(RALEIGH) To increase access to safe and effective COVID-19 vaccines for those who so choose, Governor Josh Stein earlier today directed the State Health Director, Dr. Larry Greenblatt, to issue Standing Orders if, in his medical judgment, it advances the public health. Dr. Greenblatt, North Carolina Department of Health and Human Services (NCDHHS) Chief Medical Officer and State Health Director, has now issued Standing Orders that allow seniors 65 years or older and adults over 18 years who meet certain criteria to get a COVID-19 vaccine at a pharmacy without having to get a prescription from a 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.”
“Requiring an office visit to obtain a prescription to receive the COVID-19 vaccine is an administrative barrier for patients, providers, and pharmacies,” said Health and Human Services Secretary Dev Sangvai. “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, North Carolina had more than 120,000 emergency department visits for COVID-like illness, resulting in more than 21,600 hospitalizations. Vaccines remain an important part of overall health and well-being and are one of the most effective means available to prevent severe illness, hospitalization, and death. They help protect the health of children and adults, their families, and entire communities from the spread of infectious diseases. The Food and Drug Administration (FDA) approved the next round of COVID-19 vaccines in late August, and the Standing Order aligns with those federal recommendations.
Per state law, immunizing pharmacists in North Carolina are permitted to administer vaccines that the federal Advisory Committee on Immunization Practices (ACIP) recommends, but the committee has not yet given its recommendations for COVID-19 vaccines this season. Without ACIP recommendations, immunizing pharmacists in North Carolina may only administer COVID-19 vaccines for those ages 18 and up with a prescription. With the Standing Order, adults over age 65 or with increased risk for severe COVID-19 can get the COVID-19 vaccine at a local pharmacy without having to visit a health care provider first. The Standing Order will serve as a prescription for immunizing pharmacists to administer COVID-19 vaccines to adults for whom the FDA has already approved the vaccine. For children ages six months to 17 years, parents should talk to their pediatricians, family physicians, or health care providers about vaccine availability. The Standing Order will increase access to care for millions of people in North Carolina who want to get a COVID-19 vaccine. According to NCDHHS, more than 70% of COVID-19 doses in North Carolina were given at pharmacies last year, showing those facilities are an important point of access for those who want the COVID-19 vaccine.
“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.” – Andy Ellen, NCRMA President and General Counsel
“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. Mark McNeill, MD, FAAFP, President of the North Carolina Academy of Family Physicians
“The important steps taken today by the Governor and Dr. Greenblatt will save lives by improving access to vaccines.” – Dr. John Meier, MD, President of the North Carolina Medical Society
“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. Wesley Ibazebo, MD, President of the Old North State Medical Society
“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.” – Dr. Marion M. McCrary, MD, FACP, FAMWA, Governor, American College of Physicians North Carolina chapter
North Carolina is currently one of 10 states where, without ACIP recommendations, immunizing pharmacists can give the COVID-19 vaccine to people of certain age groups only if they have a prescription. The Standing Order aligns North Carolina with the vast majority of states where people do not need a prescription to get the COVID-19 vaccine.
The Order will align with the FDA’s Aug. 27, 2025, approval indicating the COVID-19 vaccine for:
- All people 65 years of age and older.
- Individuals 18 and older who have at least one high-risk condition. This is a broad list that includes high-risk conditions such as obesity, asthma, diabetes, physical inactivity, depression, former or current smoking, and pregnancy, among many other conditions.
- If you think you may be eligible, you can view the list of risk factors for severe COVID-19 infection on the CDC’s website.
Most pharmacies already have the updated 2025-2026 COVID-19 vaccine available, but since the seasonal vaccine formulations were recently approved by FDA, it may not yet be available at all locations. People should call their pharmacy of choice to see if they have COVID-19 vaccines available and make an appointment if needed. You should bring your insurance card if you have one and be prepared to answer a few simple questions, like how old you are or whether you have a qualifying condition. NCDHHS is continuing to work with partners to maximize the availability of COVID-19 vaccines for individuals who want the vaccine and would benefit from its protection.
To date, the following retail pharmacies have announced they have the updated COVID-19 vaccine available: Brisson Drugs, Carlie C’s, Central Pharmacy of Durham, Costco, CVS Pharmacy, Food Lion, Hope Mills Pharmacy Fairmont Drug Company, Ingles Markets, Med Smart Pharmacy, Med Source Pharmacy, Publix Pharmacies, Sam’s Club, Walgreens, and Walmart.
This a partial list of pharmacies available to provide COVID vaccines. If you do not see your pharmacy’s name on this list, please reach out to confirm they are administering vaccines.
ACIP recommendations are expected later in September, and federal guidance may continue to evolve. As this happens, North Carolina will do everything it can to ensure people have access to safe and affordable COVID-19 vaccines.
Individuals, including parents, should talk with their health care provider or their child’s health care provider about the benefits and any concerns regarding seasonal vaccines, including the COVID-19 vaccine. NCDHHS also has a bilingual childhood vaccinations toolkit in English and Spanish for providers to help individuals, parents, and providers have conversations about the importance of vaccination.
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