Pharmacist-administered immunizations

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  • (a) As used in this section:

    • (i) “CDC” means the United States Centers for Disease Control and Prevention.

    • (ii) “Eligible patient” means an eligible patient in accordance with CDC guidelines for each recommended immunization.

    • (iii) “Immunization” means any immunization approved by the United States Food and Drug Administration and listed on the routine immunization schedules recommended by the CDC Advisory Committee on Immunization Practices (ACIP), in compliance with individual ACIP vaccine recommendations.

  • (b) A pharmacist may recommend and administer immunizations to eligible patients in accordance with subsections (c) through (k) of this section.

  • (c) A pharmacist may recommend and administer immunizations without a patient-specific prescription under prescriptive authority to an eligible patient, if the pharmacist meets the qualifications and standards specified by the Board of Pharmacy which must include:

    • (i) Unrestricted license to practice pharmacy in the Territory;

    • (ii) Successful completion of a training program as provided in subsection (e); and

    • (iii) A current certificate in basic cardiopulmonary resuscitation (CPR).

  • (d) A pharmacist who has authority to administer immunizations to an eligible patient may not delegate such authority to any other pharmacist or employee, unless the person is a registered pharmacy intern.

  • (e) A training program for pharmacists to administer immunizations to an eligible patient must:

    • (1) be accredited by the Accreditation Council for Pharmacy Education or a similar health authority or professional body approved by the Board of Pharmacy;

    • (2) include study materials, hands-on training and techniques for administering immunizations; and

    • (3) provide instruction and experiential training in the following content areas:

      • (A) Basic immunology, immunization-preventable diseases and the human immune response;

      • (B) Mechanics of immunity, contraindications, drug interactions, dose and administration schedule of available immunizations;

      • (C) Response to an emergency situation as a result of the administration of an immunization;

      • (D) Physiology and techniques for immunization administration;

      • (E) Standards for immunization practice;

      • (F) Pre-immunization and post-immunization assessment and counseling;

      • (G) Immunization storage management;

      • (H) Biohazard waste disposal, sterile techniques and needle stick management;

      • (I) Understanding immunization coverage by federal and territorial entities; and

      • (J) Immunization records management and reporting requirements.

  • (f) A pharmacist shall comply with applicable federal and territorial privacy statutes, rules, and regulations when releasing patient health information.

  • (g) Before administering an immunization to an eligible patient, the pharmacist shall:

    • (1) Give the appropriate Vaccine Information Statement to the patient or legal representative with each dose of immunization covered by these forms; and

    • (2) Ensure that the patient or legal representative has received and signed the informed consent form and has had their questions answered.

  • (h) The pharmacy shall report:

    • (1) Administration of the immunization to any territorial immunization registry established by the Department of Health, as may be required; and

    • (2) Adverse events as required by the Vaccine Adverse Events Reporting System and to the primary care provider as identified by the patient.

  • (i) The pharmacy shall maintain the following information for 5 years for each immunization administered:

    • (1) The name, address, and date of birth of the patient;

    • (2) Patient responses to screening questions for indications/contra indications to the immunization being administered;

    • (3) The date of the administration and site of immunization injection;

    • (4) The name, dose, manufacturer, lot number and expiration date of the immunization;

    • (5) The name or identifiable initials of the administering pharmacist., or if the administration is by a pharmacy intern, the initials of both the intern and supervising pharmacist;

    • (6) The signed informed consent document for each administration; and

    • (7) Identification of the Vaccine Information Statement provided, including its publication date.

  • (j) A pharmacist administering immunizations pursuant to this section, may also initiate and administer epinephrine or diphenhydramine by injection for the treatment of a severe allergic reaction.

  • (k) A pharmacy may allow a pharmacist to remove immunizations from the pharmacy to be administered at an off-site location.


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