Bill allowing pharmacists to prescribe, administer vaccines passes Alabama House committee

The House Health Committee Wednesday approved a bill that would allow pharmacies to administer vaccines to adults without a standing order from a physician.

HB 290, sponsored by Rep. Phillip Rigsby, R-Huntsville, would allow pharmacists to administer any vaccine to adults, but require them to have a physician’s order for vaccines for minors.

“They have to contract or pay a physician to ‘bless’ their orders so that they can administer the medicines,” said Rigsby, a pharmacist by trade. “It’s still the pharmacist that’s making all these determinations of whether that vaccine is appropriate, necessary, and preparing and administering that vaccine – even with a standing order, we’re still the ones doing that.”

The bill passed the House Health committee on a voice vote. It goes to the full House for consideration.

Prior to the COVID-19 pandemic, pharmacists needed a standing order from a physician to administer vaccines. This meant pharmacies needed a physician to sign off on a vaccine from a doctor or pay a monthly fee to a physician for the ability to administer vaccines.

Following the outbreak of the pandemic in 2020, Congress passed the PREP Act, which allowed pharmacists to administer the COVID-19 and flu vaccines, along with pediatric vaccines, without a physician’s order. Vaccines for HPV and shingles still needed a standing order.

Rigsby’s bill originally would have allowed pharmacies to dispense pediatric vaccines without a standing order. But Rep. Paul Lee, R-Dothan, the chair of the committee, introduced an amendment to remove them. He said that getting a child to a doctor may be the only chance to see a child that needs medical attention, such as abuse.

“I just think it’s very important that these children need to be in front of a pediatrician at least once a year if nothing other than vaccines,” Lee said.

The bill faced some opposition. Rep. David Cole, R-Madison, pointed out that before the pandemic, the PREP Act did not exist.

“I still have significant concerns even though pediatrics is out,” he said. “This does not address the healthcare and concerns of people who are immunocompromised, and it does not address any of the other medical conditions that healthcare providers have to use their clinician skills to make sure the vaccine is administered properly.”

The bill would allow pharmacists to administer any vaccine under the Center for Disease Control’s (CDC) Advisory Committee on Immunization Practices Immunization Schedules (ACIP). Cole said there is not one pharmacist in the ACIP committee.

Cole also asked about whether pharmacists have contact with the patient or if they have experience with patient intake and questioned their training level to administer that level of care.

“Do you actually go through a course that actually talks about how they can talk to patients and how to gather information?” he asked Rigsby.

Rigsby said that they do, and that pharmacists do patient contact in their personal rotations “to actually do this on a real-life basis.”

Even though a physician has to sign off on an order to allow pharmacists to administer a vaccine, Rigsby said that “never once did that physician lay eyes on any of my patients that I administered vaccines to” during the time he operated a pharmacy.

“So, all we’re asking for us to do is let us prescribe,” he said. “Let us save my $200 a month from that physician, because they are not involved in the process at all, except their name goes on the prescription.”