe-ort\/)\n  - [Outbreak Reporting Tool for Private, Independent, and Charter Schools](https:\/\/health.hawaii.gov\/docd\/ort\/)\n  - [COVID-19 School Guidance](https:\/\/health.hawaii.gov\/coronavirusdisease2019\/resources\/school-guidance\/)\n- [Respiratory Viruses](https:\/\/health.hawaii.gov\/docd\/disease-types\/respiratory-viruses\/)\n  - [Respiratory Virus Guidance](https:\/\/health.hawaii.gov\/docd\/disease-types\/respiratory-viruses\/)\n  - [COVID-19](https:\/\/health.hawaii.gov\/coronavirusdisease2019\/)\n- [Mpox](https:\/\/health.hawaii.gov\/docd\/disease_listing\/mpox\/)\n- [WCHA](https:\/\/health.hawaii.gov\/docd\/wcha\/)\n- [DOH HOME](https:\/\/health.hawaii.gov\/)\n\n# Respiratory Viruses\n- [Diseases A-Z](https:\/\/health.hawaii.gov\/docd\/diseases-a-z\/)\n- [Disease Types](https:\/\/health.hawaii.gov\/docd\/disease-types\/)\n  - [Animal-Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/animal-transmitted\/)\n  - [Bioterrorism-Related](https:\/\/health.hawaii.gov\/docd\/disease-types\/bioterrorism-related\/)\n  - [Bloodborne](https:\/\/health.hawaii.gov\/docd\/disease-types\/bloodborne\/)\n  - [Common Infections](https:\/\/health.hawaii.gov\/docd\/disease-types\/community-infections\/)\n  - [Environmental](https:\/\/health.hawaii.gov\/docd\/disease-types\/environmental\/)\n  - [Foodborne](https:\/\/health.hawaii.gov\/docd\/disease-types\/foodborne\/)\n  - [Healthcare & Hospital-Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/healthcare-hospital-transmitted\/)\n  - [Influenza](https:\/\/health.hawaii.gov\/docd\/disease-types\/influenza\/)\n  - [Mosquito-Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/mosquito-transmitted\/)\n  - [Pest-Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/pest-transmitted\/)\n  - [Recreation-Related](https:\/\/health.hawaii.gov\/docd\/disease-types\/recreation-related\/)\n  - [Respiratory Viruses](https:\/\/health.hawaii.gov\/docd\/disease-types\/respiratory-viruses\/)\n  - [Sexually Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/sexually-transmitted\/)\n  - [Travel-Related](https:\/\/health.hawaii.gov\/docd\/disease-types\/travel-related\/)\n  - [Vaccine-Preventable](https:\/\/health.hawaii.gov\/docd\/disease-types\/vaccine-preventable\/)\n  - [Waterborne](https:\/\/health.hawaii.gov\/docd\/disease-types\/waterborne\/)\n\n- [Diseases A-Z](https:\/\/health.hawaii.gov\/docd\/diseases-a-z\/)\n- [Disease Types](https:\/\/health.hawaii.gov\/docd\/disease-types\/)\n  - [Animal-Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/animal-transmitted\/)\n  - [Bioterrorism-Related](https:\/\/health.hawaii.gov\/docd\/disease-types\/bioterrorism-related\/)\n  - [Bloodborne](https:\/\/health.hawaii.gov\/docd\/disease-types\/bloodborne\/)\n  - [Common Infections](https:\/\/health.hawaii.gov\/docd\/disease-types\/community-infections\/)\n  - [Environmental](https:\/\/health.hawaii.gov\/docd\/disease-types\/environmental\/)\n  - [Foodborne](https:\/\/health.hawaii.gov\/docd\/disease-types\/foodborne\/)\n  - [Healthcare & Hospital-Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/healthcare-hospital-transmitted\/)\n  - [Influenza](https:\/\/health.hawaii.gov\/docd\/disease-types\/influenza\/)\n  - [Mosquito-Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/mosquito-transmitted\/)\n  - [Pest-Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/pest-transmitted\/)\n  - [Recreation-Related](https:\/\/health.hawaii.gov\/docd\/disease-types\/recreation-related\/)\n  - [Respiratory Viruses](https:\/\/health.hawaii.gov\/docd\/disease-types\/respiratory-viruses\/)\n  - [Sexually Transmitted](https:\/\/health.hawaii.gov\/docd\/disease-types\/sexually-transmitted\/)\n  - [Travel-Related](https:\/\/health.hawaii.gov\/docd\/disease-types\/travel-related\/)\n  - [Vaccine-Preventable](https:\/\/health.hawaii.gov\/docd\/disease-types\/vaccine-preventable\/)\n  - [Waterborne](https:\/\/health.hawaii.gov\/docd\/disease-types\/waterborne\/)\n\n## Report a Case\n**Disease Reporting Line:**  \n(808) 586-4586\n\nAs part of the [**West Coast Health Alliance (WCHA)**](https:\/\/health.hawaii.gov\/docd\/wcha\/), Hawaii Department of Health (DOH) issued immunization recommendations for the 2025–2026 respiratory virus season. This page aligns with these immunization recommendations.\n\n[**View Immunization Recommendations**](https:\/\/health.hawaii.gov\/docd\/disease-types\/respiratory-viruses\/#imm_rec)\n\n## Immunization Recommendations\n![](https:\/\/health.hawaii.gov\/docd\/files\/2025\/09\/consensus_WCHA_2025-2026_respiratory_virus_season_immunization_recommendations.jpg)\n\n### COVID-19\n**COVID-19 Vaccine Timing 2025-26 – Routine Schedule ([View PDF](https:\/\/health.hawaii.gov\/docd\/files\/2025\/09\/COVID-19-Vaccine-Timing-2025-26-Routine-Schedule.pdf))**\n\n**Populations at Increased Risk Recommended for Vaccination Against COVID-19**\n\n***A. Due to Population Characteristics***\n\nDOH especially recommends vaccination against COVID-19 for the following persons:\n\n- Those with increased occupational or residential risks:\n  - Healthcare workers\n  - Residents of long-term care facilities or other congregate settings\n  - Those with household contacts who are at high risk for severe COVID-19\n- Those who have never been vaccinated against COVID-19\n- Infants and children 6 through 23 months of age\n- Adults over 65 years of age\n\n***B. Due to Medical Conditions That Increase the Risk of Severe COVID-19***\n\nDOH especially recommends vaccination against COVID-19 for persons with underlying medical conditions that increase their risk of severe COVID-19 disease. These tables provide examples of such underlying medical conditions but are not meant to be complete lists.\n\n**Children and Adolescents – in accordance with [AAP guidance](https:\/\/publications.aap.org\/pediatrics\/article\/doi\/10.1542\/peds.2025-073924\/203222\/Recommendations-for-COVID-19-Vaccines-in-Infants)**\n\n| Category | Examples |\n|---|---|\n| Blood diseases | Sickle cell disease |\n| Cancers or other immunosuppressive conditions | Leukemia, Receipt of immunosuppressive therapy, Primary immunodeficiency, HIV infection, Transplant Receipt (hematopoietic cell or solid organ) |\n| Cardiovascular diseases | Congenital heart disease |\n| Chronic lung diseases | Asthma or reactive airway disease, Chronic lung disease of prematurity, Compromised respiratory function, e.g., airway abnormality, tracheostomy, or ventilator dependent) |\n| Gastrointestinal or liver disorders | Feeding tube dependent, Inflammatory bowel disease, Chronic liver disease |\n| Metabolic disorders | Diabetes mellitus |\n| Neurologic or neurodevelopmental disorders | Cerebral palsy, Epilepsy. Intellectual developmental disorder. Compromised mobility (e.g., wheelchair dependent) |\n| Obesity |   |\n| Pregnancy |   |\n| Rheumatologic or autoimmune diseases | Systemic lupus erythematosus, Juvenile idiopathic arthritis |\n\n**Adults**\n\n| Category | Examples |\n|---|---|\n| Cancers or other immunosuppressive conditions | Hematologic malignancies, Receipt of immunosuppressive therapy, Primary immunodeficiency, HIV infection  Transplant Receipt (hematopoietic cell or solid organ) |\n| Cardiovascular disease | Hypertension, coronary artery disease, cardiomyopathies, congestive heart failure, atrial fibrillation, aortic stenosis |\n| Chronic kidney disease | Chronic kidney disease at any stage |\n| Chronic lung disease | Asthma, bronchiectasis, COPD, cystic fibrosis, OSA, interstitial lung disease, pulmonary embolism, pulmonary hypertension, oxygen dependency |\n| Chronic metabolic disease | Diabetes mellitus, type 1 or type 2 |\n| Disabilities | Any type of disability including but not limited to ADHD, intellectual and developmental disabilities, learning disabilities, compromised mobility |\n| Gastrointestinal and liver disease | Alcoholic liver disease, non-alcoholic fatty liver disease, cirrhosis, autoimmune hepatitis, ulcerative colitis, Crohn’s disease, chronic liver disease |\n| Hematologic disease | Sickle cell disease, thalassemia |\n| Mental Health | Mood disorders including depression and schizophrenia spectrum |\n| Neurologic disorders | Dementia, Alzheimer’s disease, Parkinson’s disease, seizure disorders, cerebral palsy, cerebrovascular disease, spinal cord injury |\n| Overweight and obesity |   |\n| Physical inactivity |   |\n| Pregnancy | Pregnancy, postpartum, lactating, or planning pregnancy |\n| Rheumatologic and autoimmune disorders | Rheumatoid arthritis, lupus erythematosus, vasculitis |\n| Smoking | Current or former |\n| Substance use disorders |   |\n### Respiratory Syncytial Virus (RSV)\nDOH recommends year-round RSV immunization in the State of Hawaii for all infants through either maternal RSV vaccination or administration of long-acting RSV monoclonal antibody (nirsevimab or clesrovimab) to the infant.\n\n#### **RSV immunization guidance:**\n**Children**\n\n- All younger than 8 months\\*\n- All 8-19 months with risk factors\n\nRefer to the [American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule](https:\/\/downloads.aap.org\/AAP\/PDF\/AAP-Immunization-Schedule.pdf) for Ages 18 Years or Younger\n\n**Pregnancy**\n\n- Between 32-36 weeks gestation\\*\n\n**Adults**\n\n- All 75 years and older\\*\\*\n- All 50-74 years with risk factors\n\n**\\****Protect infants with either prenatal RSV vaccine or infant dose of RSV monoclonal antibody (nirsevimab or clesrovimab)*\n\n**\\*\\****Adult RSV vaccination recommendations are currently for a single lifetime dose. Those who have previously received a dose do not need a second dose*\n### Influenza (Flu)\n#### **Influenza immunization guidance:**\n**Children**\n\n- All 6 months and older\n\nRefer to the [American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule](https:\/\/downloads.aap.org\/AAP\/PDF\/AAP-Immunization-Schedule.pdf) for Ages 18 Years or Younger\n\n**Pregnancy**\n\n- All who are planning pregnancy, pregnant, postpartum or lactating\n\n**Adults**\n\n- All adults\n\n## Staying Safe from Respiratory Viruses\nRespiratory viruses circulate throughout the year in Hawaii. They can cause symptoms like runny nose, cough, and sometimes fever, often thought of as “flu-like” or “common cold” symptoms. They can also cause severe disease in some people. We can all help prevent the spread of respiratory viruses.\n\n\n\n### Get immunized.\nStay up to date on your flu, COVID-19, and RSV immunizations.\n\n\n\n### Stay home when sick.\nStay home until fever-free for 24 hours without using fever reducing medication AND other symptoms are mild and improving.\n\n\n\n### Wear a mask.\nWearing a mask when you are indoors with other people is a precaution you can take at any time. Wearing a mask helps protect you and those around you.\n\n\n\n### Practice good hygiene.\nCover your coughs and sneezes, clean frequently touched surfaces, and wash your hands often.\n\n\n\n### Take steps for cleaner air.\nOpen doors or windows to bring in fresh outside air, purify indoor air or gather outdoors.\n\n\n\n### Test and treat.\nIf you have cold or flu symptoms, and are at higher risk for severe disease, knowing what illness you have can help get you the right treatment. Antiviral medications for COVID-19 and flu work best when taken as soon as possible and are recommended for those at higher risk.\n\n### Additional Resources:\n- [**Preventing Respiratory Illness \\| CDC**](https:\/\/www.cdc.gov\/respiratory-viruses\/prevention\/index.html)\n- [**Respiratory Virus Season**](https:\/\/health.hawaii.gov\/docd\/wcha\/)\n- [**All About the AAP Recommended Immunization Schedule \\| HealthyChildren.org**](https:\/\/www.healthychildren.org\/English\/safety-prevention\/immunizations\/Pages\/Recommended-Immunization-Schedules.aspx)\n- [**Find COVID19, Influenza, RSV vaccine locations near you \\| VaccineFinder.org**](http:\/\/vaccinefinder.org\/)\n- [**Health Centers Here for You \\| Hawaii Primary Care Association**](https:\/\/www.hawaiipca.net\/health-centers-here-for-you)\n- [**Germs Can Live in the Respiratory System (PDF)**](https:\/\/www.cdc.gov\/project-firstline\/media\/pdfs\/Healthcare-Germs-Body-RespiratorySystem-508.pdf)\n\n## Respiratory Virus Q & A\n### Should I wear a mask?\n- Wearing a mask is usually a personal decision (it may be required in some settings). Here are some things that can help you decide whether to wear a mask:\n  - Wearing a well-fitted mask that fully covers your nose and mouth helps protect you from breathing in other people’s germs.\n  - Wearing a mask helps protect others from breathing in your germs.\n  - You can be contagious before you feel sick. Wearing a mask helps prevent accidental spread to others even when you feel well.\n  - Wearing a mask helps protect someone else’s loved one, who may be at [higher risk of severe disease](https:\/\/health.hawaii.gov\/docd\/disease-types\/respiratory-viruses\/#who-is-at-higher-risk).\n\n### When should I wear a mask?\n- Here are some circumstances in which a mask is a good idea:\n  - When you are around others if you have cold or flu symptoms (e.g., runny nose, sore throat, cough) or are recovering from respiratory illness.\n  - If you test positive for COVID-19, wear a mask for 5 days after your fever is gone and you start to feel better. Masking for 10 days after a positive COVID-19 test is recommended if you have regular contact with someone who is at higher-risk.\n  - If you or someone you live with, care for, or spend time with is at higher-risk, consider wearing a mask in crowded indoor spaces or when you may not be able to maintain distance from others.\n  - If you were exposed to someone with cold and flu symptoms, consider masking if you are in a crowded indoor space or if you are in contact with someone who is higher risk.\n  - Everyone should consider masking in indoor public spaces when respiratory viral disease rates are high in your [**community**](https:\/\/www.cdc.gov\/respiratory-viruses\/data\/activity-levels.html).\n\n### What mask should I wear?\n- The most effective mask is one you can wear comfortably and correctly:\n  - Choose the most protective one that fully covers your nose and mouth and that you can comfortably wear for extended periods of time.\n  - The [**type of mask**](https:\/\/www.cdc.gov\/niosh\/ppe\/php\/community-respirators-masks\/) and how well it fits your face affects how well it reduces the number of germs you breathe in or out.\n  - N95, KN95, or KF94 masks can be purchased at drugstores, hardware stores, and online. They offer more protection than surgical masks or cloth face covering.\n\n### Is there anyone who should not wear a mask?\n- Masks are not recommended for:\n  - Children under 2 years\n  - People with sensory, cognitive, or behavioral issues for whom wearing a mask might be difficult\n  - Anyone having trouble breathing or who is unconscious, incapacitated, or unable to remove a mask without help\n\n### What if I’m at higher risk for severe disease?\nThose at higher risk for severe disease (including kūpuna, those with weakened immune systems, and pregnant people) can take additional steps to protect themselves.\n\n- **Get vaccinated\\!** Some vaccinations have specific guidelines for people in high risk groups.\n  |   |   |\n  |---|---|\n  | **Vaccine** | **Populations with specialized guidelines** |\n  | COVID-19 | All 2-18 years with risk factors or never vaccinated against COVID-19 Adults younger than 65 with risk factors, and all 65 years and older Immunocompromised people Pregnant people |\n  | [RSV](https:\/\/www.cdc.gov\/vaccines\/vpd\/rsv\/index.html) | Adults 50-74 years with risk factors and all 75 years and older Infants younger than 8 months and all 8-19 months with risk factors Pregnant people between 32-36 weeks of gestation |\n  | [Influenza](https:\/\/www.cdc.gov\/flu\/hcp\/acip\/) | Adults 65 and older Children aged 6 months through 8 years receiving the flu vaccine for the first time Pregnant people |\n- **Wear a mask** any time you are in crowded indoor spaces, especially when you cannot maintain physical distancing.\n- If you start having symptoms, **get tested.** Knowing what illness you have can help get you the right treatment. If you are sick with COVID-19 or influenza, antiviral treatments can help you feel better faster and reduce the risk of complications. Antiviral medications for COVID-19 and influenza work best when taken as soon as possible.\n\n### Who is at higher risk for severe disease?\n- Kūpuna\n  - Older adults are at higher risk for hospitalization, complications, and death from many respiratory viral diseases, including COVID-19, influenza, and RSV.\n- Young keiki\n  - Infants under 6 months of age have similar COVID-19 hospitalization rates to older adults.\n  - Children under 5 years old, and especially infants, are at higher risk of hospitalization or complications from [influenza](https:\/\/www.cdc.gov\/flu\/takingcare\/infantcare.html) and [RSV](https:\/\/www.cdc.gov\/rsv\/infants-young-children\/).\n- People with weakened immune systems\n  - People with weakened immune systems (also referred to as immunocompromised) may not be able to fight off infections as well as others and may not have developed strong immunity against infections from vaccinations.\n  - This group includes, but is not limited to, people undergoing cancer treatment, people who have received organ transplants, and people with chronic immune deficiencies.\n- People with certain medical conditions such as:\n  - Cancer\n  - Diabetes\n  - Chronic lung disease\n  - Heart disease\n  - Disabilities that increase risk\n- People who live in congregate facilities, such as:\n  - Skilled nursing facility\n  - Correctional facility\n  - Shelter\n- Pregnant people\n  - Pregnancy can cause changes to the immune system, heart, and lungs, placing pregnant people at higher risk for severe disease.\n\n### What if I live with, care for, or have regular contact with someone who is at high risk for severe disease? How can I protect them?\n- Take preventive measures: Get vaccinated, practice good hygiene, take steps for cleaner air, and wear a mask when you are in indoor crowded places or unable to physically distance.\n- If you have been exposed to someone with cold and flu symptoms:\n  - Wear a well-fitted mask when you are indoors with the higher risk person. It can take as long as 4-6 days for symptoms to develop after an exposure, so it’s a good idea to wear a mask for at least that long after you’ve been exposed.\n- If you develop cold and flu symptoms:\n  - Stay away from those at high risk. If you’re unable to avoid higher risk individuals, wear a well-fitted mask, wash your hands frequently, and open doors and windows to increase air flow as much as possible. Continue to wear a mask for at least 5 days after symptoms are improving and you have not had a fever for 24 hours without use of a fever-lowering medication. Take a COVID-19 test.\n- If you test positive for COVID-19:\n  - Follow all of the above guidelines for a **full 10 days**. You can stop after 5 days **IF** you test negative on two home tests in a row taken at least 24 hours apart.\n\n### Is RSV immunization for you?\n- Infants should receive an RSV monoclonal antibody if younger than 8 months old and their mother was not vaccinated during that pregnancy\n- Pregnant people between 32-36 weeks gestation to protect their newborn. The RSV vaccine is given only once, so for future pregnancies the infant can receive an RSV monoclonal antibody\n- Adults 75+, and adults 50-74 years with risk factors such as chronic heart or lung disease, a weakened immune system, other medical conditions, or living in a nursing home\n\n## More Information on Specific Respiratory Viruses\n**[Adenovirus](https:\/\/health.hawaii.gov\/docd\/disease_listing\/adenovirus\/) [Coronaviruses (Common Cold Viruses)](https:\/\/health.hawaii.gov\/docd\/disease_listing\/coronaviruses\/) [COVID-19](https:\/\/health.hawaii.gov\/docd\/disease_listing\/covid-19\/) [Influenza (Flu)](https:\/\/health.hawaii.gov\/docd\/disease_listing\/influenza-flu\/) [Parainfluenza](https:\/\/health.hawaii.gov\/docd\/disease_listing\/parainfluenza\/) [Parvovirus B19 (Fifth Disease)](https:\/\/health.hawaii.gov\/docd\/disease_listing\/fifth-disease-parvovirus-b19\/) [Respiratory Syncytial Virus (RSV)](https:\/\/health.hawaii.gov\/docd\/disease_listing\/respiratory-syncytial-virus-rsv\/) [Rhinovirus (Common Cold)](https:\/\/health.hawaii.gov\/docd\/disease_listing\/rhinovirus\/)**\n\n- [**Infection Control Action for Respiratory Viruses**](https:\/\/www.cdc.gov\/project-firstline\/media\/pdfs\/Respiratory-Actions-508.pdf)\n\n## Hawaiʻi Reports and Dashboards\n[](https:\/\/health.hawaii.gov\/coronavirusdisease2019\/current-situation-in-hawaii\/)\n\n### [COVID-19 Dashboard](https:\/\/health.hawaii.gov\/coronavirusdisease2019\/current-situation-in-hawaii\/)\n\n[](https:\/\/health.hawaii.gov\/docd\/resources\/reports\/influenza-reports\/)\n\n### [Influenza and Respiratory Surveillance Reports](https:\/\/health.hawaii.gov\/docd\/resources\/reports\/influenza-reports\/)\n\n## Policies\n- [Terms of Use](https:\/\/portal.ehawaii.gov\/terms-of-use.html)\n- [Accessibility](https:\/\/portal.ehawaii.gov\/accessibility.html)\n- [Privacy Policy](https:\/\/portal.ehawaii.gov\/privacy-policy.html)\n\n![State of Hawaii seal](https:\/\/health.hawaii.gov\/docd\/files\/2021\/11\/footer-seal.png)\n\n[![Powered By ehawaii.gov](https:\/\/health.hawaii.gov\/docd\/files\/2021\/11\/poweredby.png)](https:\/\/portal.ehawaii.gov\/)\n\nCopyright © 2026, State of Hawaii. All rights reserved.\n\n- [Follow](https:\/\/www.facebook.com\/HI.DOCD \"Follow on Facebook\")\n- [Follow](https:\/\/twitter.com\/HawaiiDOH \"Follow on X\")\n- [Follow](https:\/\/www.instagram.com\/hi_doh_docd\/ \"Follow on Instagram\")","attrs_readable_markdown":"## Report a Case\n**Disease Reporting Line:**  \n(808) 586-4586\n\nAs part of the [**West Coast Health Alliance (WCHA)**](https:\/\/health.hawaii.gov\/docd\/wcha\/), Hawaii Department of Health (DOH) issued immunization recommendations for the 2025–2026 respiratory virus season. This page aligns with these immunization recommendations.\n\n[**View Immunization Recommendations**](https:\/\/health.hawaii.gov\/docd\/disease-types\/respiratory-viruses\/#imm_rec)\n\nImmunization Recommendations\n\n![](https:\/\/health.hawaii.gov\/docd\/files\/2025\/09\/consensus_WCHA_2025-2026_respiratory_virus_season_immunization_recommendations.jpg)\n\nCOVID-19\n\n**COVID-19 Vaccine Timing 2025-26 – Routine Schedule ([View PDF](https:\/\/health.hawaii.gov\/docd\/files\/2025\/09\/COVID-19-Vaccine-Timing-2025-26-Routine-Schedule.pdf))**\n\n**Populations at Increased Risk Recommended for Vaccination Against COVID-19**\n\n***A. Due to Population Characteristics***\n\nDOH especially recommends vaccination against COVID-19 for the following persons:\n\n- Those with increased occupational or residential risks:\n  - Healthcare workers\n  - Residents of long-term care facilities or other congregate settings\n  - Those with household contacts who are at high risk for severe COVID-19\n- Those who have never been vaccinated against COVID-19\n- Infants and children 6 through 23 months of age\n- Adults over 65 years of age\n\n***B. Due to Medical Conditions That Increase the Risk of Severe COVID-19***\n\nDOH especially recommends vaccination against COVID-19 for persons with underlying medical conditions that increase their risk of severe COVID-19 disease. These tables provide examples of such underlying medical conditions but are not meant to be complete lists.\n\n**Children and Adolescents – in accordance with [AAP guidance](https:\/\/publications.aap.org\/pediatrics\/article\/doi\/10.1542\/peds.2025-073924\/203222\/Recommendations-for-COVID-19-Vaccines-in-Infants)**\n\n| Category | Examples |\n|---|---|\n| Blood diseases | Sickle cell disease |\n| Cancers or other immunosuppressive conditions | Leukemia, Receipt of immunosuppressive therapy, Primary immunodeficiency, HIV infection, Transplant Receipt (hematopoietic cell or solid organ) |\n| Cardiovascular diseases | Congenital heart disease |\n| Chronic lung diseases | Asthma or reactive airway disease, Chronic lung disease of prematurity, Compromised respiratory function, e.g., airway abnormality, tracheostomy, or ventilator dependent) |\n| Gastrointestinal or liver disorders | Feeding tube dependent, Inflammatory bowel disease, Chronic liver disease |\n| Metabolic disorders | Diabetes mellitus |\n| Neurologic or neurodevelopmental disorders | Cerebral palsy, Epilepsy. Intellectual developmental disorder. Compromised mobility (e.g., wheelchair dependent) |\n| Obesity |   |\n| Pregnancy |   |\n| Rheumatologic or autoimmune diseases | Systemic lupus erythematosus, Juvenile idiopathic arthritis |\n\n**Adults**\n\n| Category | Examples |\n|---|---|\n| Cancers or other immunosuppressive conditions | Hematologic malignancies, Receipt of immunosuppressive therapy, Primary immunodeficiency, HIV infection  Transplant Receipt (hematopoietic cell or solid organ) |\n| Cardiovascular disease | Hypertension, coronary artery disease, cardiomyopathies, congestive heart failure, atrial fibrillation, aortic stenosis |\n| Chronic kidney disease | Chronic kidney disease at any stage |\n| Chronic lung disease | Asthma, bronchiectasis, COPD, cystic fibrosis, OSA, interstitial lung disease, pulmonary embolism, pulmonary hypertension, oxygen dependency |\n| Chronic metabolic disease | Diabetes mellitus, type 1 or type 2 |\n| Disabilities | Any type of disability including but not limited to ADHD, intellectual and developmental disabilities, learning disabilities, compromised mobility |\n| Gastrointestinal and liver disease | Alcoholic liver disease, non-alcoholic fatty liver disease, cirrhosis, autoimmune hepatitis, ulcerative colitis, Crohn’s disease, chronic liver disease |\n| Hematologic disease | Sickle cell disease, thalassemia |\n| Mental Health | Mood disorders including depression and schizophrenia spectrum |\n| Neurologic disorders | Dementia, Alzheimer’s disease, Parkinson’s disease, seizure disorders, cerebral palsy, cerebrovascular disease, spinal cord injury |\n| Overweight and obesity |   |\n| Physical inactivity |   |\n| Pregnancy | Pregnancy, postpartum, lactating, or planning pregnancy |\n| Rheumatologic and autoimmune disorders | Rheumatoid arthritis, lupus erythematosus, vasculitis |\n| Smoking | Current or former |\n| Substance use disorders |   |\n\nRespiratory Syncytial Virus (RSV)\n\nDOH recommends year-round RSV immunization in the State of Hawaii for all infants through either maternal RSV vaccination or administration of long-acting RSV monoclonal antibody (nirsevimab or clesrovimab) to the infant.\n\n#### **RSV immunization guidance:**\n**Children**\n\n- All younger than 8 months\\*\n- All 8-19 months with risk factors\n\nRefer to the [American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule](https:\/\/downloads.aap.org\/AAP\/PDF\/AAP-Immunization-Schedule.pdf) for Ages 18 Years or Younger\n\n**Pregnancy**\n\n- Between 32-36 weeks gestation\\*\n\n**Adults**\n\n- All 75 years and older\\*\\*\n- All 50-74 years with risk factors\n\n**\\****Protect infants with either prenatal RSV vaccine or infant dose of RSV monoclonal antibody (nirsevimab or clesrovimab)*\n\n**\\*\\****Adult RSV vaccination recommendations are currently for a single lifetime dose. Those who have previously received a dose do not need a second dose*\n\nInfluenza (Flu)\n\n#### **Influenza immunization guidance:**\n**Children**\n\n- All 6 months and older\n\nRefer to the [American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule](https:\/\/downloads.aap.org\/AAP\/PDF\/AAP-Immunization-Schedule.pdf) for Ages 18 Years or Younger\n\n**Pregnancy**\n\n- All who are planning pregnancy, pregnant, postpartum or lactating\n\n**Adults**\n\n- All adults\n\nStaying Safe from Respiratory Viruses\n\nRespiratory viruses circulate throughout the year in Hawaii. They can cause symptoms like runny nose, cough, and sometimes fever, often thought of as “flu-like” or “common cold” symptoms. They can also cause severe disease in some people. We can all help prevent the spread of respiratory viruses.\n\n\n\nStay up to date on your flu, COVID-19, and RSV immunizations.\n\n\n\nStay home until fever-free for 24 hours without using fever reducing medication AND other symptoms are mild and improving.\n\n\n\nWearing a mask when you are indoors with other people is a precaution you can take at any time. Wearing a mask helps protect you and those around you.\n\n\n\nCover your coughs and sneezes, clean frequently touched surfaces, and wash your hands often.\n\n\n\nOpen doors or windows to bring in fresh outside air, purify indoor air or gather outdoors.\n\n\n\nIf you have cold or flu symptoms, and are at higher risk for severe disease, knowing what illness you have can help get you the right treatment. Antiviral medications for COVID-19 and flu work best when taken as soon as possible and are recommended for those at higher risk.\n\nRespiratory Virus Q & A\n\n### Should I wear a mask?\n- Wearing a mask is usually a personal decision (it may be required in some settings). Here are some things that can help you decide whether to wear a mask:\n  - Wearing a well-fitted mask that fully covers your nose and mouth helps protect you from breathing in other people’s germs.\n  - Wearing a mask helps protect others from breathing in your germs.\n  - You can be contagious before you feel sick. Wearing a mask helps prevent accidental spread to others even when you feel well.\n  - Wearing a mask helps protect someone else’s loved one, who may be at [higher risk of severe disease](https:\/\/health.hawaii.gov\/docd\/disease-types\/respiratory-viruses\/#who-is-at-higher-risk).\n\n### When should I wear a mask?\n- Here are some circumstances in which a mask is a good idea:\n  - When you are around others if you have cold or flu symptoms (e.g., runny nose, sore throat, cough) or are recovering from respiratory illness.\n  - If you test positive for COVID-19, wear a mask for 5 days after your fever is gone and you start to feel better. Masking for 10 days after a positive COVID-19 test is recommended if you have regular contact with someone who is at higher-risk.\n  - If you or someone you live with, care for, or spend time with is at higher-risk, consider wearing a mask in crowded indoor spaces or when you may not be able to maintain distance from others.\n  - If you were exposed to someone with cold and flu symptoms, consider masking if you are in a crowded indoor space or if you are in contact with someone who is higher risk.\n  - Everyone should consider masking in indoor public spaces when respiratory viral disease rates are high in your [**community**](https:\/\/www.cdc.gov\/respiratory-viruses\/data\/activity-levels.html).\n\n### What mask should I wear?\n- The most effective mask is one you can wear comfortably and correctly:\n  - Choose the most protective one that fully covers your nose and mouth and that you can comfortably wear for extended periods of time.\n  - The [**type of mask**](https:\/\/www.cdc.gov\/niosh\/ppe\/php\/community-respirators-masks\/) and how well it fits your face affects how well it reduces the number of germs you breathe in or out.\n  - N95, KN95, or KF94 masks can be purchased at drugstores, hardware stores, and online. They offer more protection than surgical masks or cloth face covering.\n\n### Is there anyone who should not wear a mask?\n- Masks are not recommended for:\n  - Children under 2 years\n  - People with sensory, cognitive, or behavioral issues for whom wearing a mask might be difficult\n  - Anyone having trouble breathing or who is unconscious, incapacitated, or unable to remove a mask without help\n\n### What if I’m at higher risk for severe disease?\nThose at higher risk for severe disease (including kūpuna, those with weakened immune systems, and pregnant people) can take additional steps to protect themselves.\n\n- **Get vaccinated\\!** Some vaccinations have specific guidelines for people in high risk groups.\n  |   |   |\n  |---|---|\n  | **Vaccine** | **Populations with specialized guidelines** |\n  | COVID-19 | All 2-18 years with risk factors or never vaccinated against COVID-19 Adults younger than 65 with risk factors, and all 65 years and older Immunocompromised people Pregnant people |\n  | [RSV](https:\/\/www.cdc.gov\/vaccines\/vpd\/rsv\/index.html) | Adults 50-74 years with risk factors and all 75 years and older Infants younger than 8 months and all 8-19 months with risk factors Pregnant people between 32-36 weeks of gestation |\n  | [Influenza](https:\/\/www.cdc.gov\/flu\/hcp\/acip\/) | Adults 65 and older Children aged 6 months through 8 years receiving the flu vaccine for the first time Pregnant people |\n- **Wear a mask** any time you are in crowded indoor spaces, especially when you cannot maintain physical distancing.\n- If you start having symptoms, **get tested.** Knowing what illness you have can help get you the right treatment. If you are sick with COVID-19 or influenza, antiviral treatments can help you feel better faster and reduce the risk of complications. Antiviral medications for COVID-19 and influenza work best when taken as soon as possible.\n\n### Who is at higher risk for severe disease?\n- Kūpuna\n  - Older adults are at higher risk for hospitalization, complications, and death from many respiratory viral diseases, including COVID-19, influenza, and RSV.\n- Young keiki\n  - Infants under 6 months of age have similar COVID-19 hospitalization rates to older adults.\n  - Children under 5 years old, and especially infants, are at higher risk of hospitalization or complications from [influenza](https:\/\/www.cdc.gov\/flu\/takingcare\/infantcare.html) and [RSV](https:\/\/www.cdc.gov\/rsv\/infants-young-children\/).\n- People with weakened immune systems\n  - People with weakened immune systems (also referred to as immunocompromised) may not be able to fight off infections as well as others and may not have developed strong immunity against infections from vaccinations.\n  - This group includes, but is not limited to, people undergoing cancer treatment, people who have received organ transplants, and people with chronic immune deficiencies.\n- People with certain medical conditions such as:\n  - Cancer\n  - Diabetes\n  - Chronic lung disease\n  - Heart disease\n  - Disabilities that increase risk\n- People who live in congregate facilities, such as:\n  - Skilled nursing facility\n  - Correctional facility\n  - Shelter\n- Pregnant people\n  - Pregnancy can cause changes to the immune system, heart, and lungs, placing pregnant people at higher risk for severe disease.\n\n### What if I live with, care for, or have regular contact with someone who is at high risk for severe disease? How can I protect them?\n- Take preventive measures: Get vaccinated, practice good hygiene, take steps for cleaner air, and wear a mask when you are in indoor crowded places or unable to physically distance.\n- If you have been exposed to someone with cold and flu symptoms:\n  - Wear a well-fitted mask when you are indoors with the higher risk person. It can take as long as 4-6 days for symptoms to develop after an exposure, so it’s a good idea to wear a mask for at least that long after you’ve been exposed.\n- If you develop cold and flu symptoms:\n  - Stay away from those at high risk. If you’re unable to avoid higher risk individuals, wear a well-fitted mask, wash your hands frequently, and open doors and windows to increase air flow as much as possible. Continue to wear a mask for at least 5 days after symptoms are improving and you have not had a fever for 24 hours without use of a fever-lowering medication. Take a COVID-19 test.\n- If you test positive for COVID-19:\n  - Follow all of the above guidelines for a **full 10 days**. You can stop after 5 days **IF** you test negative on two home tests in a row taken at least 24 hours apart.\n\n### Is RSV immunization for you?\n- Infants should receive an RSV monoclonal antibody if younger than 8 months old and their mother was not vaccinated during that pregnancy\n- Pregnant people between 32-36 weeks gestation to protect their newborn. The RSV vaccine is given only once, so for future pregnancies the infant can receive an RSV monoclonal antibody\n- Adults 75+, and adults 50-74 years with risk factors such as chronic heart or lung disease, a weakened immune system, other medical conditions, or living in a nursing home\n\nMore Information on Specific Respiratory Viruses\n\nHawaiʻi Reports and Dashboards","meta_canonical":null}

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URL	https://health.hawaii.gov/docd/disease-types/respiratory-viruses/
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Boilerpipe Text	Report a Case Disease Reporting Line: (808) 586-4586 As part of the West Coast Health Alliance (WCHA) , Hawaii Department of Health (DOH) issued immunization recommendations for the 2025–2026 respiratory virus season. This page aligns with these immunization recommendations. View Immunization Recommendations Immunization Recommendations COVID-19 COVID-19 Vaccine Timing 2025-26 – Routine Schedule ( View PDF ) Populations at Increased Risk Recommended for Vaccination Against COVID-19 A. Due to Population Characteristics DOH especially recommends vaccination against COVID-19 for the following persons: Those with increased occupational or residential risks: Healthcare workers Residents of long-term care facilities or other congregate settings Those with household contacts who are at high risk for severe COVID-19 Those who have never been vaccinated against COVID-19 Infants and children 6 through 23 months of age Adults over 65 years of age B. Due to Medical Conditions That Increase the Risk of Severe COVID-19 DOH especially recommends vaccination against COVID-19 for persons with underlying medical conditions that increase their risk of severe COVID-19 disease. These tables provide examples of such underlying medical conditions but are not meant to be complete lists. Children and Adolescents – in accordance with AAP guidance Category Examples Blood diseases Sickle cell disease Cancers or other immunosuppressive conditions Leukemia, Receipt of immunosuppressive therapy, Primary immunodeficiency, HIV infection, Transplant Receipt (hematopoietic cell or solid organ) Cardiovascular diseases Congenital heart disease Chronic lung diseases Asthma or reactive airway disease, Chronic lung disease of prematurity, Compromised respiratory function, e.g., airway abnormality, tracheostomy, or ventilator dependent) Gastrointestinal or liver disorders Feeding tube dependent, Inflammatory bowel disease, Chronic liver disease Metabolic disorders Diabetes mellitus Neurologic or neurodevelopmental disorders Cerebral palsy, Epilepsy. Intellectual developmental disorder. Compromised mobility (e.g., wheelchair dependent) Obesity Pregnancy Rheumatologic or autoimmune diseases Systemic lupus erythematosus, Juvenile idiopathic arthritis Adults Category Examples Cancers or other immunosuppressive conditions Hematologic malignancies, Receipt of immunosuppressive therapy, Primary immunodeficiency, HIV infection Transplant Receipt (hematopoietic cell or solid organ) Cardiovascular disease Hypertension, coronary artery disease, cardiomyopathies, congestive heart failure, atrial fibrillation, aortic stenosis Chronic kidney disease Chronic kidney disease at any stage Chronic lung disease Asthma, bronchiectasis, COPD, cystic fibrosis, OSA, interstitial lung disease, pulmonary embolism, pulmonary hypertension, oxygen dependency Chronic metabolic disease Diabetes mellitus, type 1 or type 2 Disabilities Any type of disability including but not limited to ADHD, intellectual and developmental disabilities, learning disabilities, compromised mobility Gastrointestinal and liver disease Alcoholic liver disease, non-alcoholic fatty liver disease, cirrhosis, autoimmune hepatitis, ulcerative colitis, Crohn’s disease, chronic liver disease Hematologic disease Sickle cell disease, thalassemia Mental Health Mood disorders including depression and schizophrenia spectrum Neurologic disorders Dementia, Alzheimer’s disease, Parkinson’s disease, seizure disorders, cerebral palsy, cerebrovascular disease, spinal cord injury Overweight and obesity Physical inactivity Pregnancy Pregnancy, postpartum, lactating, or planning pregnancy Rheumatologic and autoimmune disorders Rheumatoid arthritis, lupus erythematosus, vasculitis Smoking Current or former Substance use disorders Respiratory Syncytial Virus (RSV) DOH recommends year-round RSV immunization in the State of Hawaii for all infants through either maternal RSV vaccination or administration of long-acting RSV monoclonal antibody (nirsevimab or clesrovimab) to the infant. RSV immunization guidance: Children All younger than 8 months* All 8-19 months with risk factors Refer to the American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger Pregnancy Between 32-36 weeks gestation* Adults All 75 years and older** All 50-74 years with risk factors * Protect infants with either prenatal RSV vaccine or infant dose of RSV monoclonal antibody (nirsevimab or clesrovimab) ** Adult RSV vaccination recommendations are currently for a single lifetime dose. Those who have previously received a dose do not need a second dose Influenza (Flu) Influenza immunization guidance: Children All 6 months and older Refer to the American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger Pregnancy All who are planning pregnancy, pregnant, postpartum or lactating Adults All adults Staying Safe from Respiratory Viruses Respiratory viruses circulate throughout the year in Hawaii. They can cause symptoms like runny nose, cough, and sometimes fever, often thought of as “flu-like” or “common cold” symptoms. They can also cause severe disease in some people. We can all help prevent the spread of respiratory viruses.  Stay up to date on your flu, COVID-19, and RSV immunizations.  Stay home until fever-free for 24 hours without using fever reducing medication AND other symptoms are mild and improving.  Wearing a mask when you are indoors with other people is a precaution you can take at any time. Wearing a mask helps protect you and those around you.  Cover your coughs and sneezes, clean frequently touched surfaces, and wash your hands often.  Open doors or windows to bring in fresh outside air, purify indoor air or gather outdoors.  If you have cold or flu symptoms, and are at higher risk for severe disease, knowing what illness you have can help get you the right treatment. Antiviral medications for COVID-19 and flu work best when taken as soon as possible and are recommended for those at higher risk. Respiratory Virus Q & A Should I wear a mask? Wearing a mask is usually a personal decision (it may be required in some settings). Here are some things that can help you decide whether to wear a mask: Wearing a well-fitted mask that fully covers your nose and mouth helps protect you from breathing in other people’s germs. Wearing a mask helps protect others from breathing in your germs. You can be contagious before you feel sick. Wearing a mask helps prevent accidental spread to others even when you feel well. Wearing a mask helps protect someone else’s loved one, who may be at higher risk of severe disease . When should I wear a mask? Here are some circumstances in which a mask is a good idea: When you are around others if you have cold or flu symptoms (e.g., runny nose, sore throat, cough) or are recovering from respiratory illness. If you test positive for COVID-19, wear a mask for 5 days after your fever is gone and you start to feel better. Masking for 10 days after a positive COVID-19 test is recommended if you have regular contact with someone who is at higher-risk. If you or someone you live with, care for, or spend time with is at higher-risk, consider wearing a mask in crowded indoor spaces or when you may not be able to maintain distance from others. If you were exposed to someone with cold and flu symptoms, consider masking if you are in a crowded indoor space or if you are in contact with someone who is higher risk. Everyone should consider masking in indoor public spaces when respiratory viral disease rates are high in your community . What mask should I wear? The most effective mask is one you can wear comfortably and correctly: Choose the most protective one that fully covers your nose and mouth and that you can comfortably wear for extended periods of time. The type of mask and how well it fits your face affects how well it reduces the number of germs you breathe in or out. N95, KN95, or KF94 masks can be purchased at drugstores, hardware stores, and online. They offer more protection than surgical masks or cloth face covering. Is there anyone who should not wear a mask? Masks are not recommended for: Children under 2 years People with sensory, cognitive, or behavioral issues for whom wearing a mask might be difficult Anyone having trouble breathing or who is unconscious, incapacitated, or unable to remove a mask without help What if I’m at higher risk for severe disease? Those at higher risk for severe disease (including kūpuna, those with weakened immune systems, and pregnant people) can take additional steps to protect themselves. Get vaccinated! Some vaccinations have specific guidelines for people in high risk groups. Vaccine Populations with specialized guidelines COVID-19 All 2-18 years with risk factors or never vaccinated against COVID-19 Adults younger than 65 with risk factors, and all 65 years and older Immunocompromised people Pregnant people RSV Adults 50-74 years with risk factors and all 75 years and older Infants younger than 8 months and all 8-19 months with risk factors Pregnant people between 32-36 weeks of gestation Influenza Adults 65 and older Children aged 6 months through 8 years receiving the flu vaccine for the first time Pregnant people Wear a mask any time you are in crowded indoor spaces, especially when you cannot maintain physical distancing. If you start having symptoms, get tested. Knowing what illness you have can help get you the right treatment. If you are sick with COVID-19 or influenza, antiviral treatments can help you feel better faster and reduce the risk of complications. Antiviral medications for COVID-19 and influenza work best when taken as soon as possible. Who is at higher risk for severe disease? Kūpuna Older adults are at higher risk for hospitalization, complications, and death from many respiratory viral diseases, including COVID-19, influenza, and RSV. Young keiki Infants under 6 months of age have similar COVID-19 hospitalization rates to older adults. Children under 5 years old, and especially infants, are at higher risk of hospitalization or complications from influenza and RSV . People with weakened immune systems People with weakened immune systems (also referred to as immunocompromised) may not be able to fight off infections as well as others and may not have developed strong immunity against infections from vaccinations. This group includes, but is not limited to, people undergoing cancer treatment, people who have received organ transplants, and people with chronic immune deficiencies. People with certain medical conditions such as: Cancer Diabetes Chronic lung disease Heart disease Disabilities that increase risk People who live in congregate facilities, such as: Skilled nursing facility Correctional facility Shelter Pregnant people Pregnancy can cause changes to the immune system, heart, and lungs, placing pregnant people at higher risk for severe disease. What if I live with, care for, or have regular contact with someone who is at high risk for severe disease? How can I protect them? Take preventive measures: Get vaccinated, practice good hygiene, take steps for cleaner air, and wear a mask when you are in indoor crowded places or unable to physically distance. If you have been exposed to someone with cold and flu symptoms: Wear a well-fitted mask when you are indoors with the higher risk person. It can take as long as 4-6 days for symptoms to develop after an exposure, so it’s a good idea to wear a mask for at least that long after you’ve been exposed. If you develop cold and flu symptoms: Stay away from those at high risk. If you’re unable to avoid higher risk individuals, wear a well-fitted mask, wash your hands frequently, and open doors and windows to increase air flow as much as possible. Continue to wear a mask for at least 5 days after symptoms are improving and you have not had a fever for 24 hours without use of a fever-lowering medication. Take a COVID-19 test. If you test positive for COVID-19: Follow all of the above guidelines for a full 10 days . You can stop after 5 days IF you test negative on two home tests in a row taken at least 24 hours apart. Is RSV immunization for you? Infants should receive an RSV monoclonal antibody if younger than 8 months old and their mother was not vaccinated during that pregnancy Pregnant people between 32-36 weeks gestation to protect their newborn. The RSV vaccine is given only once, so for future pregnancies the infant can receive an RSV monoclonal antibody Adults 75+, and adults 50-74 years with risk factors such as chronic heart or lung disease, a weakened immune system, other medical conditions, or living in a nursing home More Information on Specific Respiratory Viruses Hawaiʻi Reports and Dashboards
Markdown	- [For Providers](https://health.hawaii.gov/docd/for-healthcare-providers/news-updates/) - [Contact Us](https://health.hawaii.gov/docd/contact-us/) - [Archive](https://health.hawaii.gov/docd/advisories/) [![SOH DOH logos](https://health.hawaii.gov/docd/files/2021/11/SOH-DOH-logos.png)](https://health.hawaii.gov/docd/) State of Hawaii, Department of Health \\| Ka ʻOihana Olakino Disease Outbreak Control Division - [Home](https://health.hawaii.gov/docd/) - [Vaccines & Immunizations](https://health.hawaii.gov/docd/vaccines-immunizations/) - [Recommendations by Age](https://health.hawaii.gov/docd/vaccines-immunizations/recommendations-by-age/) - [Infants & Toddlers](https://health.hawaii.gov/docd/vaccines-immunizations/recommendations-by-age/infants-toddlers/) - [Preteens & Adolescents](https://health.hawaii.gov/docd/vaccines-immunizations/recommendations-by-age/preteens-adolescents/) - [Adults](https://health.hawaii.gov/docd/vaccines-immunizations/recommendations-by-age/adults/) - [School Health Requirements](https://health.hawaii.gov/docd/vaccines-immunizations/school-health-requirements/sy-20-21/) - [Vaccine-Preventable](https://health.hawaii.gov/docd/disease-types/vaccine-preventable/) - [Seasonal Flu](https://health.hawaii.gov/docd/disease_listing/influenza-flu/) - [Traveler’s Health](https://health.hawaii.gov/docd/resources/travelers-health/) - [Hawaii State Immunization System (HiSIS)](https://health.hawaii.gov/docd/about-us/programs/hawaii-immunization-information-system-hisis/) - [Stop Flu at School (SFAS)](https://health.hawaii.gov/docd/about-us/programs/stop-flu-at-school/) - [Vaccines for Children (VFC) Program](https://health.hawaii.gov/docd/vaccines-immunizations/vaccines-for-children-vfc-program/) - [Diseases](https://health.hawaii.gov/docd/diseases-a-z/) - [Diseases A-Z](https://health.hawaii.gov/docd/diseases-a-z/) - [Disease Types](https://health.hawaii.gov/docd/disease-types/) - [Animal-Transmitted](https://health.hawaii.gov/docd/disease-types/animal-transmitted/) - [Bioterrorism-Related](https://health.hawaii.gov/docd/disease-types/bioterrorism-related/) - [Bloodborne](https://health.hawaii.gov/docd/disease-types/bloodborne/) - [Common Infections](https://health.hawaii.gov/docd/disease-types/community-infections/) - [Environmental](https://health.hawaii.gov/docd/disease-types/environmental/) - [Foodborne](https://health.hawaii.gov/docd/disease-types/foodborne/) - [Healthcare & Hospital-Transmitted](https://health.hawaii.gov/docd/disease-types/healthcare-hospital-transmitted/) - [Influenza](https://health.hawaii.gov/docd/disease-types/influenza/) - [Mosquito-Transmitted](https://health.hawaii.gov/docd/disease-types/mosquito-transmitted/) - [Pest-Transmitted](https://health.hawaii.gov/docd/disease-types/pest-transmitted/) - [Recreation-Related](https://health.hawaii.gov/docd/disease-types/recreation-related/) - [Respiratory Viruses](https://health.hawaii.gov/docd/disease-types/respiratory-viruses/) - [Sexually Transmitted](https://health.hawaii.gov/docd/disease-types/sexually-transmitted/) - [Travel-Related](https://health.hawaii.gov/docd/disease-types/travel-related/) - [Vaccine-Preventable](https://health.hawaii.gov/docd/disease-types/vaccine-preventable/) - [Waterborne](https://health.hawaii.gov/docd/disease-types/waterborne/) - [Prevention](https://health.hawaii.gov/docd/prevention/) - [Vaccines](https://health.hawaii.gov/docd/prevention/vaccines/) - [Handwashing and Hand Hygiene](https://health.hawaii.gov/docd/prevention/handwashing-and-hand-hygiene/) - [Using Antibiotics Wisely](https://health.hawaii.gov/docd/prevention/using-antibiotics-wisely/) - [Mosquito Bite Prevention](https://health.hawaii.gov/docd/prevention/mosquito-bite-prevention/) - [Traveler’s Health](https://health.hawaii.gov/docd/resources/travelers-health/) - [Natural Disasters and Pandemics](https://health.hawaii.gov/docd/prevention/natural-disasters/) - [Bioterrorism, Chemical, Radiological, and Nuclear Emergencies](https://health.hawaii.gov/docd/prevention/bioterrorism/) - [Reporting an Illness](https://health.hawaii.gov/docd/reporting-an-illness/restaurant-related/) - [Restaurant-Related](https://health.hawaii.gov/docd/reporting-an-illness/restaurant-related/) - [Individual](https://health.hawaii.gov/docd/reporting-an-illness/individual/) - [School-Related](https://health.hawaii.gov/docd/reporting-an-illness/school-related/) - [Long-Term Care-Related](https://health.hawaii.gov/docd/reporting-an-illness/long-term-care-related/) - [For Healthcare Providers](https://health.hawaii.gov/docd/for-healthcare-providers/reporting-an-illness-for-healthcare-providers/) - [Resources](https://health.hawaii.gov/docd/resources/) - [Traveler’s Health](https://health.hawaii.gov/docd/resources/travelers-health/) - [Wastewater Surveillance](https://health.hawaii.gov/docd/wastewater-surveillance/) - [Disaster Preparedness](https://health.hawaii.gov/docd/resources/disaster-preparedness/) - [Reports](https://health.hawaii.gov/docd/resources/reports/) - [School Assessment Forms and Instructions](https://health.hawaii.gov/docd/resources/reports/school-assessment-reports/) - [Influenza and Respiratory Reports](https://health.hawaii.gov/docd/resources/reports/influenza-reports/) - [Healthcare Associated Infections (HAIs) Reports](https://health.hawaii.gov/docd/resources/reports/healthcare-associated-infections-hais-reports/) - [Summary of Reported Cases of Notifiable Diseases](https://health.hawaii.gov/docd/resources/reports/summary-of-reported-cases-of-notifiable-diseases/) - [Conferences](https://health.hawaii.gov/docd/resources/conferences/) - [Print Materials](https://health.hawaii.gov/docd/resources/print-materials/) - [Video/Digital Materials](https://health.hawaii.gov/docd/resources/videodigital-materials/) - [Disease Factsheets](https://health.hawaii.gov/docd/resources/disease-fact-sheets/) - [CDC National Notifiable Diseases Surveillance System (NNDSS)](https://www.cdc.gov/nndss) - [News Archive](https://health.hawaii.gov/docd/news/) - [Lab Reporting](https://health.hawaii.gov/docd/for-healthcare-providers/reporting-an-illness-for-healthcare-providers/reportable-diseases-laboratory/) - [Schools](https://health.hawaii.gov/docd/schools/) - [Reporting COVID-19, Influenza, and Gastrointestinal Illness](https://health.hawaii.gov/docd/reporting-an-illness/school-related/) - [Outbreak Reporting Tool for DOE Schools](https://health.hawaii.gov/docd/doe-ort/) - [Outbreak Reporting Tool for Private, Independent, and Charter Schools](https://health.hawaii.gov/docd/ort/) - [COVID-19 School Guidance](https://health.hawaii.gov/coronavirusdisease2019/resources/school-guidance/) - [Respiratory Viruses](https://health.hawaii.gov/docd/disease-types/respiratory-viruses/) - [Respiratory Virus Guidance](https://health.hawaii.gov/docd/disease-types/respiratory-viruses/) - [COVID-19](https://health.hawaii.gov/coronavirusdisease2019/) - [Mpox](https://health.hawaii.gov/docd/disease_listing/mpox/) - [WCHA](https://health.hawaii.gov/docd/wcha/) - [DOH HOME](https://health.hawaii.gov/) # Respiratory Viruses - [Diseases A-Z](https://health.hawaii.gov/docd/diseases-a-z/) - [Disease Types](https://health.hawaii.gov/docd/disease-types/) - [Animal-Transmitted](https://health.hawaii.gov/docd/disease-types/animal-transmitted/) - [Bioterrorism-Related](https://health.hawaii.gov/docd/disease-types/bioterrorism-related/) - [Bloodborne](https://health.hawaii.gov/docd/disease-types/bloodborne/) - [Common Infections](https://health.hawaii.gov/docd/disease-types/community-infections/) - [Environmental](https://health.hawaii.gov/docd/disease-types/environmental/) - [Foodborne](https://health.hawaii.gov/docd/disease-types/foodborne/) - [Healthcare & Hospital-Transmitted](https://health.hawaii.gov/docd/disease-types/healthcare-hospital-transmitted/) - [Influenza](https://health.hawaii.gov/docd/disease-types/influenza/) - [Mosquito-Transmitted](https://health.hawaii.gov/docd/disease-types/mosquito-transmitted/) - [Pest-Transmitted](https://health.hawaii.gov/docd/disease-types/pest-transmitted/) - [Recreation-Related](https://health.hawaii.gov/docd/disease-types/recreation-related/) - [Respiratory Viruses](https://health.hawaii.gov/docd/disease-types/respiratory-viruses/) - [Sexually Transmitted](https://health.hawaii.gov/docd/disease-types/sexually-transmitted/) - [Travel-Related](https://health.hawaii.gov/docd/disease-types/travel-related/) - [Vaccine-Preventable](https://health.hawaii.gov/docd/disease-types/vaccine-preventable/) - [Waterborne](https://health.hawaii.gov/docd/disease-types/waterborne/) - [Diseases A-Z](https://health.hawaii.gov/docd/diseases-a-z/) - [Disease Types](https://health.hawaii.gov/docd/disease-types/) - [Animal-Transmitted](https://health.hawaii.gov/docd/disease-types/animal-transmitted/) - [Bioterrorism-Related](https://health.hawaii.gov/docd/disease-types/bioterrorism-related/) - [Bloodborne](https://health.hawaii.gov/docd/disease-types/bloodborne/) - [Common Infections](https://health.hawaii.gov/docd/disease-types/community-infections/) - [Environmental](https://health.hawaii.gov/docd/disease-types/environmental/) - [Foodborne](https://health.hawaii.gov/docd/disease-types/foodborne/) - [Healthcare & Hospital-Transmitted](https://health.hawaii.gov/docd/disease-types/healthcare-hospital-transmitted/) - [Influenza](https://health.hawaii.gov/docd/disease-types/influenza/) - [Mosquito-Transmitted](https://health.hawaii.gov/docd/disease-types/mosquito-transmitted/) - [Pest-Transmitted](https://health.hawaii.gov/docd/disease-types/pest-transmitted/) - [Recreation-Related](https://health.hawaii.gov/docd/disease-types/recreation-related/) - [Respiratory Viruses](https://health.hawaii.gov/docd/disease-types/respiratory-viruses/) - [Sexually Transmitted](https://health.hawaii.gov/docd/disease-types/sexually-transmitted/) - [Travel-Related](https://health.hawaii.gov/docd/disease-types/travel-related/) - [Vaccine-Preventable](https://health.hawaii.gov/docd/disease-types/vaccine-preventable/) - [Waterborne](https://health.hawaii.gov/docd/disease-types/waterborne/) ## Report a Case Disease Reporting Line: (808) 586-4586 As part of the [West Coast Health Alliance (WCHA)](https://health.hawaii.gov/docd/wcha/), Hawaii Department of Health (DOH) issued immunization recommendations for the 2025–2026 respiratory virus season. This page aligns with these immunization recommendations. [View Immunization Recommendations](https://health.hawaii.gov/docd/disease-types/respiratory-viruses/#imm_rec) ## Immunization Recommendations ![](https://health.hawaii.gov/docd/files/2025/09/consensus_WCHA_2025-2026_respiratory_virus_season_immunization_recommendations.jpg) ### COVID-19 COVID-19 Vaccine Timing 2025-26 – Routine Schedule ([View PDF](https://health.hawaii.gov/docd/files/2025/09/COVID-19-Vaccine-Timing-2025-26-Routine-Schedule.pdf)) Populations at Increased Risk Recommended for Vaccination Against COVID-19 *A. Due to Population Characteristics* DOH especially recommends vaccination against COVID-19 for the following persons: - Those with increased occupational or residential risks: - Healthcare workers - Residents of long-term care facilities or other congregate settings - Those with household contacts who are at high risk for severe COVID-19 - Those who have never been vaccinated against COVID-19 - Infants and children 6 through 23 months of age - Adults over 65 years of age *B. Due to Medical Conditions That Increase the Risk of Severe COVID-19* DOH especially recommends vaccination against COVID-19 for persons with underlying medical conditions that increase their risk of severe COVID-19 disease. These tables provide examples of such underlying medical conditions but are not meant to be complete lists. Children and Adolescents – in accordance with [AAP guidance](https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2025-073924/203222/Recommendations-for-COVID-19-Vaccines-in-Infants) \| Category \| Examples \| \|---\|---\| \| Blood diseases \| Sickle cell disease \| \| Cancers or other immunosuppressive conditions \| Leukemia, Receipt of immunosuppressive therapy, Primary immunodeficiency, HIV infection, Transplant Receipt (hematopoietic cell or solid organ) \| \| Cardiovascular diseases \| Congenital heart disease \| \| Chronic lung diseases \| Asthma or reactive airway disease, Chronic lung disease of prematurity, Compromised respiratory function, e.g., airway abnormality, tracheostomy, or ventilator dependent) \| \| Gastrointestinal or liver disorders \| Feeding tube dependent, Inflammatory bowel disease, Chronic liver disease \| \| Metabolic disorders \| Diabetes mellitus \| \| Neurologic or neurodevelopmental disorders \| Cerebral palsy, Epilepsy. Intellectual developmental disorder. Compromised mobility (e.g., wheelchair dependent) \| \| Obesity \| \| \| Pregnancy \| \| \| Rheumatologic or autoimmune diseases \| Systemic lupus erythematosus, Juvenile idiopathic arthritis \| Adults \| Category \| Examples \| \|---\|---\| \| Cancers or other immunosuppressive conditions \| Hematologic malignancies, Receipt of immunosuppressive therapy, Primary immunodeficiency, HIV infection Transplant Receipt (hematopoietic cell or solid organ) \| \| Cardiovascular disease \| Hypertension, coronary artery disease, cardiomyopathies, congestive heart failure, atrial fibrillation, aortic stenosis \| \| Chronic kidney disease \| Chronic kidney disease at any stage \| \| Chronic lung disease \| Asthma, bronchiectasis, COPD, cystic fibrosis, OSA, interstitial lung disease, pulmonary embolism, pulmonary hypertension, oxygen dependency \| \| Chronic metabolic disease \| Diabetes mellitus, type 1 or type 2 \| \| Disabilities \| Any type of disability including but not limited to ADHD, intellectual and developmental disabilities, learning disabilities, compromised mobility \| \| Gastrointestinal and liver disease \| Alcoholic liver disease, non-alcoholic fatty liver disease, cirrhosis, autoimmune hepatitis, ulcerative colitis, Crohn’s disease, chronic liver disease \| \| Hematologic disease \| Sickle cell disease, thalassemia \| \| Mental Health \| Mood disorders including depression and schizophrenia spectrum \| \| Neurologic disorders \| Dementia, Alzheimer’s disease, Parkinson’s disease, seizure disorders, cerebral palsy, cerebrovascular disease, spinal cord injury \| \| Overweight and obesity \| \| \| Physical inactivity \| \| \| Pregnancy \| Pregnancy, postpartum, lactating, or planning pregnancy \| \| Rheumatologic and autoimmune disorders \| Rheumatoid arthritis, lupus erythematosus, vasculitis \| \| Smoking \| Current or former \| \| Substance use disorders \| \| ### Respiratory Syncytial Virus (RSV) DOH recommends year-round RSV immunization in the State of Hawaii for all infants through either maternal RSV vaccination or administration of long-acting RSV monoclonal antibody (nirsevimab or clesrovimab) to the infant. #### RSV immunization guidance: Children - All younger than 8 months\* - All 8-19 months with risk factors Refer to the [American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule](https://downloads.aap.org/AAP/PDF/AAP-Immunization-Schedule.pdf) for Ages 18 Years or Younger Pregnancy - Between 32-36 weeks gestation\* Adults - All 75 years and older\\ - All 50-74 years with risk factors \*Protect infants with either prenatal RSV vaccine or infant dose of RSV monoclonal antibody (nirsevimab or clesrovimab) *\\***Adult RSV vaccination recommendations are currently for a single lifetime dose. Those who have previously received a dose do not need a second dose ### Influenza (Flu) #### Influenza immunization guidance: Children - All 6 months and older Refer to the [American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule](https://downloads.aap.org/AAP/PDF/AAP-Immunization-Schedule.pdf) for Ages 18 Years or Younger Pregnancy - All who are planning pregnancy, pregnant, postpartum or lactating Adults - All adults ## Staying Safe from Respiratory Viruses Respiratory viruses circulate throughout the year in Hawaii. They can cause symptoms like runny nose, cough, and sometimes fever, often thought of as “flu-like” or “common cold” symptoms. They can also cause severe disease in some people. We can all help prevent the spread of respiratory viruses.  ### Get immunized. Stay up to date on your flu, COVID-19, and RSV immunizations.  ### Stay home when sick. Stay home until fever-free for 24 hours without using fever reducing medication AND other symptoms are mild and improving.  ### Wear a mask. Wearing a mask when you are indoors with other people is a precaution you can take at any time. Wearing a mask helps protect you and those around you.  ### Practice good hygiene. Cover your coughs and sneezes, clean frequently touched surfaces, and wash your hands often.  ### Take steps for cleaner air. Open doors or windows to bring in fresh outside air, purify indoor air or gather outdoors.  ### Test and treat. If you have cold or flu symptoms, and are at higher risk for severe disease, knowing what illness you have can help get you the right treatment. Antiviral medications for COVID-19 and flu work best when taken as soon as possible and are recommended for those at higher risk. ### Additional Resources: - [Preventing Respiratory Illness \\| CDC](https://www.cdc.gov/respiratory-viruses/prevention/index.html) - [Respiratory Virus Season](https://health.hawaii.gov/docd/wcha/) - [All About the AAP Recommended Immunization Schedule \\| HealthyChildren.org](https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Recommended-Immunization-Schedules.aspx) - [Find COVID19, Influenza, RSV vaccine locations near you \\| VaccineFinder.org](http://vaccinefinder.org/) - [Health Centers Here for You \\| Hawaii Primary Care Association](https://www.hawaiipca.net/health-centers-here-for-you) - [Germs Can Live in the Respiratory System (PDF)](https://www.cdc.gov/project-firstline/media/pdfs/Healthcare-Germs-Body-RespiratorySystem-508.pdf) ## Respiratory Virus Q & A ### Should I wear a mask? - Wearing a mask is usually a personal decision (it may be required in some settings). Here are some things that can help you decide whether to wear a mask: - Wearing a well-fitted mask that fully covers your nose and mouth helps protect you from breathing in other people’s germs. - Wearing a mask helps protect others from breathing in your germs. - You can be contagious before you feel sick. Wearing a mask helps prevent accidental spread to others even when you feel well. - Wearing a mask helps protect someone else’s loved one, who may be at [higher risk of severe disease](https://health.hawaii.gov/docd/disease-types/respiratory-viruses/#who-is-at-higher-risk). ### When should I wear a mask? - Here are some circumstances in which a mask is a good idea: - When you are around others if you have cold or flu symptoms (e.g., runny nose, sore throat, cough) or are recovering from respiratory illness. - If you test positive for COVID-19, wear a mask for 5 days after your fever is gone and you start to feel better. Masking for 10 days after a positive COVID-19 test is recommended if you have regular contact with someone who is at higher-risk. - If you or someone you live with, care for, or spend time with is at higher-risk, consider wearing a mask in crowded indoor spaces or when you may not be able to maintain distance from others. - If you were exposed to someone with cold and flu symptoms, consider masking if you are in a crowded indoor space or if you are in contact with someone who is higher risk. - Everyone should consider masking in indoor public spaces when respiratory viral disease rates are high in your [community](https://www.cdc.gov/respiratory-viruses/data/activity-levels.html). ### What mask should I wear? - The most effective mask is one you can wear comfortably and correctly: - Choose the most protective one that fully covers your nose and mouth and that you can comfortably wear for extended periods of time. - The [type of mask](https://www.cdc.gov/niosh/ppe/php/community-respirators-masks/) and how well it fits your face affects how well it reduces the number of germs you breathe in or out. - N95, KN95, or KF94 masks can be purchased at drugstores, hardware stores, and online. They offer more protection than surgical masks or cloth face covering. ### Is there anyone who should not wear a mask? - Masks are not recommended for: - Children under 2 years - People with sensory, cognitive, or behavioral issues for whom wearing a mask might be difficult - Anyone having trouble breathing or who is unconscious, incapacitated, or unable to remove a mask without help ### What if I’m at higher risk for severe disease? Those at higher risk for severe disease (including kūpuna, those with weakened immune systems, and pregnant people) can take additional steps to protect themselves. - Get vaccinated\! Some vaccinations have specific guidelines for people in high risk groups. \| \| \| \|---\|---\| \| Vaccine \| Populations with specialized guidelines \| \| COVID-19 \| All 2-18 years with risk factors or never vaccinated against COVID-19 Adults younger than 65 with risk factors, and all 65 years and older Immunocompromised people Pregnant people \| \| [RSV](https://www.cdc.gov/vaccines/vpd/rsv/index.html) \| Adults 50-74 years with risk factors and all 75 years and older Infants younger than 8 months and all 8-19 months with risk factors Pregnant people between 32-36 weeks of gestation \| \| [Influenza](https://www.cdc.gov/flu/hcp/acip/) \| Adults 65 and older Children aged 6 months through 8 years receiving the flu vaccine for the first time Pregnant people \| - Wear a mask any time you are in crowded indoor spaces, especially when you cannot maintain physical distancing. - If you start having symptoms, get tested. Knowing what illness you have can help get you the right treatment. If you are sick with COVID-19 or influenza, antiviral treatments can help you feel better faster and reduce the risk of complications. Antiviral medications for COVID-19 and influenza work best when taken as soon as possible. ### Who is at higher risk for severe disease? - Kūpuna - Older adults are at higher risk for hospitalization, complications, and death from many respiratory viral diseases, including COVID-19, influenza, and RSV. - Young keiki - Infants under 6 months of age have similar COVID-19 hospitalization rates to older adults. - Children under 5 years old, and especially infants, are at higher risk of hospitalization or complications from [influenza](https://www.cdc.gov/flu/takingcare/infantcare.html) and [RSV](https://www.cdc.gov/rsv/infants-young-children/). - People with weakened immune systems - People with weakened immune systems (also referred to as immunocompromised) may not be able to fight off infections as well as others and may not have developed strong immunity against infections from vaccinations. - This group includes, but is not limited to, people undergoing cancer treatment, people who have received organ transplants, and people with chronic immune deficiencies. - People with certain medical conditions such as: - Cancer - Diabetes - Chronic lung disease - Heart disease - Disabilities that increase risk - People who live in congregate facilities, such as: - Skilled nursing facility - Correctional facility - Shelter - Pregnant people - Pregnancy can cause changes to the immune system, heart, and lungs, placing pregnant people at higher risk for severe disease. ### What if I live with, care for, or have regular contact with someone who is at high risk for severe disease? How can I protect them? - Take preventive measures: Get vaccinated, practice good hygiene, take steps for cleaner air, and wear a mask when you are in indoor crowded places or unable to physically distance. - If you have been exposed to someone with cold and flu symptoms: - Wear a well-fitted mask when you are indoors with the higher risk person. It can take as long as 4-6 days for symptoms to develop after an exposure, so it’s a good idea to wear a mask for at least that long after you’ve been exposed. - If you develop cold and flu symptoms: - Stay away from those at high risk. If you’re unable to avoid higher risk individuals, wear a well-fitted mask, wash your hands frequently, and open doors and windows to increase air flow as much as possible. Continue to wear a mask for at least 5 days after symptoms are improving and you have not had a fever for 24 hours without use of a fever-lowering medication. Take a COVID-19 test. - If you test positive for COVID-19: - Follow all of the above guidelines for a full 10 days. You can stop after 5 days IF you test negative on two home tests in a row taken at least 24 hours apart. ### Is RSV immunization for you? - Infants should receive an RSV monoclonal antibody if younger than 8 months old and their mother was not vaccinated during that pregnancy - Pregnant people between 32-36 weeks gestation to protect their newborn. The RSV vaccine is given only once, so for future pregnancies the infant can receive an RSV monoclonal antibody - Adults 75+, and adults 50-74 years with risk factors such as chronic heart or lung disease, a weakened immune system, other medical conditions, or living in a nursing home ## More Information on Specific Respiratory Viruses [Adenovirus](https://health.hawaii.gov/docd/disease_listing/adenovirus/) [Coronaviruses (Common Cold Viruses)](https://health.hawaii.gov/docd/disease_listing/coronaviruses/) [COVID-19](https://health.hawaii.gov/docd/disease_listing/covid-19/) [Influenza (Flu)](https://health.hawaii.gov/docd/disease_listing/influenza-flu/) [Parainfluenza](https://health.hawaii.gov/docd/disease_listing/parainfluenza/) [Parvovirus B19 (Fifth Disease)](https://health.hawaii.gov/docd/disease_listing/fifth-disease-parvovirus-b19/) [Respiratory Syncytial Virus (RSV)](https://health.hawaii.gov/docd/disease_listing/respiratory-syncytial-virus-rsv/) [Rhinovirus (Common Cold)](https://health.hawaii.gov/docd/disease_listing/rhinovirus/) - [Infection Control Action for Respiratory Viruses](https://www.cdc.gov/project-firstline/media/pdfs/Respiratory-Actions-508.pdf) ## Hawaiʻi Reports and Dashboards [](https://health.hawaii.gov/coronavirusdisease2019/current-situation-in-hawaii/) ### [COVID-19 Dashboard](https://health.hawaii.gov/coronavirusdisease2019/current-situation-in-hawaii/) [](https://health.hawaii.gov/docd/resources/reports/influenza-reports/) ### [Influenza and Respiratory Surveillance Reports](https://health.hawaii.gov/docd/resources/reports/influenza-reports/) ## Policies - [Terms of Use](https://portal.ehawaii.gov/terms-of-use.html) - [Accessibility](https://portal.ehawaii.gov/accessibility.html) - [Privacy Policy](https://portal.ehawaii.gov/privacy-policy.html) ![State of Hawaii seal](https://health.hawaii.gov/docd/files/2021/11/footer-seal.png) [![Powered By ehawaii.gov](https://health.hawaii.gov/docd/files/2021/11/poweredby.png)](https://portal.ehawaii.gov/) Copyright © 2026, State of Hawaii. All rights reserved. - [Follow](https://www.facebook.com/HI.DOCD "Follow on Facebook") - [Follow](https://twitter.com/HawaiiDOH "Follow on X") - [Follow](https://www.instagram.com/hi_doh_docd/ "Follow on Instagram")
Readable Markdown	## Report a Case Disease Reporting Line: (808) 586-4586 As part of the [West Coast Health Alliance (WCHA)](https://health.hawaii.gov/docd/wcha/), Hawaii Department of Health (DOH) issued immunization recommendations for the 2025–2026 respiratory virus season. This page aligns with these immunization recommendations. [View Immunization Recommendations](https://health.hawaii.gov/docd/disease-types/respiratory-viruses/#imm_rec) Immunization Recommendations ![](https://health.hawaii.gov/docd/files/2025/09/consensus_WCHA_2025-2026_respiratory_virus_season_immunization_recommendations.jpg) COVID-19 COVID-19 Vaccine Timing 2025-26 – Routine Schedule ([View PDF](https://health.hawaii.gov/docd/files/2025/09/COVID-19-Vaccine-Timing-2025-26-Routine-Schedule.pdf)) Populations at Increased Risk Recommended for Vaccination Against COVID-19 *A. Due to Population Characteristics* DOH especially recommends vaccination against COVID-19 for the following persons: - Those with increased occupational or residential risks: - Healthcare workers - Residents of long-term care facilities or other congregate settings - Those with household contacts who are at high risk for severe COVID-19 - Those who have never been vaccinated against COVID-19 - Infants and children 6 through 23 months of age - Adults over 65 years of age *B. Due to Medical Conditions That Increase the Risk of Severe COVID-19* DOH especially recommends vaccination against COVID-19 for persons with underlying medical conditions that increase their risk of severe COVID-19 disease. These tables provide examples of such underlying medical conditions but are not meant to be complete lists. Children and Adolescents – in accordance with [AAP guidance](https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2025-073924/203222/Recommendations-for-COVID-19-Vaccines-in-Infants) \| Category \| Examples \| \|---\|---\| \| Blood diseases \| Sickle cell disease \| \| Cancers or other immunosuppressive conditions \| Leukemia, Receipt of immunosuppressive therapy, Primary immunodeficiency, HIV infection, Transplant Receipt (hematopoietic cell or solid organ) \| \| Cardiovascular diseases \| Congenital heart disease \| \| Chronic lung diseases \| Asthma or reactive airway disease, Chronic lung disease of prematurity, Compromised respiratory function, e.g., airway abnormality, tracheostomy, or ventilator dependent) \| \| Gastrointestinal or liver disorders \| Feeding tube dependent, Inflammatory bowel disease, Chronic liver disease \| \| Metabolic disorders \| Diabetes mellitus \| \| Neurologic or neurodevelopmental disorders \| Cerebral palsy, Epilepsy. Intellectual developmental disorder. Compromised mobility (e.g., wheelchair dependent) \| \| Obesity \| \| \| Pregnancy \| \| \| Rheumatologic or autoimmune diseases \| Systemic lupus erythematosus, Juvenile idiopathic arthritis \| Adults \| Category \| Examples \| \|---\|---\| \| Cancers or other immunosuppressive conditions \| Hematologic malignancies, Receipt of immunosuppressive therapy, Primary immunodeficiency, HIV infection Transplant Receipt (hematopoietic cell or solid organ) \| \| Cardiovascular disease \| Hypertension, coronary artery disease, cardiomyopathies, congestive heart failure, atrial fibrillation, aortic stenosis \| \| Chronic kidney disease \| Chronic kidney disease at any stage \| \| Chronic lung disease \| Asthma, bronchiectasis, COPD, cystic fibrosis, OSA, interstitial lung disease, pulmonary embolism, pulmonary hypertension, oxygen dependency \| \| Chronic metabolic disease \| Diabetes mellitus, type 1 or type 2 \| \| Disabilities \| Any type of disability including but not limited to ADHD, intellectual and developmental disabilities, learning disabilities, compromised mobility \| \| Gastrointestinal and liver disease \| Alcoholic liver disease, non-alcoholic fatty liver disease, cirrhosis, autoimmune hepatitis, ulcerative colitis, Crohn’s disease, chronic liver disease \| \| Hematologic disease \| Sickle cell disease, thalassemia \| \| Mental Health \| Mood disorders including depression and schizophrenia spectrum \| \| Neurologic disorders \| Dementia, Alzheimer’s disease, Parkinson’s disease, seizure disorders, cerebral palsy, cerebrovascular disease, spinal cord injury \| \| Overweight and obesity \| \| \| Physical inactivity \| \| \| Pregnancy \| Pregnancy, postpartum, lactating, or planning pregnancy \| \| Rheumatologic and autoimmune disorders \| Rheumatoid arthritis, lupus erythematosus, vasculitis \| \| Smoking \| Current or former \| \| Substance use disorders \| \| Respiratory Syncytial Virus (RSV) DOH recommends year-round RSV immunization in the State of Hawaii for all infants through either maternal RSV vaccination or administration of long-acting RSV monoclonal antibody (nirsevimab or clesrovimab) to the infant. #### RSV immunization guidance: Children - All younger than 8 months\* - All 8-19 months with risk factors Refer to the [American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule](https://downloads.aap.org/AAP/PDF/AAP-Immunization-Schedule.pdf) for Ages 18 Years or Younger Pregnancy - Between 32-36 weeks gestation\* Adults - All 75 years and older\\ - All 50-74 years with risk factors \*Protect infants with either prenatal RSV vaccine or infant dose of RSV monoclonal antibody (nirsevimab or clesrovimab) *\\***Adult RSV vaccination recommendations are currently for a single lifetime dose. Those who have previously received a dose do not need a second dose Influenza (Flu) #### Influenza immunization guidance: Children - All 6 months and older Refer to the [American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule](https://downloads.aap.org/AAP/PDF/AAP-Immunization-Schedule.pdf) for Ages 18 Years or Younger Pregnancy - All who are planning pregnancy, pregnant, postpartum or lactating Adults - All adults Staying Safe from Respiratory Viruses Respiratory viruses circulate throughout the year in Hawaii. They can cause symptoms like runny nose, cough, and sometimes fever, often thought of as “flu-like” or “common cold” symptoms. They can also cause severe disease in some people. We can all help prevent the spread of respiratory viruses.  Stay up to date on your flu, COVID-19, and RSV immunizations.  Stay home until fever-free for 24 hours without using fever reducing medication AND other symptoms are mild and improving.  Wearing a mask when you are indoors with other people is a precaution you can take at any time. Wearing a mask helps protect you and those around you.  Cover your coughs and sneezes, clean frequently touched surfaces, and wash your hands often.  Open doors or windows to bring in fresh outside air, purify indoor air or gather outdoors.  If you have cold or flu symptoms, and are at higher risk for severe disease, knowing what illness you have can help get you the right treatment. Antiviral medications for COVID-19 and flu work best when taken as soon as possible and are recommended for those at higher risk. Respiratory Virus Q & A ### Should I wear a mask? - Wearing a mask is usually a personal decision (it may be required in some settings). Here are some things that can help you decide whether to wear a mask: - Wearing a well-fitted mask that fully covers your nose and mouth helps protect you from breathing in other people’s germs. - Wearing a mask helps protect others from breathing in your germs. - You can be contagious before you feel sick. Wearing a mask helps prevent accidental spread to others even when you feel well. - Wearing a mask helps protect someone else’s loved one, who may be at [higher risk of severe disease](https://health.hawaii.gov/docd/disease-types/respiratory-viruses/#who-is-at-higher-risk). ### When should I wear a mask? - Here are some circumstances in which a mask is a good idea: - When you are around others if you have cold or flu symptoms (e.g., runny nose, sore throat, cough) or are recovering from respiratory illness. - If you test positive for COVID-19, wear a mask for 5 days after your fever is gone and you start to feel better. Masking for 10 days after a positive COVID-19 test is recommended if you have regular contact with someone who is at higher-risk. - If you or someone you live with, care for, or spend time with is at higher-risk, consider wearing a mask in crowded indoor spaces or when you may not be able to maintain distance from others. - If you were exposed to someone with cold and flu symptoms, consider masking if you are in a crowded indoor space or if you are in contact with someone who is higher risk. - Everyone should consider masking in indoor public spaces when respiratory viral disease rates are high in your [community](https://www.cdc.gov/respiratory-viruses/data/activity-levels.html). ### What mask should I wear? - The most effective mask is one you can wear comfortably and correctly: - Choose the most protective one that fully covers your nose and mouth and that you can comfortably wear for extended periods of time. - The [type of mask](https://www.cdc.gov/niosh/ppe/php/community-respirators-masks/) and how well it fits your face affects how well it reduces the number of germs you breathe in or out. - N95, KN95, or KF94 masks can be purchased at drugstores, hardware stores, and online. They offer more protection than surgical masks or cloth face covering. ### Is there anyone who should not wear a mask? - Masks are not recommended for: - Children under 2 years - People with sensory, cognitive, or behavioral issues for whom wearing a mask might be difficult - Anyone having trouble breathing or who is unconscious, incapacitated, or unable to remove a mask without help ### What if I’m at higher risk for severe disease? Those at higher risk for severe disease (including kūpuna, those with weakened immune systems, and pregnant people) can take additional steps to protect themselves. - Get vaccinated\! Some vaccinations have specific guidelines for people in high risk groups. \| \| \| \|---\|---\| \| Vaccine \| Populations with specialized guidelines \| \| COVID-19 \| All 2-18 years with risk factors or never vaccinated against COVID-19 Adults younger than 65 with risk factors, and all 65 years and older Immunocompromised people Pregnant people \| \| [RSV](https://www.cdc.gov/vaccines/vpd/rsv/index.html) \| Adults 50-74 years with risk factors and all 75 years and older Infants younger than 8 months and all 8-19 months with risk factors Pregnant people between 32-36 weeks of gestation \| \| [Influenza](https://www.cdc.gov/flu/hcp/acip/) \| Adults 65 and older Children aged 6 months through 8 years receiving the flu vaccine for the first time Pregnant people \| - Wear a mask any time you are in crowded indoor spaces, especially when you cannot maintain physical distancing. - If you start having symptoms, get tested. Knowing what illness you have can help get you the right treatment. If you are sick with COVID-19 or influenza, antiviral treatments can help you feel better faster and reduce the risk of complications. Antiviral medications for COVID-19 and influenza work best when taken as soon as possible. ### Who is at higher risk for severe disease? - Kūpuna - Older adults are at higher risk for hospitalization, complications, and death from many respiratory viral diseases, including COVID-19, influenza, and RSV. - Young keiki - Infants under 6 months of age have similar COVID-19 hospitalization rates to older adults. - Children under 5 years old, and especially infants, are at higher risk of hospitalization or complications from [influenza](https://www.cdc.gov/flu/takingcare/infantcare.html) and [RSV](https://www.cdc.gov/rsv/infants-young-children/). - People with weakened immune systems - People with weakened immune systems (also referred to as immunocompromised) may not be able to fight off infections as well as others and may not have developed strong immunity against infections from vaccinations. - This group includes, but is not limited to, people undergoing cancer treatment, people who have received organ transplants, and people with chronic immune deficiencies. - People with certain medical conditions such as: - Cancer - Diabetes - Chronic lung disease - Heart disease - Disabilities that increase risk - People who live in congregate facilities, such as: - Skilled nursing facility - Correctional facility - Shelter - Pregnant people - Pregnancy can cause changes to the immune system, heart, and lungs, placing pregnant people at higher risk for severe disease. ### What if I live with, care for, or have regular contact with someone who is at high risk for severe disease? How can I protect them? - Take preventive measures: Get vaccinated, practice good hygiene, take steps for cleaner air, and wear a mask when you are in indoor crowded places or unable to physically distance. - If you have been exposed to someone with cold and flu symptoms: - Wear a well-fitted mask when you are indoors with the higher risk person. It can take as long as 4-6 days for symptoms to develop after an exposure, so it’s a good idea to wear a mask for at least that long after you’ve been exposed. - If you develop cold and flu symptoms: - Stay away from those at high risk. If you’re unable to avoid higher risk individuals, wear a well-fitted mask, wash your hands frequently, and open doors and windows to increase air flow as much as possible. Continue to wear a mask for at least 5 days after symptoms are improving and you have not had a fever for 24 hours without use of a fever-lowering medication. Take a COVID-19 test. - If you test positive for COVID-19: - Follow all of the above guidelines for a full 10 days. You can stop after 5 days IF you test negative on two home tests in a row taken at least 24 hours apart. ### Is RSV immunization for you? - Infants should receive an RSV monoclonal antibody if younger than 8 months old and their mother was not vaccinated during that pregnancy - Pregnant people between 32-36 weeks gestation to protect their newborn. The RSV vaccine is given only once, so for future pregnancies the infant can receive an RSV monoclonal antibody - Adults 75+, and adults 50-74 years with risk factors such as chronic heart or lung disease, a weakened immune system, other medical conditions, or living in a nursing home More Information on Specific Respiratory Viruses Hawaiʻi Reports and Dashboards
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