NC order expands COVID booster access after laws led CVS, Walgreens to limit shots

The state’s health director issued standing orders on Friday expanding access to COVID-19 vaccine boosters to get around limitations on who could get shots in North Carolina.

In the absence of federal guidelines, state law requires a prescription for the vaccines. And with those guidelines still pending, major pharmacy chains such as CVS and Walgreens restricted who can get a shot in North Carolina, The Charlotte Observer reported.

Now Gov. Josh Stein’s administration is following several states including Minnesota, Washington and New York that have found workarounds to keep boosters more widely available.

But many people aren’t covered by the orders.

Who the change affects

Stein directed State Health Director Dr. Larry Greenblatt to issue standing orders if it advanced public health, according to a news release from Stein’s office.

The orders allow people 65 and older, and adults 18 and up who meet certain criteria, to get a COVID-19 vaccine at a pharmacy without needing a prescription from a provider.

The standing orders align with federal recommendations, said Stein’s release. But it expands access to those who are eligible.

“Health care providers and pharmacists recommend vaccination as a safe and effective tool to protect yourself and your community from COVID-19,” said Stein in the news release. “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.”

The News & Observer reported Thursday that Stein was exploring ways to expand vaccine access after the U.S. Food and Drug Administration 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.

Even for those groups, North Carolina law made it hard to get the vaccine. Pharmacists in the state can only give COVID-19 vaccines to adults 18 and older with a prescription, or if the vaccines are recommended by the CDC’s Advisory Committee on Immunization Practices.

The CDC committee has not yet given its recommendations for this season’s vaccines. It is scheduled to meet Sept. 18 and 19, according to the CDC’s website.

Without CDC guidance or a prescription, many adults would have had to make a doctor’s appointment to get permission for a shot the FDA already said they could have. The new standing order gives a blanket prescription: It lets pharmacists vaccinate adults 65 and older, and younger adults at higher risk, without waiting on the CDC or requiring individual doctor visits.

As federal guidance evolves, “North Carolina will do everything it can to ensure people have access to safe and affordable COVID-19 vaccines,” says the release.

North Carolina is one of 10 states where, without ACIP recommendations, pharmacists can only vaccinate adults 18 and older if they have a prescription. The order brings North Carolina in line with most states where a prescription is not required, said the news release.

For children ages 6 months to 17, parents should consult their pediatricians or other health care providers about vaccine availability, the release said. According to NCDHHS, more than 70% of COVID-19 doses in North Carolina last year were given at pharmacies.

“Requiring an office visit to obtain a prescription to receive the COVID-19 vaccine is an administrative barrier for patients, providers, and pharmacies,” said NC Health and Human Services Secretary Dev Sangvai in the news release. “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.”

This story was originally published September 12, 2025 at 4:52 PM.

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.