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COVID cases are exploding in Washington as Delta variant spreads among the unvaccinated

[OLYMPIA, Wash] – (MTN) New cases of COVID are exploding as the latest data from the Washington State Department of Health indicates under testing, high positivity rates, and a dwindling number of ICU beds statewide. Analyzing population, vaccination rate, and COVID positive rates in Washington’s 39 counties shows that regions with lower vaccination rates are driving the increase in statewide numbers.

As of August 3, the 7-day rolling average of new coronavirus cases detected statewide was 1,788, up 510% from July 1. Hospitalization now exceeds the Third Wave April 27 peak. Washington state is down to 203 ICU beds statewide, and 17.4% of ICU patients are being treated for COVID. Persons under 65 now make up the majority of hospitalized patients.

Washington State Department of Health Dashboard for COVID patients in the ICU – August 5, 2021

Malcontent News pulled the vaccination data from the Washington State Department of Health COVID Dashboard and population by county data from the United States Census. County-by-county COVID positivity rates were taken from the Washington State Department of Health website, using the most recent data available through July 29.

Washington state rate of 100K newly diagnosed COVID cases based on a 14-day rolling average is 209.9 – data through July 29

In the 24 Washington counties where more than 10% of COVID tests are coming back positive, 44.6% of the total population is fully vaccinated. For the remaining 15 counties where positivity is below 9.9%, the rate is 59.7%

There are currently six Washington counties where COVID tests are over 20% positive. In those counties, only 41% are vaccinated.

The Kaiser Family Foundation released a study on Friday that shows just how effective COVID vaccines are. The study showed unvaccinated residents are 67 times more likely to test positive for COVID and 60 times more likely to require hospitalization. 

“Overall, the data showed that approximately 1 in 900 vaccinated people had breakthrough infections,” the report stated. “Odds that would be comparable to dying in a motorcycle crash, according to data from the National Safety Council.”

Statewide COVID positivity has almost tripled since June 29, 2021

The statewide data paints a troubling picture for the potential for COVID hospitalizations to increase. Hospitalizations are a trailing indicator. The increasing number of COVID cases being detected indicates that hospitalizations will rapidly rise within the next two to three weeks. In a KOMO News article, Prosser Memorial Hospital in Benton County has run out of beds and is sending patients out of state. 

There is some good news within the data. The spread of the Delta variant and increasing infections appears to be motivating unvaccinated Washingtonians to take action. Every Washington county showed a jump in those who have received their first COVID dose in the last two weeks.

King County Health and a number of medical facilities continue to provide COVID testing across King County.

COVID vaccines are free for anyone over 12 years old, and no appointment is necessary at most locations. Lyft and Hopelink provide free transportation, and KinderCare, the Learning Care Group, and the YMCA offer free childcare during vaccination appointments or recuperation.

For information on getting a vaccination in King County, you can visit the King County Department of Public Health website.

CountyPopulationFully VaccinatedPartial & Fully VaccinatedCOVID Positivity – 14 Day Moving Average Through July 29
San Juan16,78872.86%77.92%4.50%
Jefferson31,28568.18%71.24%7.60%
King2,195,50266.04%71.21%5.90%
Whatcom220,82158.03%63.48%6.20%
Snohomish798,80855.85%60.99%8.00%
Chelan76,22954.70%60.70%14.20%
Clallam75,39255.14%59.22%7.50%
Skagit125,61253.68%58.69%8.50%
Thurston279,71151.82%56.43%9.80%
Island82,86649.29%55.79%10.60%
Clark473,25250.50%55.78%18.20%
Okanogan41,84249.89%54.07%11.40%
Douglas42,02347.89%53.36%10.20%
Walla Walla60,63547.31%51.97%15.80%
Kitsap265,88247.82%51.35%8.70%
Mason63,80446.94%51.31%6.80%
Pacific21,68846.33%50.63%15.50%
Grays Harbor72,77945.81%50.62%7.30%
Cowlitz106,77845.90%50.06%24.70%
Pierce877,01344.96%49.93%13.30%
Spokane505,50544.43%48.99%12.90%
Yakima249,69742.76%48.50%15.10%
Kittitas45,89744.82%48.41%11.20%
Benton197,51841.55%46.75%26.50%
Wahkiakum4,26843.06%45.78%27.30%
Grant95,50240.66%44.69%8.90%
Klickitat21,72141.02%44.68%20.90%
Adams19,59440.04%44.52%9.60%
Lincoln10,57440.43%43.16%20.50%
Lewis78,14538.00%41.97%15.50%
Franklin92,00934.24%39.35%26.00%
Ferry7,57835.11%38.97%18.20%
Whitman49,21334.78%38.10%13.20%
Columbia3,99232.31%35.05%5.40%
Skamania11,75331.76%33.70%14.30%
Asotin22,42130.77%33.04%14.70%
Pend Oreille13,37729.87%32.79%10.80%
Stevens44,65526.46%29.01%13.50%
Garfield2,23024.84%28.21%0.00%
Percentage of the total population fully and partially vaccinated by county, with COVID positivity rate 14 day rolling average, through July 29, 2021

COVID cases and hospitalizations are increasing dramatically in Washington

[OLYMPIA, Wash] – (MTN) The number of patients in Washington ICUs has surged to the highest levels since April, while the 7-day moving average of new cases is now at the highest level since May and rising rapidly. Just 36 days after King County ended the masked mandate, cases fueled by the highly contagious Delta variant are exploding.

On June 27, there were only 167 new COVID cases statewide. That number has climbed 748% in a month, with the 7-day moving average up to 1,251 cases on July 28, per the Washington Department of Health. In the most recently available data, 173 patients are in the ICU with COVID – which represents 14.3% of all available ICU beds in the state and is well above the 10% threshold.

Statewide, Washington is no longer achieving any metric that would indicate the spread of COVID remains under control.

According to the Washington State Department of Health data through July 26, 2021, COVID positivity has climbed to 6.5% statewide. The target is to be below 5%, and over 7% is an indication of growing community spread and under testing. Only the sparsely populated counties of San Juan, Garfield, and Columbia were under 5%. Asotin, Lincoln, Franklin, Walla Walla, Benton, Klickitat, Pacific, Cowlitz, and Skamania were over 15% positive – Benton county was over 25%. King County was at 4.3%.

Statewide acute care hospital beds continue to exceed guidelines. Statewide 82.2% of beds are supporting patients, while in King County, it is 84.6% of available beds. Of the 7,517 patients in the hospital, 647 have COVID. For ICUs, the numbers are more concerning. Statewide, 81.7% of all ICU beds are occupied, and in King County, it is 83.9%. Some area hospitals already have full ICUs, just as the state appears to be heading towards its biggest surge since the spring of 2021.

Although there is no specific cure for COVID, the medical community has a much better understanding of supportive therapies than they did at the pandemic’s beginning. Due to low positive outcomes, moving a patient to a ventilator is now considered a last line of defense.

Some of the strain on the state medical system in Washington is caused by out-of-state patients from Idaho, Montana, Oregon, and Alaska. Hospitals in eastern Washington support trauma and the sickest COVID patients from Idaho and western Montana, while hospitals in Portland and Seattle take patients from Oregon. Trauma patients in Alaska are flown to Seattle once they are stabilized. This spring and summer have seen a dramatic increase in general trauma unrelated to COVID, accounting for the current high occupancy rate.

Locally, Evergreen Hospital was reporting 12 COVID patients in Kirkland and 5 in Monroe.

Hospitals are normally staffed to support 60% to 80% capacity, with the remainder aside to support short-term surges. An increasing number of specialists, doctors, and nurses are leaving the medical field as the stress of the last 18 months has taken an emotional and physical toll.

To a layperson, 80% to 85% occupancy may not seem like a challenge, but the primary issue is a lack of medical staff when rates get this high.

COVID deaths remain low in Washington but are a trailing indicator and don’t spike until 4 to 6 weeks after hospitalizations increase. The IHME current forecast indicates COVID hospitalizations will peak next month, and deaths will grow an additional 70,000 to 130,000 nationally by October 31. The same forecast models indicate that masks would dramatically lower that number.

The Delta variant is now the dominant strain in the United States. Last week, the CDC reported that the COVID variant that emerged in India is as transmissible as chickenpox]. A super spreader event in Massachusetts over the 4th of July holiday sickened more than 880 with 74% vaccinated. Five were hospitalized, including 4 vaccinated people. The data from that incident resulted in a renewed recommendation to wear masks.

The NIH reported that in June 2021, the most recent data available, over 99% of people who died of COVID in the United States were unvaccinated. A vast majority of vaccinated people who test positive for the Delta variant are asymptomatic or mildly sick. However, unlike previous variants, the vaccinated carry a high virus load and can spread the disease. In states hit harder by Delta, such as Tennessee, vaccination rates have significantly increased as the impact of COVID becomes more real.

King County, Washington is over 80% vaccinated, and Washington state is over 70%. The highest rates of positivity are in areas with low vaccination rates statewide. The FDA is expected to provide full approval to the Pfizer vaccine next month.

COVID vaccines are free for anyone over 12 years old, and no appointment is necessary at most locations. Lyft and Hopelink provide free transportation, and KinderCare, the Learning Care Group, and the YMCA offer free childcare during vaccination appointments or recuperation.

For information on getting a vaccination in King County, you can visit the King County Department of Public Health website.

24 days later, King County is asking you to mask up – again

[SEATTLE, Wash] – (MTN) With COVID cases climbing in King County and 90% of detected COVID cases are “variants of concern,” King County health officer Dr. Jeff Duchin is recommending to mask up once again.

“I know this is frustrating and disappointing to many,” said Duchin. “It certainly is to me. I didn’t want to be in this position. And I acknowledge that the changing communication on masking has been a real problem nationally.”

King County is one of the most vaccinated counties in the country, where 80.3% of residents 12 and over have at least one dose of a COVID vaccine. Despite those numbers, 700,000 residents of King County remain unvaccinated including the young and the immunocompromised.

On June 28, the county was logging 56 new COVID cases a day. The count has climbed to 171, a 294% increase. Test positivity had dropped to as low as 1.2% but is now up to 4.1%. That is still within an acceptable range and indicates adequate testing, but the sharp increase in just 3 weeks is concerning to health officials.

Statewide, 9.4% of all ICU patients have COVID, moving closer to the 10% red light metric.

Hospitals in King County are near capacity – but not due to COVID

The Washington State Department of Health is reporting that 90.8% of all acute care beds and 88.7% of ICU beds are occupied in King County. Normally during this time of the year utilization would be 60% to 80%. As of July 22, only 2.6% of acute care beds and 5.4% of ICU beds have COVID patients. The problem? Area hospitals are overflowing with accident and trauma patients and patients that had elective surgeries delayed last year are moving through the system.

To the south in Thurston County, there are so many traumas and accidents 911 and ambulances are overwhelmed creating service delays.

Growing concern over Delta, Lambda, and Gamma variants

The Delta variant, B1671.2 from India, now makes up 83% of all cases in the United States. Two different studies found that Delta produces 1000% to 1200% more virus load than the original COVID strain. Neither study has been peer reviewed, however, both independent reports reached similar conclusions. The variant is 200% to 225% more transmissible than the original variant and has an R0 estimated to be 3.5 to 4.0 among unvaccinated populations according to Yale University.

Lambda has been identified in approximately 700 patients in the United States in the last 14 days. The South American variant appears to be less transmissible than Delta, so it likely won’t get established within the population. In South America, Lambda is over 9% fatal, but researchers believe this may be to lower quality healthcare, and only the sickest patients getting tested.

In Illinois, Gamma is the dominant variant with cases detected in Texas and Washington. According to a CDC study released this week, Gamma is showing a “strikingly high attack rate among persons vaccinated.” The report added, “Such a low vaccine efficiency against infection by the Gamma variant was not expected.”

Skeptic Republican leaders appeal to get vaccinated

In the last week, Steve Scalise (LA-R), House Minority Leader Mitch McConnell (KY-R), and Alabama Governor Kay Ivey (AL-R) have appealed for constituents to get vaccinated. Alabama has the lowest vaccination rate in the county while in Louisiana, hospitals are becoming overwhelmed.

Delta, Lambda, and Gamma all appear to break through the currently available vaccinations to varying degrees. However, data indicates that almost all breakthrough cases is asymptomatic or mild. In June, the National Institute of Health reported over 99% of all COVID-related deaths were among unvaccinated patients.

According to the White House, vaccination rates are starting to increase in some of the states hardest hit by the fourth wave.

67.8% of Washingtonians have received at least one dose of the COVID vaccine

[OLYMPIA] – (MTN) According to the Washington State Department of Health, the state is just 2.2% away from its goal of 70% of residents 16 years old and above, with at least one dose of the COVID vaccine. By the numbers, roughly 134,000 more Washingtonians will need to get their first dose (or one dose Johnson & Johnson) to reach the goal of 70% inoculated. Currently, the state is administering 15,000 first doses a day, indicating on paper, we could be back to full reopening on June 25.

However, vaccination rates in the state are plummeting – down over 70% from mid-May. Washington state has provided a number of incentives to push over the finish line including a vaccine lottery, a specific lottery for veterans and military members, and other incentives such as free college tuition.

Federal data indicates that Washington state has already reached the 70% mark but there are differences in methodology. The federal data is counting adults 18 and over and is using older census data. Washington state is counting people 16 and over and using the more up-to-date population estimates.

King County Health announced on June 15 that the county achieved its goal of 70% of residents vaccinated. The King County mask mandate will end on June 29, 2021. In a press conference on Thursday, Governor Jay Inslee made it clear that by June 30, the state will be fully reopened.

King County residents can visit the King County Health, Getting Vaccinated page to find a vaccination site, get transportation assistance, and find childcare assistance.

Ready to throw away your mask on June 29? Not so fast

[KIRKLAND] – (MTN) Yesterday, King County Health announced that the county had achieved 70% of those 16 and over completely vaccinated, and the indoor mask mandate would be ending on June 29. If you’re ready to throw your mask away, you might need to reconsider because even though the mask mandate itself is being lifted in King County, there remains plenty of exceptions.

Community living areas

Community living areas where people congregate without being able to socially distance such as homeless shelters, jails, and prisons will still require masks. That will include people who are visiting or work in these facilities.

Hospitals

Hospitals, medical art buildings, and surgical centers are required to continue the mask mandate for visitors, employees, and patients when they are waiting or involved in procedures where they don’t need to remove their face covering.

Public transportation

The mandate to wear masks on public transit such as commercial aircraft, ships, trains, light rail, and buses, is a federal mandate, not a state or county one. People will still need to wear a mask when using these forms of transportation. All of these services could decide to maintain mask requirements even if the federal requirements are lifted.

Federal buildings and property

The federal mask mandate is still in effect, however, pieces of it are being lifted. Until it is announced masks are still required inside federal buildings including offices, courthouses, and facilities at National Parks, National Forests, and Bureau of Land Management grounds.

Private businesses that still require masks

Private businesses such as restaurants, hotels, retailers, and venues, can still require masks for entry even after the county mandate ends. The request does not violate the Americans with Disabilities Act (ADA) or HIPAA. Private companies can also request to see proof of vaccination as a condition of employment or entry. Private businesses that require masks do need to provide some alternative to shop such as personal shopping or curbside pick up.

Gray areas

We checked with the Washington State Department of Health on whether Uber, Lyft, taxi, or limousine services count as public transportation. We were told these services are not considered public transportation and do not fall under federal mandates. Until June 29, masks are still required but after that date, it will be up to the policy of the companies and their drivers.

According to the websites of Uber and Lyft, both have a no mask, no ride policy in place nationally regardless of local regulations. Yellow Cab and STITA Taxi did not have mask policies on their website.

One other thing to consider before you throw away your masks, especially if you have N-95 or KN-95 masks. Models still indicate we will have a significant fire season from California to British Columbia, and from Alberta to Texas. If we have our orange skies and chewy air, only N-95 and KN-95 masks are effective at blocking the soot and other small particulates in wildfire smoke.

All Washington state counties move to Phase 3 on Tuesday as full reopening inches closer

[OLYMPIA] – (MTN) All Washington counties will move to Phase 3 on Tuesday, May 18, under the updated plan announced by Governor Inslee on Tuesday. Under the new guidelines, individual counties can decide what Phase to move to independently of the Safe Washington guidelines unless ICU utilization statewide exceeds 90% and hospitals start to cancel elective procedures.

The state of Washington hasn’t updated the data on the COVID dashboard since May 13 as of this writing. The Tacoma-Pierce County COVID-19 dashboard indicated there are 369.5 cases per 100,000 residents, and acute care hospitalizations per the State of Washington Department of Health website is over 12%. Both metrics would have put the county in Phase 1 under the old directives. Pierce County officials indicated they would be moving to Phase 3 despite positivity, caseload, and lagging immunization numbers.

Ferry County, which suffered a major outbreak after a superspreader event in the town of Republic in early April will also be moving to Phase 3. According to the Northeast Tri County Health District, the outbreak sickened almost 15% of Republic and led to 4 deaths. Numbers in the rural county have stabilized and the immunization rate went from the third lowest in Washington to twelfth place in 3 weeks.

The state of Washington will move to full reopening on June 30, 2021, or when the statewide first dose immunization percentage of those 16 and over reaches 70%.

Starbucks, Costco, and Walmart join Trader Joe’s with updated in-store mask policy

[KIRKLAND] – (MTN) A growing list of major retailers are making masks optional for individuals who have been fully vaccinated in a flurry of website updates and press releases. Starbucks has announced that starting Monday, vaccinated individuals don’t have to wear masks in their United States locations unless local rules require them. On Friday, Costco, Walmart, and Sam’s Club adopted the same policy. Sam’s Club is a membership-based warehouse store owned by Walmart and is similar to Costco. The retailer closed its western Washington locations several years ago.

Apple, Target, CVS, and Walgreens indicated they were maintaining requirements to wear a mask for now, but are evaluating CDC guidelines and might update their policies. Kroger, which owns QFC and Fred Meyer’s announced they would continue to mandate masks at its locations as did Home Depot.

Locally, Metropolitan Market issued a statement that masks are optional for fully vaccinated customers. PCC, a co-op-based grocery chain with 15 locations has also made masks optional for fully vaccinated customers.

Retailers, restaurants, bars, gyms, and other public businesses in King County are still in Phase 3 under the Safe Washington reopening program and can operate at 50% capacity. The Safe Washington reopening plan announced in March was essentially scraped by Gov. Inslee yesterday, with a new plan moving all counties to Phase 3 on May 18, and Washington state to full reopening on June 30.

The United States has administered over 250 million doses of COVID-19 vaccines nationwide. As of April 17, Washington state has administered more than 6 million doses, and over 43% of residents over 16-years old are fully vaccinated.

In King County, you can visit the Department of Health website to find a vaccination clinic, and many locations now support walk-up appointments. You can also visit the Facebook Group, Find a COVID Shot WA if you need language or technology assistance in making an appointment.

Malcontentment Happy Hour: May 13, 2021

Our live webcast from the former Seattle Anarchist Jurisdiction

The show from May 13, 2021, featured David Obelcz and our co-host Jennifer Smith. Patrons at the $5 and above level get access to our show notes and research documents.

  • Georgia Man busted after drilling holes in a U-Haul truck gas tank
  • Does Seattle have the 7th best BBQ in the United States?!?!
  • Acting Seattle Police Chief Adrian Diaz dismisses OPA use of force findings on June 1
  • Malcontented Minutes
    • Kentucky Derby Scandal deepens
    • Two Texas police officers shot and killed, one city worker wounded
    • Police hold press conference on the body of missing Indigenous found on Turtle Mountain
    • Black man beaten and robbed in Pennsylvania bar in racist incident
    • Government issues warning not to put gasoline in plastic bags
    • Florida woman arrested for pretending to be a high school student chasing Instagram clout
    • Levi’s is championing pronoun use
    • Evangelical Lutheran Church elects first openly transgender bishop
    • A mare and foal find comfort in shared grief
    • Two new mothers, one a gorilla, one human, bond at a Boston Zoo
  • Juneteenth law signed by Jay Inslee
  • COVID Update

Puget Sound COVID numbers indicate SnoCo improving, King plateaued, and Pierce getting worse

[KIRKLAND] – (MTN) On May 4 Governor Jay Inslee announced a pause in Safe Washington reopening phases for all counties for 14 days as new cases for COVID plateaued, and while new cases have flatlined in some counties, the data hasn’t gotten much better. A new deadline is looming on May 16 for another evaluation and for Pierce County that could mean going back to Phase 1 without a change in the phase requirements.

In King County, new case numbers for COVID infections and acute care patients have drifted slightly lower to 242.9 per 100,000 and 6.0% of all acute care beds occupied caring for COVID patients. Both numbers are well above the requirements to remain in Phase 3 and ICU utilization, which isn’t a factor for the Safe Washington reopening, remains troubling high at 83.8%. King County would drop to Phase 2 based on today’s numbers.

Snohomish County is in better territory than a week ago. Although new cases have decreased slightly from a high of 238 per 100,000 to 225.0, the total number of acute care patients being treated for COVID has dropped to 4.1%. If Snohomish County can hold the line, they would stay in Phase 3.

Pierce County is the worst shape of the metropolitan area. Over 12% of acute care beds have COVID patients, and the rate of 364.1 new cases per 100,000 is almost unchanged from a week ago. Of greater concern, positivity continues to increase and is up to 13.3%. Positive test results this high indicate widespread community transmission and significant under testing. Additionally, ICU utilization has increased to 88% and 18.9% of all ICU patients are battling COVID.

It isn’t all bad news in Pierce County, where the number of people fully vaccinated has increased significantly to over 42%, essentially tied with Snohomish County.

But no Washington County can match Ferry County and the dramatic rise in vaccinations in the last 10 days. On April 30, when Ferry County voluntarily moved back to Phase 2 after a super spreader event tore through the county and the town of Republic, the rural county had the third-lowest vaccination rate in the state – less than 25%. Today, 47% of Ferry County residents are fully vaccinated. Although new COVID cases remain one of the highest in the country at 847 per 100,000, the positivity rate and ICU utilization numbers continue to improve.

No official announcement has been on the next Safe Washington evaluation, but it will likely be early next week.

Pierce County COVID cases worsen while King and Snohomish County plateau

[TACOMA] – (MTN) COVID numbers in Pierce County continue to worsen with metrics for cases per 100,000 and hospitalizations indicating the county should move to Phase 1 under the Healthy Washington plan implemented on March 11. On May 4, to the surprise of the business community and health leaders, Washington Governor Jay Inslee suspended the Healthy Washington plan for 2 weeks, based on data from the Washington State Department of Health (DoH) that cases were reaching a plateau. The next evaluation will be on May 17.

In the latest data from the DoH, Pierce County has 367 cases per 100,000 and 12.1% of acute care beds occupied by COVID-19 patients. Although the case number has improved, the positivity rate has jumped to 12.3%, which indicates significant under testing and widespread community transmission. Only 35% of the population of Pierce County is vaccinated against coronavirus, the lowest among the most populated counties in the state.

Pierce County COVID Scorecard for May 8, 2021

Snohomish County has also seen cases per 100,000 drop slightly to 225.4 while the positivity rate has increased to 7.5%, which indicates under testing within the community. ICU utilization has increased significantly in the last week to 73%, and 19.1% of all ICU patients have COVID.

King County has seen cases per 100,000 drop to 249.1, which is still well over the number required to stay in Phase 2. The positivity rate has crept upward to 5.5%, which ICU utilization has fallen to 84.2%, which is considered high.

King County COVID Scorecard for May 8, 2021

Incentives are growing to increase vaccination numbers

COVID vaccine demand is declining significantly across the United States, leading many health officials to believe that the country will never achieve herd immunity. Locally, businesses and other organizations are working on promotions to encourage vaccination.

The Seattle Mariners announced that from May 6 to June 2, 5,000 additional seats will be made available for home games with discounted tickets priced at $10 or $20. Tickets are available in the outfield bleachers, the 300 section, and the 100 section.

Additional benefits include exclusive access to the T-Mobile Pen and Trident Deck, which has remained closed due to social distancing rules, a 20% discount on in-park food, a 20% discount at the team store, and special entrances to the park. Through May 19, vaccinated fans and their children can also receive a SEA Us Rise Mariners T-Shirt.

Social distancing is not required in the section, but mask wear is. Individuals over 16 years old must present a valid, signed CDC vaccination card and had their final dose 14 days or more before entry. Children from 2 to 15 don’t need to be vaccinated but are required to show proof of a negative COVID test no more than 72 hours before game time, and must be masked at all times. Tickets for the vaccinated section cannot be resold or gifted.

Additionally, private suites for 14 to 26 vaccinated fans are available. The Mariners indicated that any ticket holder for the designated vaccination sections who cannot provide proof of vaccination or a child who cannot provide a required negative COVID test will not be allowed entry into the park.

Numerous vaccination sites are also offering gift cards and certificates and other incentives to vaccination holdouts.

For those thinking they’ll print their own vaccination card or buy a fake one, be warned it comes with a stiff penalty. Because a valid vaccination card comes with a government seal on it, the production of a fake one is a federal felony. Penalties, if convicted, include fines up to $5,000 and up to 5 years in prison for each offense.