Published September 27, 2016
We often hear about immunocompromised children as the primary reason new mandatory vaccination laws have become necessary. Certain legislators and...
— William Wilberforce
You can buy virtually anything at a Wal-Mart. But will it become the primary place for vaccination? Public health agencies are partnering with medical and nonmedical providers left and right these days. Across the United States, there is a big push by lawmakers to make it easier for your local pharmacist to administer vaccines, and to younger patrons.
In February 2013, the National Association of Chain Drug Stores (NACDS) submitted comments to the U.S. Senate Finance Committee hearing to urge greater use of pharmacies and pharmacists in health services as the health care delivery system is reformed. In particular, the association made its case about granting pharmacists greater provider status to allow them to administer vaccines.1
During the 2010-11 influenza season, 18.4% of adults received their vaccine at their local supermarket or pharmacy, second only to a doctor’s office. Specifically among adults ages 65 years or older, 24.3% received their vaccine at a store.2
This growing trend to receive vaccinations in nonmedical settings continued during the 2011-12 influenza season with 20.1% of adults reporting receipt in retail stores and 17.6% in workplaces. Overall, vaccination in nonmedical locations ranged state-by-state from 32.2% in California to 60.4% in Nevada.3
Over the years, many states have given professionals with advanced degrees more flexibility in the breadth of health care they can provide, but more and more states proposed health care bills that would allow pharmacists to administer vaccines, particularly to younger recipients. Most states already allow pharmacists to vaccinate in some capacity, but usually with an age limit.
As of July 1, 2015, pharmacists in Florida with a valid vaccination certificate can administer vaccines to adults.4
In 2013, Montana and Maryland joined the bandwagon. In Montana, SB 149 was signed into law, allowing pharmacists to give flu vaccines to children ages 12 years or older. Pharmacists can also administer pneumococcal polysaccharide, tetanus and diphtheria vaccines to individuals ages 18 years or older. The last part of the bill allows pharmacists to give the herpes zoster vaccine to those who fall under the recommendations issued by the Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices.5 Maryland passed a law changing the age of children in which pharmacists can administer vaccines to 11 years or older.6 7
While most of the states only give pharmacists the authority to vaccinate patients aged 12 years or older, there are 21 states that allow pharmacists to vaccinate those as young as seven years of age. In fact, Washington allows pharmacists to vaccinate people of all ages.
Several proposed bills, including companion bills, are being considered across the nation to decrease the minimum age for which a pharmacist may administer vaccines. Pennsylvania passed HB 182 in 2015 to allow pharmacists to administer vaccines to children as young as 9 years of age.8
Two bills in Texas would expand the authority for pharmacists in giving vaccines. Currently in Texas, state law allows pharmacists to administer the flu vaccine to individuals older than seven years. For other vaccines recommended by the Centers for Disease Control and Prevention, like tetanus and diphtheria, pharmacists can administer vaccines to those older than 14 years. Companion bills SB 1013 and HB 2938, however, would change the age to seven years in which pharmacists in Texas can administer vaccines.9 10
Oregon’s SB 167 would alter the age of children at which pharmacists can administer vaccines from 10 years to as young as 3 years or older,13 while in Georgia, HB 504 would allow pharmacists (or nurses) to administer any vaccine to anyone, including children.14
Ohio SB 79 would also decrease the age of children at which pharmacists can administer vaccines. For the influenza, pneumonia, tetanus, hepatitis A, hepatitis B, meningitis, diphtheria, pertussis vaccines, pharmacists can give these to children seven years or older. They can give any other vaccines to individuals aged 18 years or older. Also, a licensed pharmacy intern licensed working under the direct supervision of a pharmacist may administer flu vaccines to individuals 18 years or older.15
Pharmacists are not the only group moving into the role of vaccinators. California’s SB 492 would expand the practice parameters of optometrists to allow the ability to immunize.16
There was another bill in Illinois (SB 1217) that tried to authorize dentists to administer vaccines, however, an amendment of the bill removed that section of the bill before it was passed.17
Giving greater authority to personnel in nonmedical settings is especially unnerving when children are injured as a result. In Texas, approximately 250 immigrant children at a Texas detention center were given adult dosages of the Hepatitis A vaccine. The adult dosage is nearly double what it is for children.18
1 Statement of the National Association of Chain Drug Stores For U.S. Senate Finance Committee. Feb. 28, 2013.
2 CDC. Place of Influenza Vaccination Among Adults – United States, 2010-11 Influenza Season. MMWR June 17, 2011; 60 (23):781-5.
3 Lu P, O’Halloran A, Ding H, et al. National and state-specific estimates of places of influenza vaccination among adult populations—United States, 2011-12 influenza season. May 30, 2014; 32 (26):3198-3204.
4 SB 465. Florida Legislature. Accessed July 26, 2015.
5 SB 149. Montana Legislature. Accessed April 23, 2013.
6 HB 179. Maryland General Assembly. Accessed April 24, 2013.
7 SB 401. Maryland General Assembly. Accessed April 24, 2013.
8 HB182. Pennsylvania General Assembly. Accessed July 26, 2015.
9 SB 1013. Texas Legislature Online. Accessed July 26, 2015.
10 HB 2938. Texas Legislature Online. Accessed July 26, 2015.
11 S2567. State of New Jersey 215th Legislature. Accessed July 26, 2015.
12 A3251. State of New Jersey 215th Legislature. Accessed July 26, 2015.
13 SB 167. Oregon Legislature Online. Accessed July 26, 2015.
14 HB 504. Georgia General Assembly. Accessed July 26, 2015.
15 SB 79. 130th General Assembly of the State of Ohio. Accessed July 26, 2015.
16 SB 492. California State Legislature. Accessed July 26, 2015.
17 SB 1217. Illinois General Assembly. Accessed July 26, 2015.
18 Associated Press. Immigrant children receive adult dose of hepatitis A vaccine at detention center. July 5, 2015.