Indiana Pharmacists Authorized to Administer Additional Immunizations

Introduction

Effective July 1, 2013, pharmacists in Indiana are able to administer additional vaccines to patients beyond the flu and shingles vaccines that they have been able to administer historically.  On April 29, 2013, Governor Michael Pence signed House Bill 1464 into law, which now allows pharmacists to administer immunizations for pneumonia; tetanus, diphtheria and acellular pertussis (whooping cough); human papillomavirus (HPV); and meningitis under a drug order, prescription or protocol approved by a physician.¹

Details

Improving access to vaccines was an important goal of this bill.  According to the Indiana Immunization Coalition, flu vaccination rates in Indiana are among the lowest in the nation.²  Prior to the passage of the bill, pharmacists were allowed to administer only flu and shingles vaccines under a physician-approved protocol and other FDA-approved drugs with a valid prescription.  Allowing pharmacists to administer a wider range of vaccines will improve patient access to vaccines, which lawmakers and public health officials hope will improve vaccination rates overall.  Improving vaccination rates among Indiana residents will help prevent the spread of communicable diseases.

Pharmacies are among the most accessible health care facilities in many communities, and retail pharmacies have quickly become a popular option for flu immunization with nearly one-fifth of adults obtaining flu vaccines from retail establishments, including pharmacies.³  Many commercial health insurance plans already cover vaccines, and the Patient Protection and Affordable Care Act expands vaccine coverage without patient cost-sharing for many more health insurance plans.

To administer vaccines, pharmacists must have a valid drug order, prescription or a protocol approved by a physician.  Physicians who prepare these protocols must be licensed, actively practicing with a medical office in Indiana and cannot be employed by a pharmacy.

The new law also lowers the minimum age for obtaining vaccines (other than for pneumonia) from a pharmacist working under a protocol developed by a physician from age 14 to 11.  It codifies consent requirements for minors and adults with legal guardians, establishes reporting requirements to the state department of health immunization data registry and allows pharmacy interns and pharmacy students to administer vaccinations under the supervision of a pharmacist.  The Indiana Board of Pharmacy will be adopting regulations related to administration of vaccinations by pharmacy students and interns.

Conclusion

Retail pharmacies are often the most accessible health care facilities in some communities, and this new law is expected to improve access to vaccines for residents across the state.  Increased access to these vaccines should in turn improve vaccination rates and help control the spread of preventable, communicable diseases.

Practical Takeaways

In light of this new law, pharmacies and other health care providers that employ pharmacists should evaluate whether they wish to offer this expanded list of vaccinations through their pharmacists.  If they do, they should:

• Develop policies and procedures that comply with the consent and minimum age requirements of the law;
• Collaborate with Indiana-licensed physicians to develop vaccine protocols that comply with the requirements of the law; and
• Develop policies and procedures that comply with reporting requirements for the state immunization data registry.

For more information about HB 1464 or pharmacy law, please contact Susan Bizzell at 317-977-1453 or sbizzell@hallrender.com, Nicholas Gonzales at 414-721-0486 or ngonzales@hallrender.com or your regular Hall Render attorney.