Five years after the first cases of COVID-19 in the United States, the disease is still with us. In fact, many parts of the country, including North Carolina, have experienced high levels of COVID-19, according to wastewater data.
“COVID-19 is still a problem for a lot of people,” says UNC Health infectious diseases specialist David Wohl, MD. “Most people will have mild to moderate illness, but a significant percentage of people are at risk for worse outcomes including long COVID, and some people do still get very sick and even die.”
This year, there has been confusion about eligibility for the COVID-19 vaccine. We talked to Dr. Wohl about what you need to know.
What do I need to know about COVID-19 right now?
The COVID-19 virus continues to change, as expected.
“The variants are changing and are more infectious,” Dr. Wohl says, noting this is a natural process for viruses. “The good news is that these variants are still variations on a theme, and parts of the virus have stayed consistent for testing, medications and vaccines.”
That means that much about COVID-19 remains the same: If you have unexpired tests, you can still use them, and if you do get sick, you can ask your provider about Paxlovid for symptom relief and take a few days off work or school to rest.
Symptoms, which include fever, cough, fatigue, congestion, headache, and nausea or diarrhea, are largely the same, with a few exceptions.
“With the most recent variant, we see more sore throat and not as much loss of smell or taste or red, swollen toes,” Dr. Wohl says.
While most cases of COVID-19 are mild, the risk of long COVID, which can cause prolonged fatigue, brain fog, chest pain and headaches, remains for both children and adults.
Are there new COVID-19 vaccines?
The COVID-19 vaccines available today are updated versions of the ones that have been working for nearly five years to prevent the virus and help lessen its severity in people who are infected.
“These updated vaccines are more closely aligned with the variants that are circulating now,” Dr. Wohl says. “It’s hard to keep up exactly, because it takes time to make the vaccines and get them to clinics, but these vaccines do protect against what’s circulating now.”
Do I need a prescription to get a COVID-19 vaccine in North Carolina?
In previous years, COVID-19 vaccines were approved by the Food and Drug Administration for everyone older than 6 months. In August 2025, the FDA put new restrictions on eligibility, and different states have provided their own guidance and recommendations.
In North Carolina, there is a statewide standing order that adults older than age 65 and adults between the ages of 18 and 64 with certain health conditions can get the COVID-19 vaccine at a pharmacy without a prescription.
The health conditions, which include diabetes, mental health conditions, disability, heart conditions and an inactive lifestyle, put you at higher risk for more serious illness if you do get sick. People age 65 and older are at higher risk of serious illness due to age.
If you are an adult and do not have one of the listed health conditions, you should talk to your healthcare provider about whether the vaccine is right for you.
What about the COVID-19 vaccine for my kids or if I’m pregnant?
Again, guidance varies by state. Currently, in North Carolina, pregnant women require clinician guidance and informed consent before vaccination. The American College of Obstetricians and Gynecologists, a professional group of more than 60,000 OB-GYNs, recommends the COVID-19 vaccine during pregnancy.
Children under the age of 18 require a provider order and parent/guardian consent. The American Academy of Pediatrics recommends vaccination for all babies between the ages of 6 and 23 months because of their risk for severe disease. For children older than 2, the AAP says that the child’s risk for serious disease, their close contact with someone at higher risk and the parent’s wishes should be considered.
“When you are vaccinated while pregnant, the antibodies do transfer to the baby,” Dr. Wohl says. “Currently, the people most likely to get sick and die from COVID are the people at extremes of age, so people over the age of 75 and babies.”
I’m confused—what should I do about the COVID-19 vaccine?
If you want advice on whether to receive a COVID-19 vaccine, talk to your healthcare provider.
Because the vaccine guidelines have changed this year, it might be helpful to call your local pharmacy before your appointment to confirm that you have what’s needed to receive your shot.
When should I get a COVID-19 vaccine?
It can be convenient to get your COVID-19 vaccine when you get your flu vaccine in the fall, and the new vaccine is a good match for current variants, but you should talk to your provider about the best time for you to get the shot.
“If you’ve had COVID in the past two to three months, you have likely developed immunity to the circulating variant, and the vaccine is probably not as beneficial as it would be for someone who has not recently had COVID-19,” Dr. Wohl says.
A COVID-19 vaccine provides two levels of protection, Dr. Wohl explains. First, there’s the “force field” that helps to prevent infection when someone coughs near you.
“That force field does a pretty good job for a few weeks, so some people want to get that protection before seeing family at the holidays or before going on a cruise,” Dr. Wohl says.
Second, if you do get sick, the vaccine provides protection from severe disease so that you have a mild case rather than a severe one. It’s not clear how long this protection lasts, but it seems at least months, if not years.
Is the COVID-19 vaccine safe?
“The vaccine is very safe,” Dr. Wohl says. “There are side effects with any vaccines, but they protect much more than they harm.”
As always, talk to your healthcare provider about the benefits and risks of this or any vaccine.
“Vaccines are easy to take for granted, because you can’t see when you weren’t infected,” Dr. Wohl says. “COVID shots are a valuable tool for keeping our families healthy this respiratory virus season.”
If you have questions about vaccines, talk to your doctor or find one near you.