WES MOORE, Governor Ch. 231 – 1 – Chapter 231 (House Bill 76) AN ACT concerning Health Occupations – Pharmacists – Administration of Vaccines FOR the purpose of authorizing a pharmacist to order and administer certain vaccinations to individuals in certain age groups if certain requirements are met; altering the vaccinations that a pharmacist can administer to individuals of at least a certain age; altering the circumstances under which a pharmacist may administer certain vaccinations; and generally relating to the administration of vaccinations by pharmacists. BY repealing and reenacting, with amendments, Article – Health Occupations Section 12–508 Annotated Code of Maryland (2021 Replacement Volume and 2023 Supplement) SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, That the Laws of Maryland read as follows: Article – Health Occupations 12–508. (a) (1) [Subject to subsection (c) of this section, a pharmacist may administer an influenza vaccination to an individual who is at least 9 years old, in accordance with regulations adopted by the Board, in consultation with the Department. (2)] Subject to [subsection (c) of this section] PARAGRAPH (3) (4) OF THIS SUBSECTION , a pharmacist may ORDER AND administer a vaccination [that] TO AN INDIVIDUAL WHO IS AT LEAST 5 3 YEARS OLD IF: (I) 1. THE VACCINE is [listed in] RECOMMENDED BY the Centers for Disease Control and Prevention’s [Recommended Immunization Schedule to an individual who: (i) Is at least 11 years old but under the age of 18 years; and (ii) Has a prescription from an authorized prescriber] ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES; OR Ch. 231 2024 LAWS OF MARYLAND – 2 – 2. THE VACCINE IS APPROV ED OR AUTHORIZED BY THE U.S. FOOD AND DRUG ADMINISTRATION THE VACCINE IS: 1. AN INFLUENZA VACCINE ; 2. A COVID–19 VACCINE; OR 3. USED IN RESPONSE TO A PUBLIC HEALTH EMERGENCY ; (II) THE PHARMACIST HAS CO MPLETED A PRACTICAL TRAINING PROGRAM OF AT LEAST 20 HOURS THAT IS APPROV ED BY THE ACCREDITATION COUNCIL FOR PHARMACY EDUCATION AND INCLUDE S: 1. HANDS–ON INJECTION TECHNIQ UES; 2. CLINICAL EVALUATION O F INDICATIONS AND CONTRAINDICATIONS OF VACCINES; AND 3. THE RECOGNITION AND T REATMENT OF EMERGENC Y REACTIONS TO VACCINE S; (III) THE PHARMACIST HAS A CURRENT CERTIFICATE IN BASIC CARDIOPULMONARY RESU SCITATION; (IV) THE PHARMACIST HAS CO MPLETED A MINIMUM OF 2 HOURS OF CONTINUING PHARMA CEUTICAL EDUCATION R ELATED TO IMMUNIZATI ONS THAT IS APPROVED BY THE ACCREDITATION COUNCIL FOR PHARMACY EDUCATION AS PART OF THE LICENSE RENEWAL REQUIREMENTS UNDER § 12–309 OF THIS TITLE; (V) THE PHARMACIST COMPLI ES WITH THE RECORD –KEEPING AND REPORTING REQUIR EMENTS IN PARAGRAPH (4) (5) OF THIS SUBSECTION A ND ANY CORRESPONDING RE GULATIONS ADOPTED BY THE BOARD; AND (VI) IF THE VACCINATION IS ADMINISTERED TO AN I NDIVIDUAL UNDER THE AGE OF 18 YEARS, THE PHARMACIST INFOR MS THE CHILD VACCINA TION PATIENT AND ADULT CA REGIVER WHO IS ACCOM PANYING THE CHILD OF THE IMPORTANCE OF WELL –CHILD VISITS WITH A PEDIATRIC PRI MARY CARE PROVIDER AND REFERS THE PATIE NT TO A PEDIATRIC PR IMARY CARE PROVIDER WHEN APPROPRIATE . (2) SUBJECT TO PARAGRAPH (4) OF THIS SUBSECTION , A PHARMACIST WHO HAS M ET THE REQUIREMENT O F PARAGRAPH (1)(II) THROUGH WES MOORE, Governor Ch. 231 – 3 – (VI) OF THIS SUBSECTION MAY ADMINIST ER TO AN INDIVIDUAL WHO IS AT LEAST 7 YEARS OLD A VACCINAT ION THAT IS: (I) RECOMMENDED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION’S ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES; OR (II) APPROVED OR AUTHORIZE D BY THE U.S. FOOD AND DRUG ADMINISTRATION . [(3)] (2) [(i)] Subject to [subparagraph (ii) of this paragraph] PARAGRAPH (3) (4) OF THIS SUBSECTION , a pharmacist WHO HAS MET THE REQUIREMENT OF PARAG RAPH (1)(II), (III), AND (IV) OF THIS SUBSECTION may administer to an adult a vaccination that is[: 1. Listed in the Centers for Disease Control and Prevention’s Recommended Immunization Schedule; or 2. Recommended] RECOMMENDED in the Centers for Disease Control and Prevention’s Health Information for International Travel. [(ii)](3) (4) A pharmacist shall administer a vaccination under [subparagraph (i)] PARAGRAPH (1) OR, (2), OR (3) of this [paragraph] SUBSECTION under a written protocol that: [1.] (I) Is vaccine specific; and [2.] (II) Meets criteria established by the Department, in consultation with the Board, the Board of Physicians, and the Board of Nursing, in regulation. (4) (5) A pharmacist shall: (i) Report all vaccinations administered by the pharmacist to the ImmuNet Program established under § 18–109 of the Health – General Article; (ii) If the vaccination has been administered in accordance with a prescription, document at least one effort to inform the individual’s authorized prescriber that the vaccination has been administered; and (iii) [For a vaccination administered under paragraph (2) or (3)] EXCEPT FOR AN INFLUEN ZA VACCINATION ADMIN ISTERED UNDER PARAGR APH (1) of this subsection, if the authorized prescriber is not the individual’s primary care provider or if the vaccination has not been administered in accordance with a prescription, document at least one effort to inform the individual’s primary care provider or other usual source of care that the vaccination has been administered. Ch. 231 2024 LAWS OF MARYLAND – 4 – (b) The Board shall: (1) Set reasonable fees for the administration of vaccinations under this section; and (2) Adopt regulations that require a pharmacist to submit a registration form to the Board that includes verification that the pharmacist: (i) Has successfully completed a certification course approved by the Board that included instruction in the guidelines and recommendations of the Centers for Disease Control and Prevention regarding vaccinations; and (ii) Is certified in basic cardiopulmonary resuscitation and obtained the certification through in–person classroom instruction. [(c) From July 1, 2021, to June 30, 2023, inclusive, a pharmacist may administer a vaccine to an individual who is at least 3 years old but under the age of 18 years if: (1) The vaccine is approved by the U.S. Food and Drug Administration; (2) The vaccination is ordered and administered in accordance with the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices immunization schedules; (3) The pharmacist has completed a practical training program of at least 20 hours that is approved by the Accreditation Council for Pharmacy Education and includes: (i) Hands–on injection techniques; (ii) Clinical evaluation of indications and contraindications of vaccines; and (iii) The recognition and treatment of emergency reactions to vaccines; (4) The pharmacist has a current certificate in basic cardiopulmonary resuscitation; (5) The pharmacist has completed a minimum of 2 hours of continuing pharmaceutical education related to immunizations that is approved by the Accreditation Council for Pharmacy Education as part of the license renewal requirements under § 12–309 of this title; WES MOORE, Governor Ch. 231 – 5 – (6) The pharmacist complies with the record–keeping and reporting requirements in subsection (a)(4) of this section and the corresponding regulations; and (7) The pharmacist informs each child vaccination patient and adult caregiver who is accompanying the child of the importance of well–child visits with a pediatric primary care provider and refers the patient to a pediatric primary care provider when appropriate.] SECTION 2. AND BE IT FURTHER ENACTED, That this Act is an emergency measure, is necessary for the immediate preservation of the public health or safety, has been passed by a yea and nay vote supported by three–fifths of all the members elected to each of the two Houses of the General Assembly, and shall take effect from the date it is enacted. Approved by the Governor, April 25, 2024.