Provider FAQs – COVID-19

Updated March 24, 2022

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Information about COVID-19 Vaccines

Information about COVID-19 Vaccines at Seattle Children’s for Patients and Families

Q: Is the COVID-19 vaccine available at Seattle Children’s?

A: Yes, we offer the vaccine to individuals ages 5 and up.  We also offer booster shots and third doses of the vaccine to qualifying individuals.

Find complete information on our website.

Q: What vaccines do you offer?

A: Only the Pfizer vaccine. The Pfizer vaccine is:

    • Approved for people 5 to 15 years old for first and second doses under an Emergency Use Authorization
    • Approved for people 16 years and older for first and second doses with full FDA approval
    • Approved for people 5 years and older who meet the defined immunocompromised categories for third doses under an Emergency Use Authorization
    • Approved for people 12 years and older for booster doses under an Emergency Use Authorization

Q: Do you screen kids to see if they should have the vaccine?

A: We advise families to talk with their PCP about any questions or concerns related to the vaccine and their child’s medical needs. We will ask some screening questions at the appointment to confirm this is the right time for the child to receive the vaccine, but our vaccine clinic staff will not be able to advise families if any underlying health conditions could stop them from receiving the vaccine or should be considered before receiving it.

Q: When and where are appointments available?

A: Vaccine appointments are available at the hospital campus Monday through Saturday from 7:30 a.m. to 5 p.m. Vaccines are also available at Odessa Brown Children’s Clinic (OBCC) and through the school-based clinics that OBCC serves.

Appointments are required and must be made via our scheduling portal. We do not offer walk-in vaccinations.

Vaccines also are offered each day to inpatients, ambulatory patients and their caregivers who are already at the hospital for care, as supplies permit.

Q: Are there any precautions to receiving the vaccine for individuals with underlying conditions?

A: We recommend following the guidance of the CDC’s ACIP on this matter.  See “Considerations for vaccination of people with certain underlying medical conditions” on the CDC website.

Q: Can I get the vaccine if I have allergies?

A: Most people who have allergies can receive the vaccine. The one exception is those who have had a severe allergic reaction to the vaccine itself or any of its components; this group should not receive the vaccine. People who have had severe allergic reactions to other vaccines or injected medications can receive the vaccine, but they should be monitored for 30 minutes. Food, environmental, and animal allergies are not restricted from receiving the vaccine in any way. Our COVID-19 vaccination clinic is prepared in the event a vaccine recipient develops symptoms of severe allergy during the 15- to 30-minute monitoring period.

Q: Is it safe for pregnant and breastfeeding women to get the COVID-19 vaccine?

A: COVID-19 vaccination is recommended for all people 5 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future. See the CDC website for more information.

The University of Washington has established a registry to follow pregnant and breastfeeding women who receive the COVID vaccine. Learn more and register. Questions can be directed to

Q: Are kids required to be vaccinated to attend school?

A: Washington state is not presently requiring children and teens to have a COVID-19 vaccine in order for them to return to school.

Q: Are there any pediatric groups who should not receive the vaccine?

A: The CDC recommends the vaccines for everyone age 5 and older unless they have had (a) a severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a component of the COVID-19 vaccines or (b) immediate allergic reaction of any severity to a previous dose or known (diagnosed) allergy to a component of the vaccine.

Q: Does the vaccine have side effects on kids?

A: Like adults, kids may have pain, redness or swelling in the arm where they got the shot. They also may experience tiredness, headache, muscle pain, chills, fever or nausea. Symptoms are usually mild and go away in a few days. Some people have no side effects.

Q: What is the risk to children of myocarditis or pericarditis from the vaccine?

A: CDC is monitoring rare reports of myocarditis and pericarditis following COVID-19 vaccination which mostly have occurred in male adolescents and young adults age 16 years or older. Symptoms were temporary (up to a few days) and included fatigue, chest pain, and disturbances in heart rhythm. There were no deaths. CDC continues to recommend COVID-19 vaccination for everyone 5 years of age and older, absent allergic reaction to a previous dose of the vaccine or a vaccine component. Learn more.

Q: Will the younger kids’ vaccine need to be repeated, like the adult one?   

A: Yes. The Pfizer vaccine for children ages 5 to 11 is given in two 10-microgram doses administered 21 days apart.

Q: Do you have suggestions on how to calm parent uneasiness about getting kids vaccinated?

A: The CDC provides talking points and materials for providers to discuss the COVID-19 vaccine with patients and families. See “Talking to Recipients about COVID-19 Vaccines” on the CDC website, which includes these documents:

More Resources

Information about COVID-19 Testing and Treatment

Q: Are you offering testing to the public?

A: Seattle Children’s offers COVID-19 testing for patients ages 20 and younger who have symptoms or have had close contact with someone who tested positive for COVID-19. For complete details, see COVID-19 Testing Information.

Q: Who are you testing for COVID-19?

A: We continue to test our patients who are having surgery, an aerosol-generating procedure or a hospital stay at Seattle Children’s as outlined below. We are not testing our asymptomatic patients who fall outside these categories including those who have a positive antigen test from the community or home, those with a high risk of exposure due to close contact with someone who has COVID-19 or those wanting testing for travel purposes.

We will continue to update our COVID-19 testing guidelines as the situation changes.

We are testing:

  1. Any Seattle Children’s patient, including those seen at our Urgent Cares or Emergency Department, with signs or symptoms potentially consistent with COVID-19, including: fever, cough, shortness of breath, fatigue, headache, chills, muscle or body aches, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea.
  2. All Seattle Children’s patients two days prior to a planned aerosol-generating procedure (AGP), unless they tested negative within the last 7 days and have been continuously hospitalized without new respiratory symptoms.
    1. Outside PCR (nucleic acid amplification) test results from NP/middle turbinate swab samples are accepted if the patient was tested within 48 hours, they have stable symptoms, and they are not considered to be at high risk for COVID-19. Results should be visually confirmed and sent to HIM to be entered in the EHR. To summarize, what tests are “accepted” versus “not accepted”: Anterior nasal swab specimens are also acceptable when obtained from asymptomatic patients.
      • ACCEPTED: Molecular tests (NAAT, PCR) that are “rapid” (e.g., Cepheid, Biofire) or “regular” (e.g., ours, Hologic, Roche, Abbott Alinity, etc.) and performed in accredited laboratories.
      • NOT ACCEPTED: Any “Antibody” test. Any “antigen” test. Some molecular tests (NAAT, PCR) with known poor performance (example: Abbott ID Now). Any test result that lacks details about the platform or test method.
    2. If you are presented with a test result from an accredited laboratory but you are uncertain about the acceptability of the test, please find the test on the FDA website (Diagnostics EUAs – Molecular Diagnostic Tests for SARS-CoV-2 | FDA) and then call the SCH Microbiology Laboratory with this information (test name and performing lab) and ask for ‘Director Review’ of a COVID-19 test platform. Drs. Murphy and Bell will review with SCH Microbiology Staff.
    3. If families are unable to test two days prior to the planned AGP, exceptions can be made to extend that window to testing within 72 hours of planned AGP.
    4. For patients who previously tested positive for SARS-CoV-2, please see COVID-19: Testing Previously Positive or Exposed Patients Prior to Procedures with AGPs, 12944.
    5. All patients with ongoing AGPs should be tested for COVID-19 every seven days.

C. All patients at admission to the hospital.

    1. Note: NICU infants for whom swabbing may be injurious, may have lower respiratory tract samples submitted if possible. If this is not possible, and the patient’s previous test is negative and they are asymptomatic, repeat testing may be performed at the discretion of the care team.

D. Previously positive inpatients:

    1. Patients will be cleared from Airborne Strict Isolation by IP and placed in Strict Isolation for 90 days.
    2. Staff will wear a respirator if the patient is undergoing an AGP through the 90 day period.
    3. No testing is required unless the patient develops symptoms consistent with COVID-19.
      1. If a patient becomes symptomatic and tests positive, the recurrent infection must be considered

E. Pre-BMT patients: will be tested per SCCA protocol.

F. Heme-onc patients: view section at the end of this document for further information.

G. We DO NOT test the following groups: asymptomatic patients not meeting the above criteria.

Educate all patients you test

If COVID-19 is being considered, whether testing is performed or not, provide the following guidance documents to patients, and emphasize the need to isolate for ill persons and self-quarantine for exposed contacts. Patients with confirmed or suspected COVID-19

Community COVID-19 testing: Please follow the Seattle Children’s guidelines above when referring patients here for COVID-19 testing. Read more information about community COVID-19 testing offered by Seattle Children’s.

Q: For pre-operative testing at Seattle Children’s, what happens when patients live far away or cannot get tested in time?

A: We are screening all pre-operative patients for COVID-19. This includes patients who will have a procedure in an operating room and those who need anesthesia in Radiology. Families who have a procedure or surgery scheduled will receive a call from our Pre-Anesthesia Testing Coordinator (PATC) to discuss the requirements for COVID-19 testing and help schedule their test at one of our four local sites (Seattle, Bellevue, Federal Way, Everett). These tests need to be collected within two days, or 72 hours at most, prior to surgery/procedure. Seattle Children’s orders the test and communicates the result.

We have a system in place to prioritize testing for pre-procedure patients. Families experiencing financial hardship or other extreme circumstances will be connected with our guest services and social work teams.

Out-of-area Testing

Outside PCR (nucleic acid amplification) test results from nasopharyngeal/mid-turbinate samples are accepted if the patient was tested within 72 hours of the procedure, they have stable symptoms, and they are not considered to be at high risk for COVID-19.  The patient’s PCP should order the test or the family may self-schedule a test if that is a locally available option. Results should be sent to Seattle Children’s to be entered in the patient’s EMR by 5 p.m. the day before procedure (fax results to the Seattle Children’s Pre-Anesthesia COVID-19 testing line at 206-987-2060).

  • ACCEPTED: Molecular tests (NAAT, PCR) that are “rapid” (e.g., Cepheid, Biofire) or “regular” (e.g., ours, Hologic, Roche, Abbott Alinity, etc.) and performed in accredited laboratories.
  • NOT ACCEPTED: Any “Antibody” test. Any “antigen” test. Some molecular tests (NAAT, PCR) with known poor performance (example: Abbott ID Now). Any test result that lacks details about the platform or test method.

Parent testing

In order for a parent to stay with their child in the hospital overnight when their child qualifies for double-rooming, they will need to be tested via PCR test within 72 hours of the procedure unless they have proof of full vaccination. Our PATC will review this requirement with the family during the pre-procedure call.

When 24 Hour Tests are Necessary

Requests for testing within 24 hours may come up for cases that are added last minute. These families can come to Seattle to have their testing performed within the 24 hour period.

There will be patients who will be unable to undergo testing prior to surgery due to distance or urgency of procedure. If testing cannot be conducted, there will be a clinical escalation to decide if the procedure should:

  • Be postponed until testing can be completed
  • Proceed – with appropriate precautions in place to protect our workforce

Q: When should a second test be obtained for SARS-CoV2?

A: Rationale for obtaining a 2nd testing during a course of illness:

  • Well-designed PCR tests for SARS-CoV2 have high analytical sensitivity, but clinical sensitivity is unknown due to lack of clinical gold standard.
  • Clinical sensitivity is dependent on day of illness and the viral load (viral load is lower later in the illness).
  • SARS-CoV2 appears to have anatomical tropism. For instance, in general, shedding persists for longer in lower respiratory tract specimens and as a result, lower respiratory tract specimens have higher sensitivity than upper respiratory tract specimens.
  • Our testing strategy at Seattle Children’s calls for utilizing upper respiratory tract specimens as the primary specimen because it is not always possible (and is often difficult) to obtain a lower tract specimen from a pediatric patient.
  • When suspicion for COVID-19 is high, a second test should be obtained, preferably from the lower respiratory tract if possible.

Preferred 2nd samples:

  • Productive cough: collect sputum if possible
  • No cough or non-productive cough:
    • Preferred specimens: induced sputum, deep suctioning through ETT, BAL
  • If above is not possible or feasible: consider repeating middle turbinate (MT) swab or nasopharyngeal (NP) sample

Isolation considerations based on 2nd SARS-CoV2 test results

  • Lower respiratory tract specimen
    • Positive: SIU
    • Negative: Can transition to viral respiratory precautions (due to pre-existing respiratory symptoms/signs)
  • Repeat MT NP swab
    • Positive: SIU
    • Negative:
      • High index of suspicion of COVID-19: remain in SIU
      • Lower index of suspicion of COVID-19: discuss with ID to consider whether strict isolation or viral respiratory isolation outside SIU is appropriate.

Q: How many children have tested positive?

A:As of January 10, 2022, Seattle Children’s had tested 61,240 pediatric patients in total with 2,697 (4.4%) testing positive. The positive rate was much higher for patients tested in January 2022 – reaching about 25% – due to recent holiday travel and the contagious omicron variant.

Q: How will I know if you are treating my patient for COVID-19?

A: If your patient is seen at Seattle Children’s for suspected COVID-19 (or any other condition), you will receive our standard fax communications regarding ER summary, admission, discharge etc.

Q: Will you notify PCPs of their patients’ coronavirus test results?

A: We send results to the provider who ordered the test. If we order the test, we notify the patient’s PCP as well as the family, and ask the family to direct any questions to their PCP if their test is negative You can expect to receive a copy of our standard lab report via fax within 48 hours of the test. (Please note: inconclusive results are being treated as “positive” until confirmed by the State or CDC.) If you don’t receive your results within the time expected, please call our clinical lab at 206-987-2102 for assistance.

Q: Does Seattle Children’s offer antibody testing?

A: Yes, two types.

Seattle Children’s offers the Abbott SARS-CoV-2 IgG nucleocapsid and spike immunoassays on the ARCHITECT instrument. These are chemiluminescent microparticle immunoassay (CMIA) used for the qualitative detection of IgG antibodies to SARS-CoV-2 nucleocapsid or spike protein in human serum and plasma.

Antibodies to the spike protein should be detectable after natural infection or vaccination (antibodies to the nucleocapsid protein are only detectable after infection).  It is not yet known how long antibodies will be detectable in blood.

These tests are not FDA-approved for diagnosis of infection due to SARS-CoV2; however, the data presented in the package insert demonstrates they are sensitive test for detecting past SARS-CoV2 infection. It also appears to be specific; however, more testing in the setting of other human coronavirus infections is needed. Thus, a positive test likely indicates past infection due to SARS-CoV2 while a negative test indicates that a person likely did NOT experience infection with SARS-CoV2. See the indications for testing and the FAQs below for more information.

Indications for serological testing for SARS-CoV-2 (COVID-19)

  • Patients who have had a prior illness consistent with COVID-19 more than 21 days ago and either tested negative or were not tested
  • Patients who had a known exposure to SARS-CoV-2 more than 21 days ago


  • Serological testing is NOT indicated for diagnosis of acute infection and should not be ordered while a patient is being investigated for active SARS-CoV-2 infection
  • For patients with new or persistentCOVID-19 symptoms, or if there is concern for active infection, molecular testing (PCR) with a nasopharyngeal swab is recommended prior to considering serologic testing
  • It is unknown if a positive antibody test indicates any level of short or long term protection against SARS-CoV-2; antibody test results should not be used to guide return-to-work decisions
  • Immunocompromised patients who have COVID-19 may have a delayed antibody response and produce levels of antibody which may not be detected as positive by the assay

Ordering antibody testing

Community providers can order the test the same way they currently order other lab tests at Seattle Children’s; no special requisition is needed. Test details are here.

Sensitivity: According to published series, at 2 weeks after onset of symptoms, sensitivity is over 50%. At approximately 25 days after symptomatic infection in hospitalized patients, the sensitivity approaches 100%. The Abbott product insert reports higher sensitivity, with 91% sensitivity by 14 days after symptom onset. The sensitivity of the test among subjects with asymptomatic infection is unclear, and the duration of positive results (seropositivity) is unknown.

Q: What do we know about risk factors for the pediatric population?

A: According to the CDCadults with the following conditions are at increased risk of severe illness from COVID-19: chronic kidney disease, chronic obstructive pulmonary disease, immunocompromised state (cancer, solid organ transplant, etc.), serious heart conditions (complex congenital heart disease, heart failure), diabetes, obesity (BMI 30 or higher), pregnancy, smoking, substance use disorders, , sickle cell disease, and trisomy 21. Children with underlying medical conditions are at increased risk for severe illness compared to children without underlying medical conditions. Current evidence on which underlying medical conditions in children are associated with increased risk is limited. Current evidence suggests that children with medical complexity, with genetic, neurologic, metabolic conditions, or with congenital heart disease can be at increased risk for severe illness from COVID-19. Similar to adults, children with obesity, diabetes, asthma or chronic lung disease, sickle cell disease, or immunosuppression can also be at increased risk for severe illness from COVID-19.

Q: What are Seattle Children’s guidelines for treating COVID-19 and MIS-C?

A: A Clinical Standard Work pathway for COVID-19 was created by a multidisciplinary team based on the available literature and will be updated frequently. There are separate algorithms for acute COVID infection and Multisystem Inflammatory Syndrome in Children (MIS-C). The current versions can all be found here: COVID-19 Clinical Standard Work pathway (includes Acute COVID and MIS-C Care Treatment algorithms).

Information about Telehealth

Q: Are you offering telemedicine and telephone visits?

A: Yes. Seattle Children’s offers telehealth visits when it is medically appropriate and possible. We are making an extra effort in January 2022 to convert in-person visits to telehealth due to the surge of the omicron variant. Bills for telehealth visits include a telehealth admin fee. Learn more.

Changes to Ambulatory Clinics, Services and Scheduling

Q: Are all Seattle Children’s clinic locations open and seeing patients?

A: Yes. 

Q: Are surgeries continuing?

A: Yes. Patients are required to take a COVID-19 test within 72 hours of their surgery.

Q: Are you screening visitors?

A: Yes. All patients and visitors are being screened for COVID-19 at our facility entrances. As we learn more about the coronavirus and the symptoms it can cause, we’ll continue to assess our entrance screening process and make adjustments as necessary to help keep our workforce members and patients safe.

View our screening algorithms for:

Visitors to the Lab who screen positive will be escorted to a negative pressure room to have their labs drawn, rather than diverted to the ED.

Q: What are your visitor/caregiver policies?

A:  At all of our clinics, we recommend that only one parent or caregiver accompany a patient to their appointment. However, if two caregivers need to come along, it is allowed at this time. Siblings who are younger than 12 months are also allowed to come along. Siblings of any other age are not allowed to come along, and we do not allow more than two caregivers without an exception. Everyone two years old and older is required to wear a mask at all times at all Seattle Children’s locations, regardless of vaccination status, including nonclinical locations and outdoors.

Q: Are lab and radiology still offering walk-ins?

A: Yes and no.

  • Radiology, no: Families who need diagnostic x-rays at Seattle Children’s are now required to schedule an appointment.  Families can call 206-987-2089 from 7 a.m. to 6 p.m. Monday through Friday to schedule. We will evaluate urgency and consider less investigative studies when appropriate. X-rays can still be done as part of an urgent care visit.
  • Lab services, yes: We still take walk-ins. COVID-19 screening is in place at entrances. Laboratory hours at our Bellevue Clinic and Surgery Center, South Clinic in Federal Way and North Clinic in Everett are now 8 a.m. to 4 p.m. on weekdays, closed Saturdays, Sundays and holidays.  Our main hospital lab is open weekdays 7 a.m. to 10 p.m. and on Saturdays, Sundays and holidays from 8 a.m. to 8 p.m. View our Laboratory Medicine and Pathology website for a full listing of all our lab locations and hours.

Q: Can families still use the hospital pharmacy?

A: Yes. On-site pick up is available 24 hours a day, 7 days a week at the hospital campus in Seattle. Prescriptions must be written by a Seattle Children’s physician.

Our pharmacy also offers curbside pickup at the hospital and mail order prescription options (some restrictions apply). Families who need to fill their child’s prescription on-site or request a refill should inquire with pharmacy staff to discuss pick-up or mail order options.

Changes to Inpatient Care

Q: If one of my patients is an inpatient at Seattle Children’s, what can they expect?

A: The clinical staff and providers at Seattle Children’s are trained on the identification, isolation and treatment of COVID-19 and other infectious diseases. At this point in time:

  • If an inpatient does not have cold or flu-like symptoms, they will continue to receive care without change.
  • If the primary caregiver has symptoms of fever or cough, they should not visit.

The situation with COVID-19 is evolving and procedures for patient care will necessarily change to best protect patients, their families and staff.

Q: Has your visitor policy changed?

A: We are allowing up to two caregivers in perioperative and inpatient settings.

Please note:

  • Patients in single rooms can have up to two caregivers in their room around the clock.
  • Patients in double rooms can have up to two caregivers in their room during visiting hours (8 a.m. to 8 p.m.) and one caregiver overnight.
  • Patients in the Emergency Department may have up to two caregivers with them.
  • Three people can be designated as caregivers for the entirety of the hospitalization.
  • All visitors are required to wear a mask at all times at all Seattle children’s locations, regardless of vaccination status, including nonclinical locations and outdoors.

We will continue evaluating and adjusting our practices to maintain the safety of our patients, families and workforce. The visitor policy is subject to change quickly if the pandemic worsens or statewide restrictions are enacted.

Q: Is Palliative Care still available for consults?

A: Yes. We temporarily scaled back on-site availability of palliative care services when the pandemic started, but our regular in-person services how now resumed. For communication with the Palliative Care team, for general questions, and patient updates/information, please contact For more acute issues, page our on call attending or APP through the hospital operator.

Changes to ED or Urgent Care

Q: Should I send my patients to Seattle Children’s Emergency Department?

A: Yes, patients who truly require emergency care should come to the ED.  Seattle Children’s is experiencing very high inpatient and ED volumes at this time. See our ED or Urgent Care Referral Guide if you are not sure whether to send them. If you are sending a patient, please call our ED Communications Center first at 206-987-8899 and let the family know the ED is at full capacity to set expectations.

We ask that providers continue to manage patients in outpatient settings whenever possible.  

Q: Are there any changes to Seattle Children’s Urgent Care?

A: Our Urgent Cares are open but have very limited availability, due in part to high levels of RSV, parainfluenza and seasonal coronaviruses. We have some limited walk-in availability, but due to overwhelming demand there have been days when we need to redirect urgent care patients elsewhere. Please encourage families to schedule online to ensure appointment availability. Appointment slots open at midnight for the upcoming day. Up to 2 caregivers and one sibling under 12 months may accompany the patient to their Urgent Care visit.

Q: Can a child come to the ED with more than one caregiver?

A: Our policy is to allow up to two caregivers with the child in the ED.

Changes to Classes and Courses

Q: Are classes and courses continuing at Seattle Children’s?

A: Due to COVID-19, Children’s has paused or changed many education and training programs. A multidisciplinary work group has developed a plan to resume some high-priority education and training:

  • Required competency — Resume Basic Life Support (BLS); Neonatal Resuscitation Program (NRP); Pediatric Emergency Assessment, Recognition and Stabilization (PEARS); Cardiopulmonary Resuscitation (CPR); and Pediatric Advanced Life Support (PALS).
  • Academic partner education (students) — Resume with a limited number of students.
  • Competency simulations — Resume high-priority simulations such as central venous line placement, Code Blue, Code Purple, and new space.

CME courses are being offered virtually. Check our website for details.

Safety remains our top priority. All training and education activities will follow strict infection prevention protocols.

Additional Resources

If your patient has questions or is concerned about COVID-19, please refer to these resources from Washington State Department of Health:

For the most up-to-date information about COVID-19, please visit:

For additional information to support families, see:

Seattle Children’s Panel Discussions on COVID-19

  • COVID-19: The Seattle Children’s Experience: Seattle Children’s infectious disease and emergency medicine experts shared their experiences from the front lines at the epicenter of the COVID-19 outbreak in the United States. This event includes a Q&A on how to prepare. Watch the video.
  • Confronting Tragic Choices in the Midst of a Pandemic: Our regional disaster healthcare network is one of the few in the country that has been focused on planning around a severe pandemic. Watch our panel discussion on how decisions are made when resources are scarce.

Information Line for Families

Community members may call our COVID-19 information center at 1-833-987-2100 to learn how Seattle Children’s is responding to this pandemic or to schedule a COVID-19 test once it has been ordered by their PCP. The line is open 8 a.m. to 5 p.m., Monday through Saturday.

This information line does not provide medical advice, test results or appointment scheduling.