Tom Koeske, MD

If you have a life-threatening condition or are experiencing a medical emergency, please call 911 or go to the nearest emergency department. If your condition requires an in-person assessment — because you need x-rays or testing or a physical examination — our staff will discuss that with you when you call to schedule your appointment.

A telehealth visit at MultiCare visit costs the same as a visit at our in-person clinics. We accept all the same types of insurance that we do at our clinics. Indigo Online Care can bill most insurance plans. If you do not have insurance, there is a flat fee of $99. If you need help finding insurance or are interested financial assistance, please contact our patient financial navigation program.

That’s ok. Just call your local clinic to schedule your appointment, and we will talk you through the rest of the process. The technology requirements for a telemedicine visit are very simple. You only need a device with a camera and a microphone. (Most modern mobile phones meet this requirement.) The rest of the process is as simple as clicking on a link. You can also review our troubleshooting documents for additional guidance.

To make an appointment, all you need is a phone. For the virtual video visit itself, you will need a smart phone, tablet or a computer that has a camera and a microphone. When you call to set up your appointment, our staff can give you detailed instructions on how to connect to your provider. We also recommend you download the MyChart App if you will be connecting to your provider through a mobile device.

If your symptoms are not severe, you can schedule an appointment and be seen like you would for any condition. MultiCare can assess you through a video visit and help you determine next steps, arranging testing when needed. If your symptoms are life threatening, for example, you are having trouble breathing, please call 9-1-1 or visit the nearest emergency department.

We understand that parents are hopeful that COVID-19 vaccines will be made available to children. At this time, none of the vaccines approved for emergency use in the United States are meant for anyone under 16 years of age. Of the three vaccines available, only the Pfizer vaccine has been shown to be safe for those between 16-18 years old. The Moderna and Johnson & Johnson vaccines have only been shown to be safe for those 18 and older. This is because the clinical trials used to test these vaccines’ effectiveness and safety did not include anyone under those ages. The Washington State Department of Health has not recommended or approved the use of any COVID-19 vaccines for patients under 16, based on CDC guidance and the FDA’s Emergency Use Authorization guidelines. In accordance with these guidelines, MultiCare is unable to schedule vaccine appointments for anyone under 16. We are also unable to schedule vaccine appointments for anyone under 16 in locations that do not have Pfizer vaccine available.

There are currently three vaccines that have emergency use authorization from the FDA: Pfizer/BioNTech vaccine — This vaccine is for people age 16 and older. It requires two doses given around 21 days apart. After the second dose, research has shown this vaccine provides around 95 percent protection from the virus. Moderna vaccine — This vaccine is for people age 18 and older. It requires two injections given around 28 days apart. After the second dose, this vaccine provides 94.1 percent immunity. Johnson & Johnson/Janssen vaccine — This vaccine is for people age 18 and older. It requires one dose and provides 72 percent immunity. Current CDC guidelines indicate that second doses for the Pfizer and Moderna vaccines may be given up to six weeks after the first dose and still be effective.

COVID-19 vaccines are only offered at specific MultiCare locations. Your MultiCare primary care provider does not have vaccines available. When scheduling your vaccine appointment, you must select one of the available vaccine locations. If you have specific questions about the COVID-19 vaccine related to your health history, please reach out to your doctor, but otherwise, please do not call your doctor’s office to try and schedule a vaccine appointment.

Even if you get the vaccine, you should continue to wear a mask around others, wash your hands and practice physical distancing. Both of the vaccines currently being used in the United States require two doses given three to four weeks apart before you are well protected. When you get your first shot, you don’t become immediately immune. It can take several weeks for your body to develop antibodies. After you get the vaccine, you should also continue to take steps to protect other people who haven’t been vaccinated yet. Experts need to understand more about the protection that COVID-19 vaccines provide before changing recommendations on what everyone should take to slow the spread of the virus. Data shows that the first vaccine dose provides about 50 percent immunity protection and you’ll have around 95 percent immunity protection a few weeks after your second dose. So, even after your second dose there is still a chance that you can get sick. We also don’t yet know if the vaccine totally prevents us from being infected or passing the virus on to someone else.

It typically takes a few weeks for the body to build immunity (protection against the virus that causes COVID-19) after you get a vaccine. That means it is possible for a person to be infected with the virus that causes COVID-19 just before or just after vaccination and still get sick. This is because the vaccine has not had enough time to provide protection.

While the COVID-19 vaccines have been developed more quickly than usual, the protocols to evaluate safety and efficacy have been the same. Before they reach us, they will have passed through a number of rounds of evaluation and approval, including the FDA, the CDC, the state Department of Health and an independent collaborative of experts from across Washington, Oregon, Nevada, Colorado and California. You can learn about vaccine safety from the CDC and learn more about the Western States Pact and Scientific Safety Review Workgroup from the Washington State Department of Health.

You are encouraged to take the vaccine type that is available when it is offered to you. We are unable to offer options to choose the manufacturer since our vaccines are based on supplies received from the state. If you have already received the first dose of vaccine for the Pfizer or Moderna vaccine, you should make sure your second dose comes from the same vaccine manufacturer.

Here’s what to expect when you arrive for your vaccine appointment at MultiCare: 1. We’ll verify you are wearing a mask and complete a temperature check. An appropriate mask will be provided for you, if necessary. 2. You’ll check-in at our registration desk, receive your vaccine card (or have your card updated if this is your second shot) and we’ll verify your information. 3. After check-in, you’ll be directed to a vaccine station, and the vaccinator will review the screening document with you. Note if you answer “yes” to any of the screening questions, you may not be able to get the vaccine that day, so we recommend you review those questions in advance. 4. You’ll receive your vaccine and instructions on how to schedule your second dose, if needed. 5. You’ll need to wait for at least 15 minutes in the observation area to be sure you do not have a reaction to the vaccine. 6. You’ll be provided with a ticket that notes when your observation time will be over. Make sure you plan your schedule to accommodate this observation time. 7. Once your observation time is up, you are free to leave, as long as you are feeling well.

According to the CDC, vaccine doses purchased with taxpayer dollars will be given at no cost to an individual. Vaccination providers are allowed to charge an administration fee for giving the shot to someone, which is reimbursed by a patient’s public or private insurance company or, for uninsured patients, by the Health Resources and Services Administration’s Provider Relief Fund. At the time you make an appointment you will be asked for the name of your insurance provider, if you have one, but there will be no out of pocket expense for you as an individual when you get your vaccine at MultiCare, regardless of whether you have insurance or not.

Before you head to your vaccine appointment, keep in mind the following: You will need to wear a mask. MultiCare will provide an appropriate mask for you, if necessary. You will have to answer a series of health screening questions. You can review those questions here. If you answer “yes” to any of these questions, you may not be able to get your vaccine dose that day. You will need your identification and insurance information so our staff can verify that information as needed. You will also need to be able to verify your eligibility to receive the vaccine. For example, if you are a health care worker or first responder, you should bring your employee badge or ID.