EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXIS TING LAW. [Brackets] indicate matter deleted from existing law. *hb1232* HOUSE BILL 1232 J2 EMERGENCY BILL 3lr3001 CF SB 372 By: Delegate Lopez Introduced and read first time: February 13, 2023 Assigned to: Rules and Executive Nominations A BILL ENTITLED AN ACT concerning 1 Health Occupations – Pharmacists – Administration of Vaccines 2 FOR the purpose of authorizing a pharmacist to order and administer certain vaccinations 3 to an individual in a certain age group if certain requirements are met; altering the 4 age of an individual to whom a pharmacist may administer certain vaccinations; 5 repealing the requirement that a pharmacist administer certain vaccinations under 6 a written protocol; authorizing a pharmacist to administer certain vaccinations to an 7 adult; and generally relating to the administration of vaccinations by pharmacists. 8 BY repealing and reenacting, with amendments, 9 Article – Health Occupations 10 Section 12–508 11 Annotated Code of Maryland 12 (2021 Replacement Volume and 2022 Supplement) 13 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 14 That the Laws of Maryland read as follows: 15 Article – Health Occupations 16 12–508. 17 (a) (1) [Subject to subsection (c) of this section, a pharmacist may administer 18 an influenza vaccination to an individual who is at least 9 years old, in accordance with 19 regulations adopted by the Board, in consultation with the Department. 20 (2) Subject to subsection (c) of this section, a] A pharmacist may ORDER 21 AND administer a vaccination [that] TO AN INDIVIDUAL WHO IS AT LEAST 3 YEARS OLD 22 BUT UNDER THE AGE OF 18 YEARS IF: 23 2 HOUSE BILL 1232 (I) 1. THE VACCINE is listed in the Centers for Disease Control 1 and Prevention’s Recommended Immunization Schedule [to an individual who: 2 (i) Is at least 11 years old but under the age of 18 years; and 3 (ii) Has a prescription from an authorized prescriber]; OR 4 2. THE VACCINE IS APPROV ED OR AUTHORIZED BY THE 5 U.S. FOOD AND DRUG ADMINISTRATION ; 6 (II) THE PHARMACIST HAS CO MPLETED A PRACTICAL TRAINING 7 PROGRAM OF AT LEAST 20 HOURS THAT IS APPROV ED BY THE ACCREDITATION 8 COUNCIL FOR PHARMACY EDUCATION AND INCLUDE S: 9 1. HANDS–ON INJECTION TECHNIQ UES; 10 2. CLINICAL EVALUATION O F INDICATIONS AND 11 CONTRAINDICATIONS OF VACCINES; AND 12 3. THE RECOGNITION AND T REATMENT OF EMERGENC Y 13 REACTIONS TO VACCINE S; 14 (III) THE PHARMACIST HAS A CURRENT CERTIFICATE IN BASIC 15 CARDIOPULMONARY RESU SCITATION; 16 (IV) THE PHARMACIST HAS CO MPLETED A MINIMUM OF 2 HOURS 17 OF CONTINUING PHARMA CEUTICAL EDUCA TION RELATED TO IMMU NIZATIONS THAT 18 IS APPROVED BY THE ACCREDITATION COUNCIL FOR PHARMACY EDUCATION AS 19 PART OF THE LICENSE RENEWAL REQUIREMENTS UNDER § 12–309 OF THIS TITLE; 20 (V) THE PHARMACIST COMPLI ES WITH THE RECORD –KEEPING 21 AND REPORTING REQUIR EMENTS IN PARAGRAPH (3) OF THIS SUBSECTION A ND ANY 22 CORRESPONDING REGULA TIONS ADOPTED BY THE BOARD; AND 23 (VI) THE PHARMACIST INFORM S EACH CHILD VACCINA TION 24 PATIENT AND ADULT CA REGIVER WHO IS ACCOM PANYING THE CHILD OF THE 25 IMPORTANCE OF WELL –CHILD VISITS WITH A PEDIATRIC PRIMARY CAR E PROVIDER 26 AND REFERS THE PATIE NT TO A PEDIATRIC PR IMARY CARE PROVIDER WHEN 27 APPROPRIATE . 28 [(3)] (2) [(i) Subject to subparagraph (ii) of this paragraph, a] A 29 pharmacist may administer to an adult a vaccination that is: 30 HOUSE BILL 1232 3 [1.] (I) Listed in the Centers for Disease Control and 1 Prevention’s Recommended Immunization Schedule; [or] 2 [2.] (II) Recommended in the Centers for Disease Control 3 and Prevention’s Health Information for International Travel; OR 4 (III) APPROVED BY THE U.S. FOOD AND DRUG 5 ADMINISTRATION . 6 [(ii) A pharmacist shall administer a vaccination under 7 subparagraph (i) of this paragraph under a written protocol that: 8 1. Is vaccine specific; and 9 2. Meets criteria established by the Department, in 10 consultation with the Board, the Board of Physicians, and the Board of Nursing, in 11 regulation.] 12 [(4)] (3) A pharmacist shall: 13 (i) Report all vaccinations administered by the pharmacist to the 14 ImmuNet Program established under § 18–109 of the Health – General Article; 15 (ii) If the vaccination has been administered in accordance with a 16 prescription, document at least one effort to inform the individual’s authorized prescriber 17 that the vaccination has been administered; and 18 (iii) [For a vaccination administered under paragraph (2) or (3)] 19 EXCEPT FOR AN INFLUEN ZA VACCINATION ADMIN ISTERED UNDER PARAGR APH (1) 20 of this subsection, if the authorized prescriber is not the individual’s primary care provider 21 or if the vaccination has not been administered in accordance with a prescription, document 22 at least one effort to inform the individual’s primary care provider or other usual source of 23 care that the vaccination has been administered. 24 (b) The Board shall: 25 (1) Set reasonable fees for the administration of vaccinations under this 26 section; and 27 (2) Adopt regulations that require a pharmacist to submit a registration 28 form to the Board that includes verification that the pharmacist: 29 (i) Has successfully completed a certification course approved by the 30 Board that included instruction in the guidelines and recommendations of the Centers for 31 Disease Control and Prevention regarding vaccinations; and 32 4 HOUSE BILL 1232 (ii) Is certified in basic cardiopulmonary resuscitation and obtained 1 the certification through in–person classroom instruction. 2 [(c) From July 1, 2021, to June 30, 2023, inclusive, a pharmacist may administer 3 a vaccine to an individual who is at least 3 years old but under the age of 18 years if: 4 (1) The vaccine is approved by the U.S. Food and Drug Administration; 5 (2) The vaccination is ordered and administered in accordance with the 6 Centers for Disease Control and Prevention’s Advisory Committee on Immunization 7 Practices immunization schedules; 8 (3) The pharmacist has completed a practical training program of at least 9 20 hours that is approved by the Accreditation Council for Pharmacy Education and 10 includes: 11 (i) Hands–on injection techniques; 12 (ii) Clinical evaluation of indications and contraindications of 13 vaccines; and 14 (iii) The recognition and treatment of emergency reactions to 15 vaccines; 16 (4) The pharmacist has a current certificate in basic cardiopulmonary 17 resuscitation; 18 (5) The pharmacist has completed a minimum of 2 hours of continuing 19 pharmaceutical education related to immunizations that is approved by the Accreditation 20 Council for Pharmacy Education as part of the license renewal requirements under § 21 12–309 of this title; 22 (6) The pharmacist complies with the record–keeping and reporting 23 requirements in subsection (a)(4) of this section and the corresponding regulations; and 24 (7) The pharmacist informs each child vaccination patient and adult 25 caregiver who is accompanying the child of the importance of well–child visits with a 26 pediatric primary care provider and refers the patient to a pediatric primary care provider 27 when appropriate.] 28 SECTION 2. AND BE IT FURTHER ENACTED, That this Act is an emergency 29 measure, is necessary for the immediate preservation of the public health or safety, has 30 been passed by a yea and nay vote supported by three–fifths of all the members elected to 31 each of the two Houses of the General Assembly, and shall take effect from the date it is 32 enacted. 33