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Posted on: January 25, 2021

Jan. 25, 2021 - County Launches ‘COVID-19 Vaccine Interest Form’

707-441-5000 ; ; Monday-Friday 8am to 5pm

All Humboldt County residents who want to receive the COVID-19 vaccine can now submit their contact information through an online interest form to be notified when doses are available for their tier. 

The form takes about two minutes to complete and asks for basic information like name, email, zip code and willingness or ability to travel to a clinic in another part of the county. Nearly 3,000 residents have filled out the form since the soft launch on Friday. 

Currently in Humboldt County, vaccine is available by appointment only due to limited supply, and priority is given to frontline health care workers and people age 75 and over as part of Phase 1A. Vaccination appointments, while still limited, will be expanded to some in Phase 1B Tier 1 in the coming days and weeks.  

Appointments will be made by priority group, as laid out by the California Department of Public Health. Completing the interest form will allow Humboldt County Public Health to contact residents directly when a clinic is scheduled for their priority group. Filling out the form does not place a resident ahead of someone in a higher priority group. 

Access the “COVID-19 Vaccine Interest Form for Individuals” here:

The State of California is developing a similar system,, but it is currently not operational in much of the state. More information about that system will be released as it becomes available.  

For the most recent COVID-19 information, visit or Local information is available at or during business hours by contacting or calling 707-441-5000.

Local COVID-19 vaccine information:
Humboldt County COVID-19 Data Dashboard:
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Humboldt Health Alert: 


JAN25 Vaccine Interest Form (PDF)
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