After FDA limits, Gov. Stein explores ways to expand COVID vaccine access in NC

COVID-19 vaccine access for some people has been upended after the U.S. Food and Drug Administration limited who can get the new boosters.

Some states have found workarounds to help keep boosters available to those who want them, including Minnesota, Washington and New York.

North Carolina has not, but it is looking into options, according to state leaders. It is among several states where access has already narrowed.

Major chains such as CVS and Walgreens are restricting in North Carolina who can schedule appointments for a shot, The Charlotte Observer reported. (At CVS MinuteClinics, the vaccine is available without a prescription but may cost $224.99).

That’s because under state law, pharmacists can only administer COVID-19 vaccines to patients over the age of 18 with a prescription, or if in line with guidelines from the CDC’s Advisory Committee on Immunization Practices. The North Carolina Board of Pharmacy says on its website that it can’t waive the requirements of the law, as some pharmacists have asked.

A spokesperson for Democratic Gov. Josh Stein’s office said in an emailed statement: “The Governor’s Office and NC DHHS are working to determine what options North Carolina has to provide convenient vaccine accessibility across the state.”

“Doctors recommend vaccination as a safe and effective tool to protect yourself and your community from COVID-19,” said the spokesperson.

Any executive action could face pushback from the legislative branch, which has a Republican supermajority.

The FDA approved the updated COVID-19 vaccines on Aug. 27, recommending them only for people 65 and older and for anyone 6 months and up with at least one high-risk condition.

The FDA has not published a definitive list of what counts as a qualifying risk but has reportedly cited a list maintained by the Centers for Disease Control and Prevention that includes asthma, cancer, obesity and more.

Once the FDA approves a vaccine, the CDC advisory committee provides recommendations, with the CDC director giving final approval on guidelines. That panel is scheduled to meet Sept. 18 and 19, according to the CDC’s website.

In June, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. dismissed all the sitting members of the panel and replaced them with his own picks. Last month, CDC Director Susan Monarez was fired after clashing with Kennedy, and other senior CDC leaders resigned. Kennedy later faced questions about those actions in a U.S. Senate hearing, including from North Carolina lawmakers.

Pharmacies, doctors, and insurers usually follow CDC guidance, leaving uncertainty for healthy adults and others who want the shot but don’t meet FDA criteria. While doctors can prescribe vaccines off-label, meaning for a different use than was approved, pharmacists in North Carolina cannot.

Vaccines recommended by the CDC are typically covered at no cost by insurers, but those left out may have to pay more than $200 out of pocket. Blue Cross NC told The Charlotte Observer it is waiting on a CDC advisory before deciding on coverage.

The state’s Department of Health and Human Services echoed Stein’s message in a separate statement, saying it was “closely monitoring for changes in federal recommendations for COVID vaccines” and “actively exploring options to improve vaccine availability and ensure that all North Carolinians have convenient access to vaccinations throughout the state.”

DHHS said “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. Professional medical societies continue to recommend COVID vaccination for all young children and pregnant women.”

DHHS also provided a link to its bilingual childhood vaccinations toolkit.

It said it was working on updating its vaccine website, which links to CDC guidance as of Wednesday that had not been updated.

The announcement comes as a new strain, NB.1.8.1 — made more transmissible by a spike protein mutation — continues to spread across the country, The Charlotte Observer reported.

Other state actions

Here are some actions other states have taken:

• Washington: The state Department of Health issued a standing order allowing health care providers —including pharmacists, nurses, medical assistants, and others — to give the updated COVID-19 vaccine for people six months and older, including pregnant individuals, without a prescription.
• Governors of Washington, Oregon, and California have also formed an alliance to provide public health guidance, particularly on COVID-19 and vaccine access, in light of federal actions. Hawaii also joined the alliance.

• New York: Gov. Kathy Hochul declared a statewide disaster emergency in a Sept. 5 executive order. The order, in effect for one month, temporarily suspends or modifies some laws so that pharmacists can both prescribe and give COVID vaccines to children as young as 3 and to adults, and it also makes it easier for doctors and nurse practitioners to authorize pharmacists to give the shots with blanket orders.
• Minnesota: Gov. Tim Walz in an executive order directed his state’s health department to issue a standing order to “ensure the broadest possible access.” Pharmacists are legally allowed to give flu and COVID-19 vaccines to anyone age 3 and up as long as the vaccine is FDA-licensed, Walz’s office said in a news release; they don’t need a prescription from a doctor or a green light from the CDC’s advisory committee.

This story was originally published September 11, 2025 at 11:16 AM.

Luciana Perez Uribe Guinassi

The News & Observer

Luciana Perez Uribe Guinassi is a politics reporter for the News & Observer. She reports on health care, including mental health and Medicaid expansion, hurricane recovery efforts and lobbying. Luciana previously worked as a Roy W. Howard Fellow at Searchlight New Mexico, an investigative news organization.