NC shifting policy on vaccines for visitors from out of state

Roughly 3 percent of people vaccinated in North Carolina came from out of state, in line with neighboring Tennessee.

Posted Updated

Travis Fain
, WRAL statehouse reporter
RALEIGH, N.C. — The state has shifted its policy on vaccinating people from across state lines, saying vaccine providers no longer have to offer coronavirus inoculations to people who don't live, work or spend "significant time" in North Carolina.
The move follows a shift in U.S. Centers for Disease Control and Prevention guidance last week – guidance that top state health officials said once required vaccinators to take all comers, provided they met the state's tiered vaccine eligibility plan.
The state Department of Health and Human Services said 2.72 percent of the first 1.1 million first doses administered in North Carolina went to non-residents. That works out to just under 30,000 shots.

It's not clear how many of those people traveled to North Carolina just to get the vaccine, as opposed to working here or staying in the state long term despite having a home address somewhere else. But there are some indications of "vaccine tourism," with people crossing into North Carolina just to get a shot.

George Allen, a former Virginia governor, traveled more than an hour from Virginia Beach, Va., to Elizabeth City last Friday to get his shot at a Walgreens, then tweeted about the trip, posting pictures on social media.

"Like many VA Beach neighbors we find NC much easier to get COVID vaccination," he wrote. "My family is happy, relieved. Will now go to Popeye's."

Former Virginia Gov. George Allen tweeted Friday, Feb. 12, 2021, that he travelled to North Carolina to get his COVID-19 vaccine.
JoAnne Kitchen said she saw Virginia license plates at a vaccination clinic in Elizabeth City two weeks ago.

"They were right in front of me, and as soon as they pulled up, [clinic providers] made them go around and turn around and get out of here," Kitchen said. "They would not let them do it until the North Carolina people had done it."

David Gray and Melanie Ezmirly said residents of Virginia Beach, Norfolk and other parts of the Hampton Roads area of Virginia should be turned away from North Carolina vaccination clinics.

"They're a bigger metropolitan area, and they probably ought to have more [doses] than we do," Gray said.

"Since each state's limit is kind of small, I think everybody should stick to their own state," Ezmirly agreed. "We're kind of small down here. Let us vaccinate our own people first."

Albemarle Regional Health Services Director R. Battle Betts, whose organization oversees public health in and around Elizabeth City, said ARHS initially had about 2,000 people show up from out of state to get their shots, in part because North Carolina and Virginia had different eligibility requirements.

"This has since been rectified and should alleviate the issue moving forward," Betts said in an email. "On the demographics front, I don’t believe it was a wealth issue, as we had a wide variety of folks present for service from all parts of VA."

For weeks, North Carolina officials have said they couldn't turn away out-of-state vaccine seekers because the vaccines are paid for and provided to each state by the federal government. But the CDC's guidance on this shifted last week, and state officials confirmed Monday that North Carolina will shift with them, though it seems local health departments, hospitals and pharmacies offering shots get the final say.

"It is permissible to not offer vaccine to temporary travelers who do not reside, work, or spend significant time in the North Carolina," DHHS spokeswoman Sarah Lewis Peel said in an email. "This could include persons briefly passing or traveling through North Carolina or coming to North Carolina for the main purpose of receiving a COVID-19 vaccine and then returning to another state."

It wasn't immediately clear whether other neighboring states will follow suit. Health departments in South Carolina and Tennessee told WRAL News on Friday that they don't have residency restrictions, and Tennessee put its out-of-state-shots percentage in the same neighborhood as North Carolina's – about 3 percent.

Health departments for the other two states that border North Carolina – Virginia and Georgia – didn't immediately respond to questions, but Georgia's health commissioner has said publicly that the state doesn't try to prevent the practice, though she considers border-crossers "irresponsible and selfish."

North Carolina got word of the CDC's shift early last week.

"A state may decide that protecting the public health of its residents requires limiting vaccinations to state residents and not temporary travelers who do not reside in the state," a liaison with the CDC's coronavirus team told DHHS, in an email later provided to WRAL News. "This would be allowable under CDC’s grant terms as long as the policy is intended to promote public health aims, such as reaching priority populations and promoting equity."

Asked about the previous policy, DHHS provided an email chain from January. Initially, a regional liaison with the CDC said it was up to the states. But two days later, on Jan. 8, that was clarified: "As a federal vaccine bought with federal funding, jurisdictions should not put restrictions on administering to non-residents, as long as those patients meet the current eligibility criteria."

Health experts say it makes sense to offer vaccinations across county and state lines in some cases. Even in discussing the latest policy shift, DHHS said "all North Carolinians will benefit from as many eligible people as possible receiving the vaccine as quickly as they are able." The department also said people who work in North Carolina or receive ongoing health care here should continue to be vaccinated here if they like.

Betts said he he didn't have a problem with Virginians from border counties coming to North Carolina for their shots.

"You could certainly make a viable argument that border counties could potentially serve each other without borders, as there tends to be quite a blend in daily living anyway," he said. "The true issue was folks attempting to come from Richmond and northward. I believe that is beyond anyone’s reasonable expectation."

Elizabeth City resident Desi Spence agrees, provided locals get the first shot at shots.

"If they need it, I feel like everyone should be entitled to get it wherever because everybody needs it," Spence said. "That'll stop the spread of the coronavirus."

WRAL reporter Bryan Mims contributed to this report.


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