Legislation Details:

UPDATE: 4/25/2024 - HB 76 and SB 18 were ENACTED. Both were approved by Governor Wes Moore on 4/25/2024, effective immediately. HB 76 was assigned Chapter 231, and SB 18 was assigned Chapter 232. (In Maryland, chapter numbers are in the numerical order in which the bills are signed by the governor.)

UPDATE: 3/29/2024 - HB 76 passed the Senate 3rd Reading by a vote of 35-10 on 3/29/2024.

UPDATE: 3/28/2024 - HB 76 passed the Senate 2nd Reading on 3/28/2024. 

UPDATE: 3/27/2024 - SB 18 passed the House 3rd Reading by a vote of 102-37 on 3/27/2024. 

UPDATE: 3/26/2024 - HB 76 was reported as favorable in the Senate Finance Committee by a vote of 7 Yeas, 3 Nays, on 3/26/2024.

UPDATE: 3/26/2024 - SB 18 passed the House 2nd Reading on 3/26/2024. 

UPDATE: 3/21/2024 - SB 18 was reported as favorable in the House Health and Government Operations Committee by a vote of 14 Yeas, 5 Nays, on 3/21/2024.

UPDATE: 3/16/2024 - SB 18 is scheduled for a hearing in the House Health and Government Operations Committee on Thursday, 3/21/2024 at 1:00PM in Room 240 of the House Office Building. View the hearing agenda and video details HERE. 

UPDATE: 3/15/2024 - SB 18 was referred to the House Health and Government Operations Committee on 3/15/2024. 

UPDATE: 3/14/2024 - HB 76 was referred to the Senate Finance Committee on 3/14/2024. 

UPDATE: 3/14/2024 - HB 76 passed the House 3rd Reading by a vote of 98 Yeas, 36 Nays, on 3/14/2024. 

UPDATE: 3/14/2024 - SB 18 passed the Senate 3rd Reading by a vote of 36 Yeas, 10 Nays, on 3/14/2024. 

UPDATE: 3/13/2024 - HB 76 as amended in the House Health and Government Operations Committee was adopted in the full House and passed the House 2nd Reading on 3/13/2024. View the amended version of HB 76 HERE. 

UPDATE: 3/13/2024 - HB 76 was reported as favorable with amendments in the House Health and Government Operations Committee by a vote of 17 Yeas, 6 Nays, on 3/13/2024. The amendments are identical to those of the Senate bill companion, SB 18. 

UPDATE: 3/11/2024 - SB 18 as amended in the Senate Finance Committee was adopted in the full Senate and passed the Senate 2nd Reading on 3/11/2024. View the amended version of SB 18 HERE. 

UPDATE: 3/5/2024 - SB 18 was reported as favorable with amendments in the Senate Finance Committee by a vote of 8 Yeas, 3 Nays, on 3/5/2024. The amendment lowers the minimum age requirement from five to three years old for children to whom pharmacists can order and administer specific vaccines. The amendment additionally authorizes pharmacists to administer any ACIP recommended vaccine, or any vaccine approved by the FDA to children 7 years and older. 

SECTION 1. Subsection (a) (1) is amended to authorize pharmacists to order and administer the following vaccinations to children 3 years and older:

1.    influenza vaccines;

2.    COVID-19 vaccines; and

3.    vaccines used in response to a public health emergency.

SECTION 1. Subsection (a) (2) is amended to authorize pharmacists to administer the following vaccinations to children 7 years and older:

1.    Vaccines recommended by the Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP); or

2.    Vaccines approved or authorized by the U.S. Food and Drug Administration (FDA).

NVIC is opposed to pharmacists being authorized to order and administer vaccines to children as young as three years old due to the inherent risks of the procedure. This amendment further undermines the doctor patient relationship with young children and the minimum training requirements do not replace the necessary medical training to provide critical health history screenings prior to vaccination. Given the contraindications associated with vaccines, a complete health screening of the child prior to the vaccine being administered would be impossible in a pharmacy setting. 

This amendment requires a change to our bill post title from " Lowers age pharmacists can order & administer vaccines to children from 11 to 5 years, accompanying adult has to verify verbal parental consent" to "Lowers age of children to whom pharmacists can order & administer vaccines and expands which vaccines they are authorized to administer to children."

UPDATE: 1/26/2024 - SB 18 is scheduled for a hearing in the Senate Finance Committee on Tuesday, 2/13/2024 at 1:00PM in the East Miller Senate Building, Room 3. The agenda is located on the hearing details under the "Meetings" Tab of the Senate Finance Committee Page. This LINK provides the witness guidelines for the committee. 

UPDATE: 1/18/2024 - HB 76 is scheduled for a hearing in the House Health and Government Operations Committee on Thursday, 2/1/2024 at 1:00PM in the HOB Room 204. The agenda is located on the hearing details under the "Meetings" Tab of the House Health and Government Operations Committee Page. This LINK provides the witness guidelines  for the committee. 

HB 76 was prefiled on 10/30/2023 and referred to the House Health and Government Operations Committee on 1/10/2024. It is sponsored by Delegate Lesley J. Lopez. 

SB 18 was prefiled on 10/30/2023 and referred to the Senate Finance Committee on 1/10/2024. It is sponsored by Senators Malcolm Augustine and Clarence K. Lam.

HB 76 and SB 18 would authorize trained pharmacists to be able to not only administer vaccines, but also order them for children ages 5-18, if the vaccine is recommended by the CDC's ACIP schedule or approved or authorized by the FDA. Pharmacists are to inform the child and accompanying adult that well-child visits with a pediatric primary care provider is important. 

Current Maryland law authorizes pharmacists to administer vaccines to children 11-18 years old if the child has a prescription from an authorized prescriber. They may administer adults vaccines that are on the CDC's Immunization Schedule or if recommended for international travel. From 7/1/2021 to 6/20/2023, pharmacists were temporarily authorized to administer FDA approved vaccines to children 3-18 years old if the vaccine was ordered and administered in accordance with the CDC's  ACIP immunization schedule. 

Maryland General Code § 18-4A-02 (2022) states that parents may delegate consent to the immunization of a minor in writing or verbally to specified family members, or "any other adult who has care and control of the minor." The person with delegated authority shall confirm the verbal delegation in writing which shall be included in the minor's medical record. A specified family members who is the primary caregiver of the minor may consent to another adult permission to immunize the minor. 

NVIC is opposed to pharmacists vaccinating children as young as five due to the inherent risks in the procedure. Entrusting vaccination to only a verbal directive from a parent could easily lead to confusion and contradiction. The provision that pharmacists inform a child or whomever is accompanying the child on the importance of pediatric visits does not appear to be a serious requirement. Given the contraindications associated with vaccines, a complete health screening of the child would be impossible. 

Below are listed some of the reasons to not vaccinate that are recorded in federally required vaccine information statements, (VIS). It is unlikely that a pharmacist or non-parent would catch these issues:

• Are pharmacists trained to distinguish allergic reactions to ingredients in the vaccine and are they going to cover all these ingredients of every vaccine?  
• Are they going to perform an exam and take the patient's temperature to make sure they don’t have a fever since fever is contraindicated for some vaccines in the VIS statements?  
• Are they going to know if the patient has a weakened immune system due to disease (such as cancer or HIV/AIDS), medical treatments (such as radiation, immunotherapy, steroids, or chemotherapy), if they have a history of seizures, if they have family member with a history of seizures, or immune system problems?  
• Will they know if a patient has recently had a transfusion or if they have ever had Guillain-Barre syndrome post vaccination? 
• Do pharmacists have lifesaving defibrillators like they do in doctors’ offices when life-threatening reactions to vaccines occur. 
• Will they have the equipment and training to be able to tell the difference between cardiac arrest, anaphylaxis, fainting, and act accordingly to save the lives of those who react at the time of vaccination? 

This bill undermines the doctor patient relationship and removes critical health history screenings prior to vaccination. Vaccines, just like all pharmaceutical products, can cause injury and death in some people.  As of 1/1/2024, The United States Government has paid over $5.1 billion dollars to vaccine victims through the National Vaccine Injury Compensation Program (VICP). As of 12/29/2023. there were 47,149 deaths and 2,568,239 adverse events reported to the US government's Vaccine Adverse Events Reporting System. Of these, 1,621,120 adverse events and 36,986 deaths were attributed to COVID-19 vaccines. The same data set reports 2481 deaths and 223,663 adverse events from influenza vaccines, and 451 deaths and 119,741 adverse events from the VARZOS shingles vaccine.

There is no doubt the pharmacy groups will support this bill, but it presents a serious conflict of interest because of the financial benefits they will receive if it passes.  

America’s biopharmaceutical research companies are developing 258 vaccines.  The U.S. Vaccine Market alone was $36.45 billion in 2018, and is expected to reach $58.4 billion by 2024 and pharmacies stand to increase their profits substantially by allowing pharmacists to vaccinate adults. 

There is an emergency provision in these bills which would allow the provisions to be immediately effective if passed by a three-fifths vote of all members elected to the House and Senate vote.

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/hb0076?ys=2024RS - text, status, and history of HB76

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/SB0018?ys=2024RS - text, status, and history of  SB18