Hawaii’s flu cases are on the rise, prompting health officials to remind residents to get vaccinated during fall respiratory virus season.
The Hawaii Department of Health said 20.3% of specimens tested positive for influenza in the last week of September compared with 11% in mid-September. Hospital admissions and emergency room visits for influenza are also on the rise.
Both influenza and respiratory syncytial virus rates are rated at medium levels and increasing, according to DOH’s dashboard, while COVID-19 rates — which rose over the summer — are now rated low and on the way down.
“Respiratory viruses circulate year-round in Hawaii and we are seeing increased activity as we enter the fall respiratory virus season,” said State Epidemiologist Dr. Sarah Kemble in a news release. “Getting recommended vaccines, staying home when you are sick and taking simple precautions around others can help reduce the spread of illness and protect people who are more vulnerable to severe disease.”
The flu levels are still low nationally, but increasing in almost every U.S. state, along with ER visits, according to Katelyn Jetelina, author of Your Local Epidemiologist.
Flu is rising in the U.S. unusually early, she said, as metrics typically start to increase in October or November, but are already doing so.
Additionally, she said flu activity usually starts in the Southeast, in states such as Florida and Texas, but started in the West this year, in states such as California, Washington and Hawaii.
Jetelina said that means people may want to get their flu vaccines now instead of later. She noted the strain driving this flu wave is an H1N1 subtype, with an evasive mutation circulating.
The CDC has been quiet, saying only that its recommendations for seasonal influenza vaccination from the July 2025 immunization schedule remain in effect for this season.
The West Coast Health Alliance, of which Hawaii is a part, has issued its immunization recommendations for the 2026-2027 season.
The alliance recommends an annual flu shot for everyone 6 months and older, along with updated COVID-19 vaccines for higher risk populations, including children ages 6 to 23 months; adults ages 65 years and older; and people ages 2 to 64 with risk factors.
The COVID vaccines are also recommended for people who are pregnant or planning to get pregnant; healthcare workers and others who live or work closely with those at higher risk; and anyone who chooses vaccination to reduce the risk of severe illness.
“People should talk with their healthcare provider about which vaccines are recommended for them and whether they are up to date,” said Kemble in the release. “The updated vaccines are an important tool for reducing the risk of severe illness, particularly for people at higher risk.”
Additionally, DOH recommends that people stay home when sick, consider wearing a mask, open doors or windows or use air purifiers to improve air quality, wash hands regularly and cover coughs and sneezes.
People at higher risk who develop symptoms of flu or COVID also should test and seek treatment quickly, as antiviral medications are available for both, but work best when taken as soon as possible.
Both flu and COVID vaccines are widely available at most pharmacies including CVS, Walgreens and in-store pharmacies at Safeway and Costco. Kaiser is also offering both at its clinics and says patients can get both the flu and COVID vaccines at the same appointment.
CVS is offering drive-thru vaccination clinics this Saturday at Waiakea Center in Hilo and at the Longs Drugs in Waimea.
COVID positivity rates ticked up during the summer, with an average positivity rate of as high as 9.0% in early September. As of last Wednesday, the statewide average positivity rate declined to 7.5%.
Hospitalizations of COVID patients increased to a seven-day average of 43 for the week ending Sept. 30. A weekly average of five per day were admitted to the ICU.
DOH was notified of a COVID outbreak at Hale Nani Rehabilitation and Nursing Center on Sept. 2. Approximately two weeks later, 45 residents and 13 staff members had tested positive for COVID, but the number of new cases declined toward the end of September.
DOH said it was also aware of reports of COVID-19 outbreaks at other congregate settings, including other long-term care facilities, and was investigating. DOH typically receives one to two reports of COVID-19 outbreaks in nursing homes each month.
