A growing number of states are taking action to ensure broad access to COVID-19 vaccines as respiratory virus season approaches.The state-level moves come after the FDA limited approval of updated shots to individuals 65 and older, and those with at least one condition that puts them at high risk for severe disease. The narrow approvals drew criticism from healthcare groups, which have said the decision will cause confusion and create new access hurdles, which could limit uptake and further strain the nation’s healthcare system in the coming months.
The Advisory Committee on Immunization Practices, which provides vaccine recommendations to the CDC, is scheduled to meet Sept. 18-19 to discuss — and potentially vote on — several shots. Vaccines for COVID-19, hepatitis B, measles, mumps, rubella, varicella and respiratory syncytial virus are on the docket.
In lieu of the committee’s guidance, which usually is issued earlier than mid-September, several states are issuing executive orders, circumventing ACIP to follow other national healthcare organizations or taking different steps to expand access to COVID-19 vaccines.
Editor’s note: The list is not exhaustive and will continue to be updated.
California: On Sept. 3, the country’s most populous state banded with Oregon and Washington to form a health alliance to coordinate vaccine recommendations. The West Coast states said they will finalize shared principles in the coming weeks, with “consistent, science-based recommendations they can rely on — regardless of shifting federal actions.”
Oregon: The state is part of the West Coast Health Alliance with California and Washington. During the COVID-19 pandemic, western states formed a similar working group to boost public confidence in vaccines.
Washington: The state joined California and Oregon to craft their own vaccine recommendations based on “respected national medical organizations,” according to a Sept. 3 news release.
Colorado: The state issued a public health order Sept. 3 that will allow pharmacists to administer vaccines without individual prescriptions to patients 6 months and older. It also requires the Colorado Department of Public Health and Environment to work with the state’s insurance division to ensure vaccines are fully covered for Medicaid members.
Pennsylvania: The commonwealth’s pharmacy board voted Sept. 3 to direct pharmacists to follow guidance from select national healthcare organizations, rather than solely from ACIP. Pennsylvania will follow recommendations from the FDA, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics and the American Academy of Family Physicians.
New York: In a Sept. 5 executive order, Gov. Kathy Hochul declared a disaster related to federal access to vaccines. The directive allows pharmacists to administer COVID-19 vaccines without a prescription to anyone 3 years or older, including pregnant women and healthy adults and children.
Minnesota: Gov. Tim Walz signed an executive order Sept. 8 directing the state epidemiologist to issue a standing order for COVID vaccines. The move will “provide greater flexibility for healthcare providers and pharmacists to provide the vaccine,” according to a news release. State officials clarified that this process is not dependent on recommendations from ACIP, meaning the vaccines will be available irrespective of upcoming recommendations from the committee on who should receive the updated shots.
New Jersey: Under an executive directive issued by the state’s health department Sept. 9, anyone 6 months and older is eligible to receive the updated COVID vaccine. The department also passed a standing order that authorizes pharmacists to administer the vaccines to individuals 3 and older. Children younger than 3 will be able to receive a vaccine directly from their healthcare provider.
Connecticut: Gov. Ned Lemont signed a series of actions Sept. 10 aimed at ensuring broad access to the vaccines. The state’s health department shared interim guidance recommending the vaccine for everyone who qualifies based on the FDA’s eligibility criteria. Through the Department of Consumer Protection, Connecticut pharmacists are advised to provide the vaccine to anyone who falls outside of the limited eligibility criteria without a prescription. Meanwhile, the Connecticut Insurance Department issued a bulletin reaffirming that coverage of the vaccines is required under state-issued insurance policies “regardless of ACIP’s position.”
What are retail pharmacy giants doing?
CVS, the nation’s largest pharmacy chain with more than 9,000 locations, has provided the most comprehensive information on which states require a prescription, according to The Washington Post.
The company is offering COVID-19 shots without a prescription in these states, according to the Post: Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, Nevada, New York, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Vermont, Washington, Wisconsin and Wyoming.
If ACIP recommends COVID-19 vaccines later in September, CVS said it will not require a prescription at its pharmacies in the other 10 states and Washington, D.C.
Walgreens said on its website it is offering COVID-19 vaccines without a prescription in 39 states.
Residents in Arizona, Georgia, Indiana, Louisiana, Maine, North Carolina, Oregon, South Carolina, Utah, West Virginia and the District of Columbia will need a prescription. Walgreens is waiting for ACIP’s guidance before offering COVID-19 shots in Florida, Puerto Rico and the Virgin Islands.
“In accordance with FDA approval and state requirements, we are offering the vaccine to all adults ages 65 years and older, as well as to individuals under 65, who are at higher risk for severe outcomes from COVID-19, as determined by the CDC,” the company said. “Pharmacies will begin offering the COVID-19 vaccine nationwide once the Advisory Committee on Immunization Practices issues eligibility guidance.”
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