Arizona issues standing orders for flu, COVID vaccines ahead of respiratory season

For people in Tucson and across Pima County, pharmacists and other qualified health care providers can now give this season’s flu and COVID vaccines without waiting for an individual prescription or updated federal recommendations. The Arizona Department of Health Services and Arizona Board of Pharmacy issued standing orders ahead of the respiratory season, which typically begins in October. The orders are intended to keep vaccination available while the federal committee that normally advises on immunization schedules remains unable to provide timely guidance.

The state’s action comes as COVID activity in Pima County has begun moving upward. During the 2025 to 2026 season, the county recorded more than 3,000 COVID cases and roughly 4,500 flu cases, according to state data. Dr. Joel Terriquez, medical director for the ADHS Division of Public Health Preparedness, said the increase in COVID cases does not amount to a surge or major peak, but it follows the seasonal pattern officials typically see as winter approaches. Health officials are watching the trend as respiratory illnesses begin placing more demands on clinics and hospitals.

A standing order works much like a prescription issued in advance. It gives authorized pharmacists and health care providers permission to administer the vaccines without obtaining a separate physician order for each patient. The flu order allows pharmacists to vaccinate people age 3 and older, while a similar order covers the newest COVID vaccine. Arizona officials said the policy is designed for residents who want protection but might otherwise face delays because of the federal situation. It is not a mandate, and pharmacies are not required to offer either vaccine.

Insurance coverage and out of pocket costs also are not guaranteed by the state directive. Residents may need to check with their pharmacy and insurance provider before receiving a shot. The order creates legal authorization to administer the vaccines, but it does not require a business to stock them or set a uniform price. If federal recommendations change, ADHS said it will review the new information and revise its guidance if necessary.

Normally, the federal Advisory Committee on Immunization Practices, known as ACIP, meets to advise the Centers for Disease Control and Prevention on vaccine recommendations. As of the state announcement, the committee had not met this year. Its website listed a possible meeting for late October, around the time Arizona’s respiratory season is already getting underway. Nicole Witt, ADHS interim deputy director of public health services, identified that timing as a concern because residents and providers need direction before illness begins spreading more widely.

The federal delay followed a dispute over the committee’s membership. Health and Human Services Secretary Robert Kennedy Jr. had replaced the panel’s independent experts earlier this year after repeatedly questioning the safety and effectiveness of routine vaccines. A federal judge blocked that move, leaving ACIP without enough members to form a quorum. Without a functioning committee, the latest flu and COVID vaccine formulations could not receive the usual federal approval needed for pharmacists to give them without a doctor’s prescription.

Terriquez said Arizona cannot predict what federal recommendations may eventually change, but the state has consulted guidance from multiple medical specialties, including pediatrics, internal medicine, obstetrics and gynecology. State officials say those groups base their recommendations on medical research and available data. Health Director Dr. Richard Carmona issued the current standing orders. Carmona previously served as U.S. surgeon general under President George W. Bush, worked as a deputy with the Pima County Sheriff’s Department and was the Democratic nominee for U.S. Senate in 2012.

Arizona has used this approach before. Nearly a year ago, ADHS issued a standing order after the federal Food and Drug Administration replaced broader COVID vaccine access rules with guidance limiting vaccination without a prescription to people age 65 and older and those with certain medical conditions. That shift contributed to Banner Health, Arizona’s largest hospital network, stopping administration of the newest COVID vaccine and saying its doctors would no longer write prescriptions for it. The earlier episode demonstrated how federal policy changes could quickly affect vaccine access for Arizona residents.

State officials say the immediate goal is to prevent those access problems while reducing severe illness, hospitalizations and pressure on the health care system. Winter illnesses can lead to pneumonia, upper respiratory infections and other conditions that increase demand on medical facilities. Carmona said vaccines remain an important tool for protecting communities, limiting disease spread and reducing health care costs. For Tucson residents, the practical next step is to ask local pharmacies or health providers whether they are offering the shots, what the cost will be and whether insurance will pay, rather than assuming every location will provide them.