North Carolina § 90-85 - 15B. Immunizing pharmacists.

§ 90-85. 15B. Immunizing pharmacists.

Except as provided in subsection (b) and (c) of this section, an immunizing pharmacist may administer vaccinations or immunizations only if the vaccinations or immunizations are recommended or required by the Centers for Disease Control and Prevention and administered to persons at least 18 years of age pursuant to a specific prescription order. An immunizing pharmacist may administer the vaccinations or immunizations listed in subdivisions (1) through (7) of this subsection to persons at least 18 years of age if the vaccinations or immunizations are administered under written protocols as defined in 21 NCAC 46. 2507(b)(12) and 21 NCAC 32U. 0101(b)(12) and in accordance with the supervising physician's responsibilities as defined in 21 NCAC 46. 2507(e) and 21 NCAC 32U. 0101(e), and the physician is licensed in and has a practice physically located in North Carolina: Pneumococcal polysaccharide or pneumococcal conjugate vaccines. Herpes zoster vaccine. Hepatitis B vaccine. Meningococcal polysaccharide or meningococcal conjugate vaccines and Serogroup B meningococcal vaccines. Tetanus-diphtheria, tetanus and diphtheria toxoids and pertussis, tetanus and diphtheria toxoids and acellular pertussis, or tetanus toxoid vaccines. However, a pharmacist shall not administer any of these vaccines if the patient discloses that the patient has an open wound, puncture, or tissue tear. Human Papillomavirus vaccine. Hepatitis A vaccine. An immunizing pharmacist may administer the influenza vaccine to persons at least 10 years of age pursuant to 21 NCAC 46. 2507 and 21 NCAC 32U. 0101. An immunizing pharmacist may administer an influenza vaccine to persons at least six years of age pursuant to a specific prescription order initiated by a prescriber following a physical examination of the patient by the prescriber. (Effective October 1, 2021) An immunizing pharmacist may administer a long-acting injectable medication to persons at least 18 years of age pursuant to a specific prescription order initiated by a prescriber following a physical examination of the patient by the prescriber. An immunizing pharmacist who administers a long-acting injectable medication pursuant to this section shall do all of the following: Maintain a record of any administration of a long-acting injectable performed by the immunizing pharmacist to the patient in a patient profile or record. Within 72 hours after the administration of the long-acting injectable performed by the immunizing pharmacist to the patient, notify the prescriber regarding which medication and dosage was administered to the patient. An immunizing pharmacist who administers a vaccine or immunization to any patient pursuant to this section shall do all of the following: Maintain a record of any vaccine or immunization administered to the patient in a patient profile. Within 72 hours after administration of the vaccine or immunization, notify any primary care provider identified by the patient. If the patient does not identify a primary care provider, the immunizing pharmacist shall direct the patient to information describing the benefits to a patient of having a primary care physician, prepared by any of the following: North Carolina Medical Board, North Carolina Academy of Family Physicians, North Carolina Medical Society, or Community Care of North Carolina. Except for influenza vaccines administered under G.S. 90-85.15B(c), access the North Carolina Immunization Registry prior to administering the vaccine or immunization and record any vaccine or immunization administered to the patient in the registry within 72 hours after the administration. In the event the registry is not operable, an immunizing pharmacist shall report as soon as reasonably possible. History (2013-246, s. 4; 2014-115, s. 40; 2019-21, s. 1; 2021-3, s. 2.9(a).) Editor's Note. - Session Laws 2013-246, s. 6, provides: "Representatives of the North Carolina Academy of Family Physicians, the North Carolina Medical Society, the North Carolina Pediatric Society, the North Carolina Association of Community Pharmacists, the North Carolina Association of Pharmacists, and the North Carolina Retail Merchants Association are directed to cooperate and collaborate to recommend a minimum standard screening questionnaire and safety procedures for written protocols for vaccinations or immunizations administered under G.S. 90-85.15 B(b). The questionnaire and recommended standards shall be submitted to the North Carolina Board of Medicine, the North Carolina Board of Nursing, the North Carolina Board of Pharmacy, and the Joint Legislative Oversight Committee on Health and Human Services no later than October 1, 2013. In the event agreement is not reached on a minimum standard screening questionnaire and safety procedures for written protocols by October 1, 2013, the Immunization Branch of the North Carolina Division of Public Health shall develop the questionnaire and standards and submit them to the North Carolina Board of Medicine, the North Carolina Board of Nursing, the North Carolina Board of Pharmacy, and the Joint Legislative Oversight Committee on Health and Human Services by January 1, 2014." Session Laws 2013-246, s. 7, provides: "Notwithstanding the provisions of Sections 1 through 5 of this act, pharmacists who were qualified to administer influenza, pneumococcal, and zoster vaccines prior to the effective date of this act may continue to administer these vaccines in accordance with the provisions of 21 NCAC 46.2507 until June 30, 2014. Notwithstanding the provisions of Sections 1 through 5 of this act, 21 NCAC 46.2507(c)(5), 21 NCAC 32U.0101(c)(5), or any other provision of law, pharmacists who were qualified to administer influenza, pneumococcal, and zoster vaccines prior to the effective date of this act may administer the influenza vaccine to persons at least 14 years old in accordance with the provisions of 21 NCAC 46.2507 until June 30, 2014." Session Laws 2015-241, s. 12H.5(a), provides: "Effective January 1, 2016, the Department of Health and Human Services, Division of Medical Assistance (Department), shall provide Medicaid and NC Health Choice reimbursement for the administration of covered vaccinations or immunizations provided by immunizing pharmacists in accordance with G.S. 90-85.15 B." Session Laws 2015-241, s. 12H.5(b), provides: "Any State Plan amendments required to implement this section shall not be subject to the 90-day prior submission requirement of G.S. 108A-54.1 A(e) but shall be submitted by January 1, 2016." Session Laws 2015-241, s. 1.1, provides: "This act shall be known as 'The Current Operations and Capital Improvements Appropriations Act of 2015.'" Session Laws 2015-241, s. 33.4, provides: "Except for statutory changes or other provisions that clearly indicate an intention to have effects beyond the 2015-2017 fiscal biennium, the textual provisions of this act apply only to funds appropriated for, and activities occurring during, the 2015-2017 fiscal biennium." Session Laws 2015-241, s. 33.6, is a severability clause. Session Laws 2020-3, s. 3A.1(a), provides: "Unless the context clearly indicates otherwise, the following definitions apply in this Part: "(1) CDC. - The federal Centers for Disease Control and Prevention. "(2) COVID-19. - Coronavirus disease 2019. "(3) COVID-19 diagnostic test. - A test the federal Food and Drug Administration has authorized for emergency use or approved to detect the presence of the severe acute respiratory syndrome coronavirus 2. "(4) COVID-19 emergency. - The period beginning March 10, 2020, and ending on the date the Governor signs an executive order rescinding Executive Order No. 116, Declaration of a State of Emergency to Coordinate Response and Protective Actions to Prevent the Spread of COVID-19. "(5) COVID-19 antibody test. - A serological blood test the federal Food and Drug Administration has authorized for emergency use or approved to measure the amount of antibodies or proteins present in the blood when the body is responding to an infection caused by the severe acute respiratory syndrome coronavirus 2." Session Laws 2020-3, s. 3D.3(a)-(d), as amended by Session Laws 2021-3, s. 2.8(a), provides: "(a) In the event the Centers for Disease Control and Prevention recommends an immunization or vaccination for COVID-19 at a time when the General Assembly is not in regular session, any person may petition the State Health Director, in writing, to authorize immunizing pharmacists, as defined in G.S. 90-85.3 , to administer the recommended immunization or vaccination for COVID-19 by means of a statewide standing order. The State Health Director shall, within 30 days after receiving such petition, consult with the following entities in evaluating the petition and respond by either approving or denying the petition: Representatives of the North Carolina Academy of Family Physicians, the North Carolina Medical Society, the North Carolina Pediatric Society, the North Carolina Association of Community Pharmacists, the North Carolina Association of Pharmacists, and the North Carolina Retail Merchants Association. "(b) Following the consultation provided in subsection (a) of this section, if the State Health Director approves the petition, the State Health Director may issue a statewide standing order authorizing the administration of an immunization or vaccination of COVID-19 by immunizing pharmacists. If the State Health Director issues a statewide standing order, it shall expire upon the adjournment of the next regular session of the General Assembly. "(c) If the State Health Director approves the petition as provided in subsection (a) of this section, the State Health Director shall, within 10 days after approval, consult with the entities listed in subsection (a) of this section to develop and submit to the North Carolina Board of Medicine, the North Carolina Board of Nursing, the North Carolina Board of Pharmacy, and the Joint Legislative Oversight Committee on Health and Human Services a minimum standard screening questionnaire and safety procedures for written protocols for the administration of the recommended immunization or vaccination for COVID-19 by immunizing pharmacists. In the event that the questionnaire and recommended standards are not developed and submitted within the 10-day period as provided in this subsection, then the Immunization Branch of the Department of Health and Human Services, Division of Public Health, shall develop the questionnaire and recommended standards within the next 10 days and submit them to the North Carolina Board of Medicine, the North Carolina Board of Nursing, the North Carolina Board of Pharmacy, and the Joint Legislative Oversight Committee on Health and Human Services. At a minimum, immunizing pharmacists who administer the recommended immunization or vaccination for COVID-19 shall be required to comply with all the requirements of G.S. 90-85.15 B. "(c1) The State Health Director shall amend, reissue, or replace any existing statewide standing order issued pursuant to this section, to ensure that the statewide standing order is consistent with federal law and guidance pertaining to qualified individuals who may administer a COVID-19 vaccine, including P.L. 109-148, "The Public Readiness and Emergence Preparedness Act," as amended, and associated declarations of public health emergencies and advisory opinions issued by the Secretary of the United States Department of Health and Human Services. "(d) All of the following individuals shall be immune from any civil or criminal liability for actions authorized by this section as follows: "(1) The State Health Director acting pursuant to this section. "(2) Any pharmacist or qualified individual under State or federal law who administers a COVID-19 immunization or vaccine pursuant to a statewide standing order issued under this section." Session Laws 2020-3, s. 5, is a severability clause. Session Laws 2021-3, s. 2.9(c), provides: "The North Carolina Board of Pharmacy may adopt temporary rules to implement this section." Effect of Amendments. - Session Laws 2014-115, s. 40, effective August 11, 2014, substituted "G.S. 90-85.15B(c)" for "G.S. 90-85.15B(b)(6)" in the first sentence of subdivision (d)(3). Session Laws 2019-21, s. 1, effective October 1, 2019, substituted "(7)" for "(5)" in the introductory paragraph of subsection (b); added "and Serogroup B meningococcal vaccines" in subdivision (b)(4); added subdivisions (b)(6) and (b)(7); and, in subsection (c), substituted "10" for "14" in the first sentence and added the last sentence. Session Laws 2021-3, s. 2.9(a), effective October 1, 2021, added subsection (c1).