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.
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SENATE BILL 18
J2 EMERGENCY BILL 4lr1233
(PRE–FILED) CF HB 76
By: Senators Augustine and Lam
Requested: October 30, 2023
Introduced and read first time: January 10, 2024
Assigned to: Finance
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: February 26, 2024
CHAPTER ______
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 individuals in certain age groups if certain requirements are met; altering the 4
vaccinations that a pharmacist can administer to individuals of at least a certain 5
age; altering the circumstances under which a pharmacist may administer certain 6
vaccinations; and generally relating to the administration of vaccinations by 7
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 2023 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 2 SENATE BILL 18
regulations adopted by the Board, in consultation with the Department. 1
(2)] Subject to [subsection (c) of this section] PARAGRAPH (3) (4) OF THIS 2
SUBSECTION , a pharmacist may ORDER AND administer a vaccination [that] TO AN 3
INDIVIDUAL WHO IS AT LEAST 5 3 YEARS OLD IF: 4
(I) 1. THE VACCINE is [listed in] RECOMMENDED BY the 5
Centers for Disease Control and Prevention’s [Recommended Immunization Schedule to an 6
individual who: 7
(i) Is at least 11 years old but under the age of 18 years; and 8
(ii) Has a prescription from an authorized prescriber] ADVISORY 9
COMMITTEE ON IMMUNIZATION PRACTICES; OR 10
2. THE VACCINE IS APPROVED OR AUTHORIZ ED BY THE 11
U.S. FOOD AND DRUG ADMINISTRATION THE VACCINE IS: 12
1. AN INFLUENZA VACCINE ; 13
2. A COVID–19 VACCINE; OR 14
3. USED IN RESPONSE TO A PUBLIC HEALTH 15
EMERGENCY ; 16
(II) THE PHARMACIST HAS CO MPLETED A PRACTICAL TRAINING 17
PROGRAM OF AT LEAST 20 HOURS THAT IS APPROV ED BY THE ACCREDITATION 18
COUNCIL FOR PHARMACY EDUCATION AND INCLUDE S: 19
1. HANDS–ON INJECTION TECHNIQ UES; 20
2. CLINICAL EVALUATION O F INDICATIONS AND 21
CONTRAINDICATIONS OF VACCINES; AND 22
3. THE RECOGNITION AND TREATMENT OF EME RGENCY 23
REACTIONS TO VACCINE S; 24
(III) THE PHARMACIST HAS A CURRENT CERTIFICATE IN BASIC 25
CARDIOPULMONARY RESU SCITATION; 26
(IV) THE PHARMACIST HAS CO MPLETED A MINIMUM OF 2 HOURS 27
OF CONTINUING PHARMA CEUTICAL EDUCATION R ELATED TO IMMUN IZATIONS THAT 28
IS APPROVED BY THE ACCREDITATION COUNCIL FOR PHARMACY EDUCATION AS 29
PART OF THE LICENSE RENEWAL REQUIREMENTS UNDER § 12–309 OF THIS TITLE; 30
SENATE BILL 18 3
(V) THE PHARMACIST COMPLI ES WITH THE RECORD –KEEPING 1
AND REPORTING REQUIR EMENTS IN PARAGRAPH (4) (5) OF THIS SUBSECTION A ND 2
ANY CORRESPONDING RE GULATIONS ADOPTED BY THE BOARD; AND 3
(VI) IF THE VACCINATION IS ADMINISTERED TO AN I NDIVIDUAL 4
UNDER THE AGE OF 18 YEARS, THE PHARMACIST INFOR MS THE CHILD VACCINA TION 5
PATIENT AND ADULT CA REGIVER WHO IS ACCOM PANYING THE CHILD OF THE 6
IMPORTANCE OF WELL –CHILD VISITS WITH A PEDIATRIC PRIMARY CA RE PROVIDER 7
AND REFERS THE PATIE NT TO A PEDIATRIC PR IMARY CARE PROVIDER WHEN 8
APPROPRIATE . 9
(2) SUBJECT TO PARAGRAPH (4) OF THIS SUBSECTION , A 10
PHARMACIST WHO HAS M ET THE REQUI REMENT OF PARAGRAPH (1)(II) THROUGH 11
(VI) OF THIS SUBSECTION M AY ADMINISTER TO AN INDIVIDUAL WHO IS AT LEAST 7 12
YEARS OLD A VACCINAT ION THAT IS: 13
(I) RECOMMENDED BY THE CENTERS FOR DISEASE CONTROL 14
AND PREVENTION’S ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES; OR 15
(II) APPROVED OR AUTHORIZE D BY THE U.S. FOOD AND DRUG 16
ADMINISTRATION . 17
[(3)] (2) [(i)] Subject to [subparagraph (ii) of this paragraph] 18
PARAGRAPH (3) (4) OF THIS SUBSECTION , a pharmacist WHO HAS MET THE 19
REQUIREMENT OF PARAG RAPH (1)(II), (III), AND (IV) OF THIS SUBSECTION may 20
administer to an adult a vaccination that is[: 21
1. Listed in the Centers for Disease Control and Prevention’s 22
Recommended Immunization Schedule; or 23
2. Recommended] RECOMMENDED in the Centers for 24
Disease Control and Prevention’s Health Information for International Travel. 25
[(ii)] (3) (4) A pharmacist shall administer a vaccination under 26
[subparagraph (i)] PARAGRAPH (1) OR, (2), OR (3) of this [paragraph] SUBSECTION 27
under a written protocol that: 28
[1.] (I) Is vaccine specific; and 29
[2.] (II) Meets criteria established by the Department, in 30
consultation with the Board, the Board of Physicians, and the Board of Nursing, in 31
regulation. 32
(4) (5) A pharmacist shall: 33
4 SENATE BILL 18
(i) Report all vaccinations administered by the pharmacist to the 1
ImmuNet Program established under § 18–109 of the Health – General Article; 2
(ii) If the vaccination has been administered in accordance with a 3
prescription, document at least one effort to inform the individual’s authorized prescriber 4
that the vaccination has been administered; and 5
(iii) [For a vaccination administered under paragraph (2) or (3)] 6
EXCEPT FOR AN INFLUEN ZA VACCINATION ADMIN ISTERED UNDER PARAGR APH (1) 7
of this subsection, if the authorized prescriber is not the individual’s primary care provider 8
or if the vaccination has not been administered in accordance with a prescription, document 9
at least one effort to inform the individual’s primary care provider or other usual source of 10
care that the vaccination has been administered. 11
(b) The Board shall: 12
(1) Set reasonable fees for the administration of vaccinations under this 13
section; and 14
(2) Adopt regulations that require a pharmacist to submit a registration 15
form to the Board that includes verification that the pharmacist: 16
(i) Has successfully completed a certification course approved by the 17
Board that included instruction in the guidelines and recommendations of the Centers for 18
Disease Control and Prevention regarding vaccinations; and 19
(ii) Is certified in basic cardiopulmonary resuscitation and obtained 20
the certification through in–person classroom instruction. 21
[(c) From July 1, 2021, to June 30, 2023, inclusive, a pharmacist may administer 22
a vaccine to an individual who is at least 3 years old but under the age of 18 years if: 23
(1) The vaccine is approved by the U.S. Food and Drug Administration; 24
(2) The vaccination is ordered and administered in accordance with the 25
Centers for Disease Control and Prevention’s Advisory Committee on Immunization 26
Practices immunization schedules; 27
(3) The pharmacist has completed a practical training program of at least 28
20 hours that is approved by the Accreditation Council for Pharmacy Education and 29
includes: 30
(i) Hands–on injection techniques; 31
(ii) Clinical evaluation of indications and contraindications of 32
vaccines; and 33
SENATE BILL 18 5
(iii) The recognition and treatment of emergency reactions to 1
vaccines; 2
(4) The pharmacist has a current certificate in basic cardiopulmonary 3
resuscitation; 4
(5) The pharmacist has completed a minimum of 2 hours of continuing 5
pharmaceutical education related to immunizations that is approved by the Accreditation 6
Council for Pharmacy Education as part of the license renewal requirements under § 7
12–309 of this title; 8
(6) The pharmacist complies with the record–keeping and reporting 9
requirements in subsection (a)(4) of this section and the corresponding regulations; and 10
(7) The pharmacist informs each child vaccination patient and adult 11
caregiver who is accompanying the child of the importance of well–child visits with a 12
pediatric primary care provider and refers the patient to a pediatric primary care provider 13
when appropriate.] 14
SECTION 2. AND BE IT FURTHER E NACTED, That this Act is an emergency 15
measure, is necessary for the immediate preservation of the public health or safety, has 16
been passed by a yea and nay vote supported by three–fifths of all the members elected to 17
each of the two Houses of the General Assembly, and shall take effect from the date it is 18
enacted. 19
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.