In 2016, a seemingly shocking idea surfaced out of the state of Idaho: allowing pharmacy technicians to administer vaccinations. Gossip among the profession and on social media spread quickly, with many saying it would be unsafe and arguing that pharmacists should not give up this hard-won responsibility. What started as rumors, however, began to be taken seriously, and word spread at state and national pharmacy meetings. Over the next few years, boards of pharmacy continued to discuss the issue, and in 2019, the topic was presented in a poster at the National Association of Boards of Pharmacy Annual Meeting.1
As word spread, states such as Utah and Rhode Island made changes to their state protocols and rules, and a follow-up publication evaluating the status of state laws and rules on the topic was published. The idea gained popularity and acceptance, but it also gained pushback as some professionals resisted change.2 Various groups were against the idea, shunning the concept for going too far. State agencies and legislators considered the topic but many hesitated. Meanwhile, Washington State University College of Pharmacy and Pharmaceutical Sciences developed a training program, published safety data, and worked on other studies to help resolve the gap in understanding.2
Then 2020 arrived, and the unthinkable occurred as the COVID-19 pandemic swept across the globe. The development of a vaccine was expedited as lawmakers, government officials, and state and federal agencies searched for a solution to ensure rapid administration was viable. A few states quickly reconsidered authorizing technicians as administrators, as governors issued executive orders and legislatures began waiving requirements. The US Department of Health and Human Services (HHS) issued the Public Readiness and Emergency Preparedness (PREP) Act in March 2020, utilizing the federal ability to enact and expedite allowances.3 In August 2020, an amendment to the PREP Act was created to permit pharmacy technicians to administer vaccines in all 50 states and Washington, DC, by way of immunity from state penalties.3 Efforts to ensure that medical professionals were prepared to handle the upcoming vaccine launch were underway. The country went from having fewer than 10 states recognize pharmacy technicians as immunizers to all 50 states and Washington, DC, nearly overnight.
From that point on, the conversation suddenly shifted. As of this writing, many states have changed laws, rules, or protocols to allow pharmacy technicians to administer vaccines. The same state and national groups that had previously frowned on the idea changed paths and monetized the training, education, and continuing education of technician-administered vaccines. Many of the naysayers even became advocates for technician-administered immunizations.
Amid all these rapid changes, the unsung heroes of the story were and continue to be hardworking pharmacy technicians who served the public daily, even during an unprecedented worldwide pandemic.
The truth is that new ideas—no matter how simple or logical—are usually not quick to be adopted by many.
As follows, you will find a list of evidence-backed truths about technician-administered immunizations as well as common myths that are not backed by evidence or are based on anecdotes or hearsay.
About NHA
This article was submitted in partnership with NHA. NHA is building the next generation of allied health professionals. Since 1989, we have helped over 1.25 million people access a better future in healthcare. From innovative learning solutions to certification and career development, we partner with individuals, educators and employers to elevate the learning experience, ensure practice and career readiness and drive positive outcomes for the industry, allied health professionals, and ultimately patients.
Truths2,4,5
- In 2016, Idaho became the first state to make legislative and regulatory changes to permit technicians to administer vaccines.
- Prior to the COVID-19 pandemic and HHS PREP Act, most states did not allow for or address pharmacy technician administration of vaccines.
- As of September 2023, more than 50% of states in the US have changed their laws, rules, or protocols to allow pharmacy technicians to administer immunizations.
- Washington State University College of Pharmacy developed the original training/education program to train the first technicians in Idaho to administer vaccines.
- There are multiple published studies and literature on the topic that can be found on PubMed and other sites, including state law, rules reviews, safety data, opinions, examples, and more.
- Pharmacy technicians have administered hundreds of thousands (if not millions) of vaccines to patients since 2016 (with most of these coming after 2020).
- Prior to 2016, pharmacy technicians in various federal branches had been reported through articles online to have been administering medications for years.
Myths
- Delegating administration of vaccines to technicians means pharmacists are no longer allowed to administer immunizations.
- Delegation of administration forfeits a positive public image for pharmacists.
- Allowing technicians to administer vaccines will cause pharmacists to be fired or let go.
- Technicians do not have options to obtain liability insurance for this added scope.
- Pharmacy technicians can administer vaccines without any training or education.
- Once the PREP Act ends, all technicians will still be able to administer vaccines (in states that do not allow or prohibit technician-administered immunizations).
About the Author
Deeb D. Eid, PharmD, RPh, is founder and content creator at the RxPosed Podcast.
References
1. Poster presenters share findings of 50-state review of pharmacy technician vaccination administration. Innovations: Newsletter of the National Association of Boards of Pharmacy. August 2019. Accessed September 28, 2023. https://nabp.pharmacy/wp-content/uploads/2019/08/Innovations-Newsletter-August-2019.pdf
2. Eid D, Osborne J, Borowicz B. Moving the needle: a 50-state and District of Columbia landscape review of laws regarding pharmacy technician vaccine administration. Pharmacy (Basel). 2019;7(4):168. doi:10.3390/pharmacy7040168
3. Public Readiness and Emergency Preparedness (PREP) Act. US Department of Health and Human Services Administration for Strategic Preparedness and Response. Accessed September 28, 2023. https://aspr.hhs.gov/legal/PREPact/Pages/default.aspx
4. Eid D. These 3 areas of opportunity are ripe for law changes. Pharmacy Times. October 28, 2022. Accessed September 28, 2023. https://www.pharmacytimes.com/view/these-3-areas-of-opportunity-are-ripe-forlaw-changes
5. Adams AJ, Bright D, Adams J. Pharmacy technician-administered immunizations: a five-year review. J Am Pharm Assoc (2003). 2022;62(2):419-423. doi:10.1016/j.japh.2021.11.011
