Michigan Law Authorizes Pharmacists to Prescribe, Administer Vaccines

Michigan Governor Gretchen Whitmer has signed Senate Bill (SB) 219 into law, authorizing pharmacists to prescribe and administer vaccines that are approved by the Advisory Committee on Immunization Practices (ACIP) for patients 3 years and older.¹

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SB 219 was introduced in March 2023 and passed the Michigan Senate in May. The Michigan House of Representatives voted overwhelmingly to pass the bill 96-12 on June 27, 2023. The Senate concurred on the same day and sent it for Whitmer’s approval.¹

“The Michigan Pharmacists Association is pleased this important piece of legislation was quickly passed by the legislature and signed by Governor Gretchen Whitmer,” Mark Glasper, CEO of the Michigan Pharmacists Association, said in a statement. “SB 219 will allow pharmacists to practice at the top of their license while creating greater access to their patients. We want to thank Senator Sylvia Santana for sponsoring the bill and our partners for working with us to create a meaningful bill for Michigan pharmacy.”¹

In a study published in the Journal of the American Pharmacists Association, researchers found that pharmacist involvement in immunizations, advocacy, or both can increase vaccine uptake, particularly with influenza vaccines in the United States and other high-income countries.²

According to the investigators, seasonal influenza causes 3 million to 5 million cases of severe illness and 290,000 to 650,000 respiratory-related deaths annually worldwide.2 As demonstrated by the COVID-19 pandemic, pharmacists can play a key role in vaccinations. During the pandemic, pharmacists administered more than 240 million doses of the various vaccines as of April 2022, according to the study.²

In Michigan, SB 219 will also allow pharmacists to independently administer tests for influenza and COVID-19 waived by the Clinical Laboratory Improvement Amendments (CLIA). If the test is positive, pharmacists are also allowed to dispense appropriate antiviral therapies to treat the patient¹.

Other key parts of the bill include the following:¹

• Pharmacists can independently order an immunization recommended by ACIP for individuals 3 years and older as long as the pharmacist has completed a boardapproved training program.
• Pharmacists are required to provide information about the Vaccines for Children Program for individuals younger than 19 years.
• Pharmacists must log all immunizations administered in the Michigan Care Improvement Registry.
• Pharmacists will also be allowed to independently order and administer CLIA-waived tests for COVID-19, influenza, or other respiratory illnesses. They must have completed a board-approved training program. This statutory authorization does not interfere with the pharmacist’s ability to order and administer CLIA-waived tests that are authorized under federal law or pursuant.
• In the event of a positive COVID-19 or influenza test, pharmacists may dispense antiviral therapy to a patient without a prescription from a physician.

In addition to SB 219, Whitmer also signed House Bills 4495 and 4496 in July, both of which are intended to increase access to the Healthy Michigan Plan. The plan now covers approximately 1 million patients in Michigan and is open to anyone aged 19 to 64 years who earns an income at or below 138% of the federal poverty level.³

The legislation prevents the program from being repealed based on operating costs and eliminates unnecessary red tape for enrollees, according to a news release from the Michigan Pharmacists Association. It also removed the previous mandate that Healthy Michigan enrollees contribute 5% of their income for cost-sharing requirements, removes a requirement that triggers elimination of the program if its net costs outweigh net savings, and discards the stipulation that the state health department seek certain waivers from the federal government in order to provide various services through Healthy Michigan.³

References

Governor signs MPA-backed pharmacist immunization and testing bill into law. News release. Michigan Pharmacists Association. July 19, 2023. Accessed August 3, 2023. https://www.michiganpharmacists.org/governor-signs-mpa-backed-pharmacist-immunization-and-testing-billinto-law/

Le LM, Veettil SK, Donaldson D, et al. The impact of pharmacist involvement on immunization uptake and other outcomes: an updated systematic review and meta-analysis. J Am Pharm Assoc (2003). 2022;62(5):1499-1513. e16. doi:10.1016/j.japh.2022.06.008

Whitmer signs legislation protecting Healthy Michigan Plan. News release. Michigan Pharmacists Association. July 20, 2023. Accessed August 8, 2023. https://www.michiganphharmacists.org/4964-2/