COVID leads NC to take ‘very important step,’ giving pharmacists more responsibility
Although the public will see very little change, a bill signed into law on Friday marks an important step forward for how pharmacists can serve health needs in North Carolina, a spokesperson for state regulators said.
Starting Sept. 1, the law will roll out a series of changes in how vaccines are distributed, starting with a permanent change that allows pharmacists, pharmacy technicians and pharmacy interns to continue administering COVID-19 vaccines to people over the age of 18.
The new law also requires written consent from parents or guardians before children under age 18 can receive a COVID-19 vaccine while it’s awaiting final U.S. Food and Drug Administration approval. The consent requirement took effect immediately.
Historically, the state’s pharmacists, pharmacy technicians and pharmacy interns lacked the authority to dispense drugs for viruses and chronic illnesses without a prescription.
Pharmacists were given the authority in 2011 to vaccinate adults against the flu, and in 2013, the list was expanded to include CDC-recommended vaccinations, such as the pneumococcal, hepatitis B, tetanus and TDAP vaccines. Pharmacists only have the authority to vaccinate younger children with a prescription.
Last year’s COVID-19 threat prompted state and federal officials to further loosen the reins.
The expanded vaccination authority — which had been temporarily handed down through the federal Public Readiness and Emergency Preparedness (PREP) Act and by a standing order from the North Carolina state health director — will take effect on Sept. 1.
That will mark an important step for North Carolina pharmacists, technicians and interns, because their federal emergency authority was going to end at some point, N.C. Board of Pharmacy spokesman Jay Campbell said.
“It’s certainly a very important step forward at such time as we’re not under these public health emergencies because of COVID,” Campbell said.
Delta prompted the changes
Gov. Roy Cooper signed the bill into law Friday as the COVID-19 delta variant continued to spread largely unabated.
The N.C. Department of Health and Human Services reported that the number of hospitalizations has risen from 409 COVID-19 patients on July 9 to at least 3,147 patients as of Friday. At least 1.1 million people in North Carolina had tested positive for the coronavirus, including 6,631 new cases reported Friday, state officials said.
Over 14,000 people have reportedly died since March 2020.
Over half of the state’s residents have been vaccinated, health officials reported, with about 64% of people age 18 and older receiving at least one dose of a COVID-19 vaccine and about 59% getting fully vaccinated.
“This important legislation will help our state administer COVID-19 vaccines more quickly and efficiently,” Cooper said in a news release about the changes.
More work, people visiting pharmacies
No public health or safety issues have been reported since pharmacists, technicians and interns were allowed to vaccinate people against COVID-19 and other viruses, Campbell said, but they have struggled to handle the increased workload.
Tiffany Barber, owner of Hillsborough Pharmacy and Nutrition, estimated that her staff has distributed roughly 8,000 vaccines this year through the pharmacy, its IndyCare clinic next door, and at neighborhood clinics held with the Orange County Health Department and the PORCH Hillsborough hunger relief organization.
“Now, with the delta variant, a good thing about that is some of the people that were hesitant have now decided it’s time to get it,” Barber said. “I don’t know if the delta variant is so scary, especially for children, or they think it’s been out long enough, but that has definitely increased it, (along with) everybody going back to school and some places requiring it. We’ve gone crazy again.”
The federal Centers for Disease Control and Prevention also announced this week that people with moderately to severely compromised immune systems, who are more at risk of a serious, prolonged illness, could get another dose of the Pfizer and Moderna vaccines. No decisions have been made about another shot for those who received the one-dose Johnson & Johnson vaccine.
Many people are coming to the Hillsborough pharmacy for a third dose, Barber said, and she expects that number to grow once other adults and eventually children are authorized. That could be around the time that people also are coming in for the flu shot, she said.
Campbell praised pharmacists who have met the challenge without any real public health or safety issues.
“Pharmacists have done incredible work being the vanguard of health care professionals out there getting folks vaccinated for COVID,” Campbell said. They “have done what we expected would be the case — they have gotten hundreds of thousands of North Carolinians vaccinated without any public health and safety risk that anybody has identified.”
What the law means for children
Until now, state law has allowed children ages 12 to 17 to seek medical treatment for some health issues, including the COVID-19 vaccine, without their parent or guardian’s permission. The new law ends that policy until an FDA-approved vaccine is available for children.
The three vaccines now being distributed — Pfizer, Moderna, and Johnson & Johnson — have received only the FDA’s emergency use authorization. The Pfizer vaccine is the only one that has been approved for children ages 12 to 17.
Final FDA approval for at least one vaccine could happen as early as Monday, but it may only apply to adults, health officials have said.
Meanwhile, over 1 million students are poised for the return to school this week in North Carolina and the delta variant is sending people to hospitals across the state. Health experts warn the delta variant is three times as contagious as the original virus.
On Friday, The News & Observer reported that 85 of the state’s 115 school districts will require face masks when students and staff return to the classroom.
What else the law changed
Some parts of the new law, including permanent statewide rules for administering and reporting vaccinations, as well as disciplinary actions for those who fail to comply with the new rules, will be rolled out over the next seven months.
On Oct. 1, pharmacists will be able to dispense long-acting medications, such as testosterone or vitamin B12 injections. Patients must be at least 18 years old and have a prescription from a doctor.
Pharmacists, starting on Feb. 1, 2022, also will be able to:
▪ Vaccinate children between the ages of 6 and 10 against COVID-19 if they have seen a doctor and received a prescription. This change is contingent on final FDA approval of a vaccine for children.
▪ Vaccinate people who are at least 10 years old against the flu without a prescription.
▪ Provide FDA-approved nicotine replacement therapy.
▪ Provide self-administered oral contraceptives or a birth control patch. A prescription is required for an emergency contraceptive, such as ulipristal acetate.
▪ Provide prenatal vitamins.
▪ Provide medications that prevent human immunodeficiency virus (HIV) in people who have been exposed through sex, shared needles or other high-risk activities..
▪ Provide Glucagon to someone experiencing severe hypoglycemia, or low blood sugar.
▪ Provide any other self-administered injection for which the person has a prescription.
Where and how to get vaccinated
Most independent and chain-store pharmacies are offering one or more of the COVID-19 vaccines to anyone 12 and older. Vaccine shots are free regardless of medical insurance status, and many places are taking walk-in patients, as well as appointments.
Here are some of the Triangle’s major pharmacies offering COVID-19 vaccinations, or check with your local, independent pharmacy. Or visit the state’s Take My Shot website at takemyshot.nc.gov.
▪ Walgreens: Same day and walk-in appointments available. Schedule a visit online at tinyurl.com/yszm25w5. COVID-19 testing also is available at the drive-thru window. Go online to tinyurl.com/ryejrjd8 to schedule an appointment.
▪ CVS: Walk-ins accepted or make an appointment. Vaccines are available at CVS pharmacies and select MinuteClinics. Schedule a visit online at cvs.com/coronavirus.
▪ Harris Teeter: The vaccine is only offered in some Harris Teeter pharmacies. Check online at harristeeter.com/covidcare for a nearby store and to make an appointment.
▪ Publix: Book an appointment online at publix.com/covid-vaccine.
▪ Costco: Walk-ins and appointments accepted. Schedule a visit online at costco.com/covid-vaccine.
▪ Walmart: Walk-ins and appointments available. Scheduling walk-in appointments only for a third dose. Plan a visit online at walmart.com/cp/1228302.
This story was originally published August 22, 2021 at 10:34 AM.
