Governor Josh Stein has directed North Carolina’s State Health Director, Dr. Larry Greenblatt, to issue Standing Orders intended to improve access to COVID-19 vaccines for those who choose to receive them. The new orders allow seniors aged 65 and older, as well as adults over 18 who meet certain risk criteria, to obtain a COVID-19 vaccine at pharmacies without needing a prescription from a healthcare provider.
“Health care providers and pharmacists recommend vaccination as a safe and effective tool to protect yourself and your community from COVID-19,” said Governor Josh Stein. “This action ensures that North Carolinians most at risk who want protection from COVID-19 can get it as we enter the cold and flu season.”
Health and Human Services Secretary Dev Sangvai commented on the administrative challenges previously faced by patients: “Requiring an office visit to obtain a prescription to receive the COVID-19 vaccine is an administrative barrier for patients, providers, and pharmacies. Vaccinations against seasonal respiratory viruses, including flu, RSV, and COVID are especially important and the right choice for those at higher risk of severe viral respiratory disease.”
Last year in North Carolina there were more than 120,000 emergency department visits related to COVID-like illness, leading to over 21,600 hospitalizations. Vaccines continue to be recognized as an important method for preventing severe illness and reducing hospitalizations. The recent Standing Order aligns with federal recommendations following the Food and Drug Administration’s approval of updated COVID-19 vaccines in late August.
Under state law, immunizing pharmacists in North Carolina can administer vaccines recommended by the federal Advisory Committee on Immunization Practices (ACIP). However, ACIP has not yet issued recommendations for this season’s COVID-19 vaccines. Without these recommendations, pharmacists could only provide vaccines to adults 18 or older with a prescription. The new Standing Order now allows adults over age 65 or those at increased risk for severe illness from COVID-19 to receive the vaccine at local pharmacies without first visiting a healthcare provider.
The order serves as a prescription for immunizing pharmacists administering FDA-approved COVID-19 vaccines to eligible adults. For children ages six months through 17 years, parents are advised to consult their pediatricians or healthcare providers regarding vaccine availability.
According to the North Carolina Department of Health and Human Services (NCDHHS), more than 70% of last year’s COVID-19 doses in the state were administered at pharmacies.
Andy Ellen, President and General Counsel of the North Carolina Retail Merchants Association (NCRMA), stated: “The North Carolina Retail Merchants Association supports allowing North Carolinians 18 and older who choose to receive a COVID vaccine to get it at their local pharmacy without a prescription in accordance with recently issued FDA guidelines. We also applaud the decision to let patients continue to choose receiving both flu and COVID vaccines at their local pharmacies, underscoring the vital role pharmacies play in community healthcare. This order reduces confusion and brings North Carolina in line with the policies in place in the overwhelmingly majority of other states.”
Dr. Mark McNeill, President of the North Carolina Academy of Family Physicians (NCAFP), said: “Vaccines are the most effective public health tool to prevent the spread of a broad range of contagious illnesses including COVID-19. The NCAFP supports the Governor’s efforts to ensure safe and appropriate access to COVID-19 vaccines, be it from a physician or a pharmacist. We must all work together to protect our communities against the spread of COVID-19 infection.”
Dr. John Meier, President of the North Carolina Medical Society added: “The important steps taken today by the Governor and Dr. Greenblatt will save lives by improving access to vaccines.”
Dr. Wesley Ibazebo of Old North State Medical Society commented: “Old North State Medical Society strongly endorses Governor Stein’s vaccination order. It fully aligns with our mission to promote health equity for the most vulnerable communities in North Carolina. Easier access for patients and reduced administrative obstacles for providers will make more vaccinations possible for underserved populations who face geographic, economic, or transportation challenges in obtaining preventive care.”
Dr. Marion M. McCrary from American College of Physicians’ NC chapter said: “Internal medicine physicians across North Carolina applaud the action of our state public health leaders and Governor Stein to increase the ability for our most vulnerable adult patients to receive the 2025-2026 COVID-19 vaccine in their neighborhood pharmacies. By removing access barriers to this crucial vaccine, we are facilitating the health of our patients and our communities.”
North Carolina was previously one of ten states where immunizing pharmacists could give certain age groups only if they had prescriptions when ACIP recommendations were absent; this order brings state policy closer into alignment with practices elsewhere.
The current FDA approval covers all people aged 65 years or older as well as individuals aged 18 or older with high-risk conditions such as obesity, asthma, diabetes, physical inactivity, depression, smoking history or pregnancy among others.
Most major pharmacy chains—including Brisson Drugs, Carlie C’s, Central Pharmacy of Durham, Costco,CVS Pharmacy, Food Lion,Walgreens, Walmart—have begun offering updated doses but availability may vary locally.
Parents are encouraged by officials such as NCDHHS staff members to discuss vaccinations directly with healthcare providers regarding children under age eighteen; resources like bilingual childhood vaccination toolkits remain available through NCDHHS channels.
Federal guidance may change once ACIP issues its recommendations later this month; state officials say they will continue efforts ensuring broad access statewide.
