COVID-19 Is No Longer “Reportable” in North Carolina: Implications for Minor’s Consent

As of May 12, 2023, SARS-CoV-2— the virus that causes COVID-19— is no longer considered a “novel” coronavirus that must be reported to public health authorities under North Carolina law. This change affects minors seeking preventive, diagnostic, and treatment services for COVID-19 under North Carolina’s minor’s consent law.

What Is a Reportable Disease or Condition?

In North Carolina, a “reportable disease or condition” is a communicable disease or condition that physicians, laboratories, school principals, and child care facility operators must report to the state’s public health system, either by making a report to a local health department or to the North Carolina Department of Health and Human Services (NCDHHS), Division of Public Health (DPH). G.S. 130A-134 directs the North Carolina Commission for Public Health (NC CPH) to establish a list of reportable diseases and conditions, which NC CPH has done by promulgating Rule 10A NCAC 41A .0101. Early in the COVID-19 pandemic, Rule 10A NCAC 41A .0101 was amended to include and require reporting of novel coronavirus infections and novel coronavirus infections causing death. In 2020, my colleague Jill Moore wrote a blog post detailing North Carolina’s communicable disease reporting laws and the process by which novel coronavirus became reportable in our state. Her blog post can be read here: How Will We Know if COVID-19 is in North Carolina? A Look at the State’s Communicable Disease Reporting Laws.

What Has Changed?

The change to COVID-19’s status as a “reportable disease or condition” under North Carolina law turns on the term “novel” coronavirus. Earlier this month, NCDHHS advised that, effective May 12, 2023, SARS-CoV-2 is no longer considered to be a “novel” coronavirus.[1] Consequently, COVID-19, the disease caused by SARS-CoV-2, is no longer reportable because 10A NCAC 41A .0101 only requires the reporting of “novel” coronavirus infections and infections causing death. This change coincided with the termination of the nationwide COVID-19 Public Health Emergency (PHE) declared under Section 319 of the federal Public Health Service Act on May 11, 2023.

Implications for Minor’s Consent

G.S. 90-21.5, which is often referred to as North Carolina’s minor’s consent law, allows unemancipated minors with decisional capacity to consent on their own to health services for the prevention, diagnosis, and treatment of the following:

• venereal disease and other diseases reportable under G.S. 130A-135,
• pregnancy,
• abuse of controlled substances or alcohol, and
• emotional disturbance.

Readers looking for a more detailed explanation of North Carolina’s minor’s consent law can find one in my 2022 blog post, An Update on Minor’s Consent: Changes to the Law and Implications for COVID-19, Mpox, and Beyond.

When COVID-19 was a “reportable disease” in North Carolina, G.S. 90-21.5 generally enabled a minor with decisional capacity to consent to receive health services for the prevention, diagnosis, and treatment of COVID-19. A 2021 amendment to the statute created a limited carve out—found in G.S. 90-21.5(a1)—that, effective as of August 20, 2021, impacted minors’ access to certain COVID-19 vaccines, which at the time were a form of “prevention” for a “reportable disease.” That carve out prohibits a health care provider from administering a vaccine that is only available under an emergency use authorization (EUA) and not yet fully approved by the United States Food and Drug Administration (FDA) to a minor without first obtaining the written consent of the minor’s parent or guardian. Because the new carve out was limited to vaccines available under an EUA, it did not affect a minor’s ability to obtain immunization with fully approved COVID-19 vaccines or treatment and diagnostic care for COVID-19.

The minor’s consent landscape looks a little different now that COVID-19 is no longer a “reportable disease or condition” under North Carolina law. Although much of the discussion of this change to date has focused on vaccine access, COVID-19’s shift from “reportable” to non-reportable has a broader impact. Now that COVID-19 is not a “reportable disease,” unemancipated minors will be unable to access preventive, diagnostic, and treatment services for COVID-19 on their own consent as of May 12, 2023. These diagnostic or treatment services could include, for example, COVID-19 PCR testing or the use of Paxlovid in someone recently diagnosed with COVID-19.

What has not changed? Minors can still access COVID-19-related health care services with the consent of a parent, guardian, custodian, or person standing in loco parentis and in certain situations described in G.S. 90-21.1. However, due to the 2021 change to the minor’s consent law and the carve out pertaining to vaccines under an EUA, health care providers administering an EUA vaccine to a minor will also be required to get the consent of the minor’s parent or guardian in writing. 

Questions?

Do you have questions about the information provided here or other questions about North Carolina public health law? Send me an email at kirsten@sog.unc.edu.

Footnotes

[1] For more information, please see the May 11, 2023 press release from NCDHHS: https://www.ncdhhs.gov/news/press-releases/2023/05/11/north-carolina-moves-forward-end-covid-19-public-health-emergency. On May 8, 2023, the NCDHHS, DPH, Epidemiology Section, Immunization Branch also sent an e-mail explaining that SARS-CoV-2 would no longer be considered a “novel” coronavirus for reporting purposes. Although reports of COVID-19 are no longer legally required, NCDHHS is continuing to encourage the reporting of COVID-19 outbreaks, according to a published summary of the May 9, 2023 Communicable Disease Branch Local Health Department Monthly Webinar, available here: https://epi.dph.ncdhhs.gov/cd/lhds/manuals/cd/monkeypox/CDB-Monthly-Key-Points-for-LHDs_05_09_23.pdf.

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