NC Expands Covid Booster Access
Governor Stein signs an executive order in a picture provided by his office. Source: NC Governor’s Office.
The new COVID-19 booster is now out, and as the federal government is tightening its recommendations for who should receive the shot, a state law requiring prescriptions for vaccines has been reinstated, causing major pharmacy chains such as CVS and Walmart to restrict access.
This restriction could prevent many North Carolinians from receiving their yearly COVID-19 shot. Governor Josh Stein and State Health Director Dr. Larry Greenblatt issued a standing order to expand vaccine access without a prescription. This order will allow people aged 65 and up, and those 18 and older who fit high-risk criteria such as obesity, asthma, diabetes, smoking, pregnancy, depression, inactivity, and more, to get a COVID-19 vaccine without having a prescription. The FDA’s list of recommended populations for the updated is nearly identical to the populations covered by the new order. Neither are as expansive as previous rules surrounding booster eligibility. While this standing order does protect some individuals’ ability to get vaccinated, it does not substantially diverge from the federal government’s recommendations. The order is similar to those enacted by Minnesota, Washington, and New York, which attempt to make vaccines more accessible.
According to Governor Stein, vaccines are “a safe and effective tool to protect yourself and your community,” and this mandate will ensure “that North Carolinians most at risk who want protection from COVID-19 can get it as we enter the cold and flu season.” The Governor’s goal is clear: to prevent new infections as flu season approaches.
Even with Governor Stein’s order allowing certain populations to receive vaccines without a prescription, any individual under 65 without an underlying health condition will face major issues in receiving new booster shots. In the peak years of the pandemic, these state laws requiring prescriptions had been overridden by the FDA's Emergency Use Authorization. With Emergency Use Authorizations for COVID-19 rescinded boosters, responsibility for vaccinating the public now falls to the states. Some, including North Carolina, are attempting to expand access; others are not.
COVID-19 and flu rates tend to increase during the winter months. According to North Carolina Health and Human Services Secretary Dev Sangvai, “requiring an office visit to obtain a prescription” for a vaccine “is an administrative barrier for patients, providers, and pharmacies.” This winter, these new restrictions are likely to reduce the number of people receiving vaccines and lead to higher rates of infection. We could therefore see disparity in health opportunities based on state residence. The move from North Carolina, Minnesota, Washington, and New York also has implications for the future of public health regulations. With some states protecting access to vaccines, it raises the question of whether the future of public health will now be in the hands of state governments.
If public health is primarily in the jurisdiction of state governments, disparity in resources between states could lead to very different health outcomes for Americans. This federalization of public health is part of the larger trend of deregulation and federalization done by the Trump administration. It could endanger the lives and health of American citizens. In North Carolina, moves like the standing order issued by Governor Stein allow for certain populations to obtain vaccinations more easily. While it doesn’t cover every citizen, it is an encouraging step in the face of weakening federal public health protection.
If you have questions about COVID-19 vaccinations in North Carolina, you can visit NCDHHS.