A Bold Move to Maintain Vaccine Access in New York State
Today, New York State Governor Kathy Hochul signed an Executive Order authorizing licensed pharmacists in New York State to administer COVID-19 vaccines to individuals three years old and older without a prescription. The order is intended to safeguard public access to vaccines amid new federal limitations that significantly restrict eligibility.
The order is effective immediately and is part of a broader effort by several Democratic-led states to maintain independent vaccine policies in response to political and regulatory uncertainty at the federal level.
Federal Restrictions Spark State-Level Action
Last week, the US Food and Drug Administration (FDA) approved updated versions of the COVID-19 vaccine but authorized them only for individuals 65 years old and older and for younger individuals with qualifying medical conditions. Children remain eligible but only if a medical provider is involved in the decision-making process.
This marks a notable departure from past years, when vaccines were generally available to most adults without restriction. Public health leaders have raised concerns that these changes reflect growing politicization of vaccine access, particularly given the vocal skepticism of mRNA vaccines by current US Health and Human Services Secretary Robert F. Kennedy Jr.
Governor Hochul’s Executive Order represents a direct challenge to those restrictions, empowering pharmacies to ensure that access remains widespread and equitable throughout New York State.
What the Executive Order Authorizes
The Executive Order grants pharmacists in New York State the authority to prescribe and administer COVID-19 vaccines to anyone three years old and older without requiring a standing order or patient-specific prescription. This expands the pharmacist’s scope of practice under New York State law for COVID-19 vaccinations only.
In a statement, Governor Hochul’s office emphasized that the move is necessary to protect public health in the face of “relentless uncertainty and political attacks on science coming out of Washington.” The governor’s goal is to allow families to obtain COVID-19 protection “quickly, safely, and close to home.”
Implementation and Compliance Considerations for Pharmacies
Pharmacies across New York State should begin preparing for immediate implementation once the Executive Order is officially signed and published. Workflow updates, staff training, and inventory management will be essential to meet anticipated demand.
While the Executive Order removes the legal requirement for prescriptions, pharmacies must continue to comply with existing obligations under state law, including proper documentation, informed consent (particularly for minors), and timely reporting to immunization registries such as the New York State Immunization Information System (NYSIIS) and New York Citywide Immunization Registry (CIR).
Pharmacists administering vaccines must also maintain up-to-date immunization certifications.
Pediatric Vaccines: Eligibility and Caution
The pediatric COVID-19 vaccine landscape is especially complex. The FDA has revoked emergency authorization for Pfizer’s shot in children under five years old, leaving Moderna’s vaccine as the only available option for children six months to four years old—and only for those with qualifying health conditions.
Further complicating the matter, the American Academy of Pediatrics has issued guidance recommending COVID-19 vaccination for all children six months to two years old, in direct contrast to the CDC, which does not recommend the vaccine for healthy children.
Pharmacies offering pediatric doses should proceed cautiously, ensuring appropriate consultation, documentation, and parental consent are in place.
Reimbursement and Insurance Uncertainty
One area of concern is whether health insurance plans will fully reimburse pharmacies for COVID-19 vaccines administered under this emergency authority. While the Executive Order expands access, it does not guarantee that commercial payers or public insurance programs will immediately update their policies to reflect the change.
Pharmacies should monitor announcements from Medicaid, Medicare, and commercial insurers and be prepared to communicate clearly with patients about coverage or potential out-of-pocket costs.
Legal Outlook and Policy Significance
The Executive Order is a temporary measure issued under the governor’s emergency public health powers. While it immediately expands access, it may be amended or rescinded as conditions evolve. Pharmacies should remain attentive to updates from the New York State Department of Health and the State Education Department, which may issue additional guidance or regulatory adjustments.
This move also signals a broader legal and political shift—where states are increasingly willing to diverge from federal public health policy to protect access for their residents. For New York State pharmacies, this order not only reaffirms their critical role in public health but also places them at the center of the state’s vaccination strategy moving forward.
Strategic Opportunity for Pharmacies
For independent pharmacies, the Executive Order offers both a responsibility and an opportunity. As some health care providers scale back or delay vaccine availability due to new restrictions, pharmacies are positioned to fill a critical access gap, particularly for working families, seniors, and underserved communities.
By taking swift action to implement the Executive Order, pharmacies can strengthen their community presence, enhance public trust, and play a leading role in the state’s COVID-19 response.
Governor Hochul’s Executive Order underscores the importance of local authority and pharmacist empowerment in maintaining access to life-saving care. As federal guidance becomes more limited and politically charged, New York State’s approach offers a practical, community-based solution.
Pharmacies must now move quickly to prepare their teams, update protocols, and navigate the regulatory and insurance landscape. With the right planning, they can meet patient demand while remaining fully compliant with evolving state law.
Barclay Damon advises pharmacies nationwide on vaccine compliance, public health orders, audits, and licensing. If your pharmacy has questions about implementing the Executive Order or requires legal assistance with operational readiness, reach out today.
If you have any questions regarding the content of this alert, please contact Brad Gallagher, co-leader of the firm's Health Care Controversies and Pharmacy Teams, at bgallagher@barclaydamon.com, or another member of the firm’s Health Care Controversies Team.