Beginning October 1, 2025, pharmacists at retail locations across North Carolina will be authorized to test and treat for influenza under new Standing Orders issued by State Health Director Dr. Larry Greenblatt. This measure allows pharmacists to evaluate individuals aged five and older who show symptoms of influenza, conduct point-of-care testing, and initiate treatment with antiviral medications when clinically appropriate. The change is made possible by House Bill 67.
Early testing and prompt treatment are especially important for those at high risk of flu complications, including people over 65, young children, pregnant women, individuals with weakened immune systems, and those with chronic health conditions such as asthma or diabetes. According to the North Carolina Department of Health and Human Services (NCDHHS), starting antiviral medication soon after symptoms begin can help prevent severe illness.
Pharmacists will also be able to offer preventive treatment to high-risk individuals who have had significant exposure to influenza within the previous 48 hours. In some cases, flu tests may not detect infections; anyone experiencing worsening or prolonged illness is advised to seek medical care regardless of test results.
NC Health and Human Services Secretary Dev Sangvai stated: “This action reduces barriers for people who are feeling sick or have been exposed to someone with the influenza virus. Being able to get tested and immediately treated at a pharmacy increases access for people do not have a regular provider and will help make communities healthier during the respiratory virus season.”
In addition to providing treatment, pharmacists will educate patients on self-care strategies, ways to limit the spread of influenza, and when follow-up care from a medical provider is necessary. Information from pharmacy visits will be sent to patients’ primary care providers for coordination; if patients do not have a doctor, pharmacists can assist in connecting them with one.
Fees may apply for evaluation and medications provided. While some private insurers may already cover these services immediately, broader coverage is expected over time. Patients are encouraged to check with their local pharmacy regarding availability of testing and treatment services; appointments may be required.
The standing orders do not affect those who prefer visiting their regular healthcare provider or clinic for flu-related concerns.
NCDHHS continues to recommend that everyone six months of age or older receive an annual flu vaccine—ideally in September or October before peak respiratory virus season begins in winter. Vaccines remain the most effective way to prevent serious illness from influenza as well as hospitalizations and deaths related to viral respiratory diseases. Flu vaccines are widely available at little or no cost through NC Medicaid, most private insurers, and the federal Vaccines for Children Program.
Vaccination remains particularly important for those at increased risk due to age or underlying health conditions. Vaccines against RSV (respiratory syncytial virus) and COVID-19 are also available throughout North Carolina.
