Health Occupations - Pharmacists - Vaccination Orders, the official text

WES MOORE, Governor                                Ch. 270

Chapter 270

                   (House Bill 1135)

AN ACT concerning

               Health Occupations – Pharmacists – Vaccination Orders

FOR the purpose of authorizing a pharmacist to order certain vaccinations for individuals
         who are at least a certain age without having to also administer the vaccination; and
         generally relating to the ordering of vaccinations by pharmacists.

BY repealing and reenacting, with amendments,
         Article – Health Occupations
         Section 12–508
         Annotated Code of Maryland
         (2021 Replacement Volume and 2025 Supplement)

         SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:

                   Article – Health Occupations

12–508.

         (a) (1) Subject to paragraph (4) of this subsection, a pharmacist may order
[and] A VACCINATION FOR INTRANASAL ADMINISTRATION OR administer a vaccination
to an individual who is at least 3 years old if:

               (i) The vaccine is:

                   1. An influenza vaccine;

                   2. A COVID–19 vaccine; or

                   3. Used in response to a public health emergency;

                           (ii) The pharmacist has completed a practical training program of at
least 20 hours that is approved by the Accreditation Council for Pharmacy Education and
includes:

                   1. Hands–on injection techniques;

                   2. Clinical evaluation of indications and contraindications of

vaccines; and

                                    –1–
Ch. 270    2026 LAWS OF MARYLAND

           3. The recognition and treatment of emergency reactions to

vaccines;

                           (iii) The pharmacist has a current certificate in basic
cardiopulmonary resuscitation;

                           (iv) The pharmacist has completed a minimum of 2 hours of
continuing pharmaceutical education related to immunizations that is approved by the
Accreditation Council for Pharmacy Education as part of the license renewal requirements
under § 12–309 of this title;

                           (v) The pharmacist complies with the record–keeping and reporting
requirements in paragraph (5) of this subsection and any corresponding regulations
adopted by the Board; and

                           (vi) If the vaccination is administered to an individual under the age
of 18 years, OR ORDERED FOR INTRANASAL ADMINISTRATION BY AN ADULT

CAREGIVER A PARENT OR GUARDIAN AN ADULT CAREGIVER TO AN INDIVIDUAL

UNDER THE AGE OF 18 YEARS, the pharmacist informs the child vaccination patient and
adult caregiver who is accompanying the child of the importance of well–child visits with a
pediatric primary care provider and refers the patient to a pediatric primary care provider
when appropriate.

                  (2) Subject to paragraph (4) of this subsection, a pharmacist who has met
the requirement of paragraph (1)(ii) through (vi) of this subsection may administer to an
individual who is at least 7 years old a vaccination that is:

                           (i) Recommended by the Centers for Disease Control and
Prevention’s Advisory Committee on Immunization Practices; or

                           (ii) Approved or authorized by the U.S. Food and Drug
Administration.

                  (3) Subject to paragraph (4) of this subsection, a pharmacist who has met
the requirement of paragraph (1)(ii), (iii), and (iv) of this subsection may administer to an
adult a vaccination that is recommended in the Centers for Disease Control and
Prevention’s Health Information for International Travel.

                  (4) (i) A pharmacist shall ORDER OR administer a vaccination under
paragraph (1), (2), or (3) of this subsection under a written protocol that:

           1. Is vaccine specific; and

                                    2. Meets criteria established by the Department, in
consultation with the Board, the Board of Physicians, and the Board of Nursing, in
regulation.

                                                           –2–
WES MOORE, Governor  Ch. 270

                           (ii) The recommendations of the Centers for Disease Control and
Prevention’s Advisory Committee on Immunization Practices cited in this section refer to
federal statutes, rules, and guidance in effect:

                                    1. On December 31, 2024; or

                                    2. At a later date to account for any new vaccines
recommended by the Centers for Disease Control and Prevention’s Advisory Committee on
Immunization Practices after December 31, 2024.

                  (5) A pharmacist shall:

                           (i) Report all vaccinations administered OR ORDERED by the
pharmacist, INCLUDING THE INTENDED RECIPIENT OF EACH VACCINATION ORDERED
BY THE PHARMACIST, to the ImmuNet Program established under § 18–109 of the
Health – General Article;

                           (ii) If the vaccination has been administered in accordance with a
prescription, document at least one effort to inform the individual’s authorized prescriber
that the vaccination has been administered; and

                           (iii) Except for an influenza vaccination administered under
paragraph (1) of this subsection, if the authorized prescriber is not the individual’s primary
care provider or if the vaccination has not been administered in accordance with a
prescription, document at least one effort to inform the individual’s primary care provider
or other usual source of care that the vaccination has been administered.

         (b) The Board shall:

                  (1) Set reasonable fees for the administration of vaccinations under this
section; and

                  (2) Adopt regulations that require a pharmacist to submit a registration
form to the Board that includes verification that the pharmacist:

                           (i) Has successfully completed a certification course approved by the
Board that included instruction in the guidelines and recommendations of the Centers for
Disease Control and Prevention regarding vaccinations in effect on December 31, 2024; and

                           (ii) Is certified in basic cardiopulmonary resuscitation and obtained
the certification through in–person classroom instruction.

         SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
October 1, 2026.

                                                           –3–
Ch. 270  2026 LAWS OF MARYLAND

Approved by the Governor, April 28, 2026.

         –4–