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    The immunizing pharmacist

    A natural progression from drug dispensing to vaccine administration


    Ned Milenkovich
    Pharmacists have, by now, overcome most legal obstacles to the right to immunize patients and have overwhelmingly demonstrated their value by increasing patient immunization rates. As the most accessible healthcare professionals, pharmacists are poised to provide immunizations to millions of people who visit pharmacies each week. Pharmacists also have the requisite knowledge of medications to ensure the proper and safe storage of vaccines.

    A new role

    Thanks in large part to successful education of state legislatures by national and state pharmacy associations, pharmacists now have yet another role in helping patients that goes beyond the traditional dispensing of drugs.

    In addition to helping persuade state legislatures to implement laws allowing for pharmacist immunizing practices, many state pharmacy associations have helped large numbers of pharmacists obtain training to administer immunizations, and these services are providing patients with much-needed access.

    Currently all 50 states, the District of Columbia, and Puerto Rico allow pharmacists to immunize patients. In this setting, pharmacists may now undergo training in vaccine administration and are able to expand their pharmacy practice.

    Laws and regulations

    Many state pharmacy practice acts, regulations, or guidelines describe how a pharmacist may gain qualifications to immunize patients and what restrictions exist when engaging in patient immunizations.

    Laws and regulations governing pharmacist immunization rights vary from state to state, so pharmacists must understand what is and is not locally permitted. For example:

    • Some states might require a patient to present a new prescription, while others allow a pharmacist to perform the immunization pursuant to a standing protocol.
    • Some very progressive states, such as Idaho, recently passed legislation allowing pharmacists to prescribe agents for active immunization for patients 12 years of age or older.
    • Some states provide that a pharmacist may immunize only adults, while other states specify the ages of children who may be immunized by a pharmacist.
    • Not all states allow pharmacists to administer the same types of vaccines. Depending on the state, there may be limits on the types of vaccines that a pharmacist may administer to patients.
    • Finally, pharmacists must be sure to comply with the laws governing training and accreditation standards in their states in order to be eligible to immunize patients there.

    A good match

    There are several ways pharmacists can get involved with immunization services:

    • Pharmacists are natural advocates for patients and have many opportunities to discuss the importance of immunizations with them.
    • Pharmacists are uniquely positioned to identify patients who are at risk for vaccine-preventable diseases on the basis of their medication profiles. Pharmacists can verify patient profiles and disease histories, and assess patients' immunization status.

    Other options

    Pharmacists who administer immunizations can have the most direct impact on patient care. Pharmacists who do not wish to give immunizations can offer value to patients and enhance their own visibility by partnering with nurses or physician assistants and offering more convenient times and locations for such immunizations.

    At present, pharmacists can administer vaccines to patients in accord with state laws and regulations. As the profession evolves its service offerings and new specialty drugs requiring administration by a healthcare professional enter the marketplace, it will be all the more necessary for pharmacists to seek legal and regulatory authorization to engage in this mode of drug administration and patient care.

    This article is not intended as legal advice and should not be used as such. When legal questions arise, pharmacists should consult with attorneys familiar with the relevant drug and pharmacy laws.

    Ned Milenkovich is a member at McDonald Hopkins LLC, and chairs its drug and pharmacy practice group. He is also a member of the Illinois State Board of Pharmacy. Contact Ned at 312-642-1480 or at
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    Ned Milenkovich, PharmD, JD
    This article is not intended as legal advice and should not be used as such. When legal questions arise, pharmacists should consult with ...