EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb1232*
HOUSE BILL 1232
J2 EMERGENCY BILL 3lr3001
CF SB 372
By: Delegate Lopez Delegates Lopez, Alston, Bagnall, Bhandari, Cullison,
Guzzone, S. Johnson, Kaiser, R. Lewis, Martinez, Pena–Melnyk, Rosenberg,
Taveras, and White
Introduced and read first time: February 13, 2023
Assigned to: Rules and Executive Nominations
Re–referred to: Health and Government Operations, February 28, 2023
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 19, 2023
CHAPTER ______
AN ACT concerning 1
Health Occupations – Pharmacists – Administration of Vaccines 2
FOR the purpose of authorizing a pharmacist altering the time period during which a 3
pharmacist is authorized to order and administer certain vaccinations to an 4
individual in a certain age group if certain requirements are met; altering the age of 5
an individual to whom a pharmacist may administer certain vaccinations; repealing 6
the requirement that a pharmacist administer certain vaccinations under a written 7
protocol; authorizing a pharmacist to administer certain vaccinations to an adult; 8
and generally relating to the administration of vaccinations by pharmacists. 9
BY repealing and reenacting, with amendments, 10
Article – Health Occupations 11
Section 12–508(c) 12
Annotated Code of Maryland 13
(2021 Replacement Volume and 2022 Supplement) 14
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 15
That the Laws of Maryland read as follows: 16
Article – Health Occupations 17
12–508. 18 2 HOUSE BILL 1232
(a) (1) [Subject to subsection (c) of this section, a pharmacist may administer 1
an influenza vaccination to an individual who is at least 9 years old, in accordance with 2
regulations adopted by the Board, in consultation with the Department. 3
(2) Subject to subsection (c) of this section, a] A pharmacist may ORDER 4
AND administer a vaccination [that] TO AN INDIVIDUAL WHO IS AT LEAST 3 YEARS OLD 5
BUT UNDER THE AGE OF 18 YEARS IF: 6
(I) 1. THE VACCINE is listed in the Centers for Disease Control 7
and Prevention’s Recommended Immunization Schedule [to an individual who: 8
(i) Is at least 11 years old but under the age of 18 years; and 9
(ii) Has a prescription from an authorized prescriber]; OR 10
2. THE VACCINE IS APPROV ED OR AUTHORIZED BY THE 11
U.S. FOOD AND DRUG ADMINISTRATION ; 12
(II) THE PHARMACIST HAS CO MPLETED A PRACTICAL TRAINING 13
PROGRAM OF AT LEAST 20 HOURS THAT IS APPROV ED BY THE ACCREDITATION 14
COUNCIL FOR PHARMACY EDUCATION AND INCLUDE S: 15
1. HANDS–ON INJECTION TECHNIQ UES; 16
2. CLINICAL EVALUATION O F INDICATIONS AND 17
CONTRAINDICATIONS OF VACCINES; AND 18
3. THE RECOGNITION AND T REATMENT OF EMERGENC Y 19
REACTIONS TO VACCINE S; 20
(III) THE PHARMACIST HAS A CURRENT CERTIFICATE IN BASIC 21
CARDIOPULMONARY RESU SCITATION; 22
(IV) THE PHARMACIST HAS CO MPLETED A MINIMUM OF 2 HOURS 23
OF CONTINUING PHARMA CEUTICAL EDUCATION R ELATED TO IMMUNIZATI ONS THAT 24
IS APPROVED BY THE ACCREDITATION COUNCIL FOR PHARMACY EDUCATION AS 25
PART OF THE LICENSE RENEWAL RE QUIREMENTS UNDER § 12–309 OF THIS TITLE; 26
(V) THE PHARMACIST COMPLI ES WITH THE RECORD –KEEPING 27
AND REPORTING REQUIR EMENTS IN PARAGRAPH (3) OF THIS SUBSECTION A ND ANY 28
CORRESPONDING REGULA TIONS ADOPTED BY THE BOARD; AND 29
(VI) THE PHARMACIST INFORM S EACH CHILD VACCINATION 30
PATIENT AND ADULT CA REGIVER WHO IS ACCOM PANYING THE CHILD OF THE 31 HOUSE BILL 1232 3
IMPORTANCE OF WELL –CHILD VISITS WITH A PEDIATRIC PRIMARY CA RE PROVIDER 1
AND REFERS THE PATIE NT TO A PEDIATRIC PR IMARY CARE PROVIDER WHEN 2
APPROPRIATE . 3
[(3)] (2) [(i) Subject to subparagraph (ii) of this paragraph, a] A 4
pharmacist may administer to an adult a vaccination that is: 5
[1.] (I) Listed in the Centers for Disease Control and 6
Prevention’s Recommended Immunization Schedule; [or] 7
[2.] (II) Recommended in the Centers for Disease Control 8
and Prevention’s Health Information for International Travel; OR 9
(III) APPROVED BY THE U.S. FOOD AND DRUG 10
ADMINISTRATION . 11
[(ii) A pharmacist shall administer a vaccination under 12
subparagraph (i) of this paragraph under a written protocol that: 13
1. Is vaccine specific; and 14
2. Meets criteria established by the Department, in 15
consultation with the Board, the Board of Physicians, and the Board of Nursing, in 16
regulation.] 17
[(4)] (3) A pharmacist shall: 18
(i) Report all vaccinations administered by the pharmacist to the 19
ImmuNet Program established under § 18–109 of the Health – General Article; 20
(ii) If the vaccination has been administered in accordance with a 21
prescription, document at least one effort to inform the individual’s authorized prescriber 22
that the vaccination has been administered; and 23
(iii) [For a vaccination administered under paragraph (2) or (3)] 24
EXCEPT FOR AN INFLUEN ZA VACCINATION ADMIN ISTERED UNDER PARAGR APH (1) 25
of this subsection, if the authorized prescriber is not the individual’s primary care provider 26
or if the vaccination has not been administered in accordance with a prescription, document 27
at least one effort to inform the individual’s primary care provider or other usual source of 28
care that the vaccination has been administered. 29
(b) The Board shall: 30
(1) Set reasonable fees for the administration of vaccinations under this 31
section; and 32
4 HOUSE BILL 1232
(2) Adopt regulations that require a pharmacist to submit a registration 1
form to the Board that includes verification that the pharmacist: 2
(i) Has successfully completed a certification course approved by the 3
Board that included instruction in the guidelines and recommendations of the Centers for 4
Disease Control and Prevention regarding vaccinations; and 5
(ii) Is certified in basic cardiopulmonary resuscitation and obtained 6
the certification through in–person classroom instruction. 7
[(c) From July 1, 2021, to June 30, 2023 JUNE 30, 2024, inclusive, a pharmacist 8
may administer a vaccine to an individual who is at least 3 years old but under the age of 9
18 years if: 10
(1) The vaccine is approved by the U.S. Food and Drug Administration; 11
(2) The vaccination is ordered and administered in accordance with the 12
Centers for Disease Control and Prevention’s Advisory Committee on Immunization 13
Practices immunization schedules; 14
(3) The pharmacist has completed a practical training program of at least 15
20 hours that is approved by the Accreditation Council for Pharmacy Education and 16
includes: 17
(i) Hands–on injection techniques; 18
(ii) Clinical evaluation of indications and contraindications of 19
vaccines; and 20
(iii) The recognition and treatment of emergency reactions to 21
vaccines; 22
(4) The pharmacist has a current certificate in basic cardiopulmonary 23
resuscitation; 24
(5) The pharmacist has completed a minimum of 2 hours of continuing 25
pharmaceutical education related to immunizations that is approved by the Accreditation 26
Council for Pharmacy Education as part of the license renewal requirements under § 27
12–309 of this title; 28
(6) The pharmacist complies with the record–keeping and reporting 29
requirements in subsection (a)(4) of this section and the corresponding regulations; and 30
(7) The pharmacist informs each child vaccination patient and adult 31
caregiver who is accompanying the child of the importance of well–child visits with a 32
pediatric primary care provider and refers the patient to a pediatric primary care provider 33
when appropriate.] 34 HOUSE BILL 1232 5
SECTION 2. AND BE IT FURTHER ENACTED, That this Act is an emergency 1
measure, is necessary for the immediate preservation of the public health or safety, has 2
been passed by a yea and nay vote supported by three–fifths of all the members elected to 3
each of the two Houses of the General Assembly, and shall take effect from the date it is 4
enacted. 5
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.