Vaccine administration education and training requirements to prevent shoulder injuries related to vaccine administration establishment and appropriation

A bill for an act

relating to health; establishing requirements for education and training on vaccine

administration to prevent shoulder injuries related to vaccine administration;

appropriating money; amending Minnesota Statutes 2024, sections 150A.055,

subdivision 2; 151.01, subdivision 27; proposing coding for new law in Minnesota

Statutes, chapter 145.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

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[145.676] SIRVA PREVENTION ACTIVITIES.

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Subdivision 1.

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Definition.

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For purposes of this section, "shoulder injury related to vaccine

administration" or "SIRVA" has the meaning given in Code of Federal Regulations, title

42, section 100.3(c)(10).

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Subd. 2.

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SIRVA prevention poster.

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All health clinics, pharmacies, and other health

care settings where vaccines are administered must display a poster created or approved by

the commissioner of health that describes proper vaccine administration techniques to

prevent shoulder injury related to vaccine administration. The poster must be displayed at

one or more locations in the clinic, pharmacy, or health care setting where the poster is

visible to the public and all health care personnel authorized to administer vaccines at the

clinic, pharmacy, or health care setting.

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Subd. 3.

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Training.

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In order to administer vaccines on or after July 1, 2026, health care

personnel otherwise authorized to administer vaccines must complete comprehensive,

competency-based training on vaccine administration. The training must conform with the

guidance of the Centers for Disease Control and Prevention on vaccine administration and

must at least address vaccine preparation, proper needle selection, site and route selection,

administration, and SIRVA as a potentially serious complication resulting from improper

vaccine administration. After completing the training, health care personnel must submit

evidence of completion to the health-related licensing board that regulates the health care

personnel.

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Subd. 4.

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Exceptions.

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This section does not apply to veterinary clinics, veterinary

hospitals, licensed veterinarians, or licensed veterinary technicians.

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Sec. 2.

Minnesota Statutes 2024, section 150A.055, subdivision 2, is amended to read:

Subd. 2.

Qualified dentists.

(a) The vaccine shall be administered only to eligible

patients 16 years of age and older and only by licensed dentists who:

(1) have immediate access to emergency response equipment, including but not limited

to oxygen administration equipment, epinephrine, and other allergic reaction response

equipment; and

(2) are trained in or have successfully completed an educational program on vaccine

administration that is approved by the Minnesota Board of Dentistry, specifically for the

administration of vaccines. The training or program must
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comply with the requirements in

section 145.676, subdivision 3, and must
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include:

(i) educational material on the disease and vaccination as prevention of the disease;

(ii) contraindications and precautions;

(iii) intramuscular administration;

(iv) communication of risk and benefits of vaccination and legal requirements involved;

(v) reporting of adverse events;

(vi) documentation required by federal law; and

(vii) storage and handling of vaccines.

(b) Any dentist giving vaccinations under this section shall comply with guidelines

established by the federal Advisory Committee on Immunization Practices relating to

vaccines and immunizations, which includes, but is not limited to, vaccine storage and

handling, vaccine administration and documentation, and vaccine contraindications and

precautions.

Sec. 3.

Minnesota Statutes 2024, section 151.01, subdivision 27, is amended to read:

Subd. 27.

Practice of pharmacy.

"Practice of pharmacy" means:

(1) interpretation and evaluation of prescription drug orders;

(2) compounding, labeling, and dispensing drugs and devices (except labeling by a

manufacturer or packager of nonprescription drugs or commercially packaged legend drugs

and devices);

(3) participation in clinical interpretations and monitoring of drug therapy for assurance

of safe and effective use of drugs, including ordering and performing laboratory tests that

are waived under the federal Clinical Laboratory Improvement Act of 1988, United States

Code, title 42, section 263a et seq. A pharmacist may collect specimens, interpret results,

notify the patient of results, and refer the patient to other health care providers for follow-up

care and may initiate, modify, or discontinue drug therapy only pursuant to a protocol or

collaborative practice agreement. A pharmacist may delegate the authority to administer

tests under this clause to a pharmacy technician or pharmacy intern. A pharmacy technician

or pharmacy intern may perform tests authorized under this clause if the technician or intern

is working under the direct supervision of a pharmacist;

(4) participation in drug and therapeutic device selection; drug administration for first

dosage and medical emergencies; intramuscular and subcutaneous drug administration under

a prescription drug order; drug regimen reviews; and drug or drug-related research;

(5) drug administration, through intramuscular and subcutaneous administration used

to treat mental illnesses as permitted under the following conditions:

(i) upon the order of a prescriber and the prescriber is notified after administration is

complete; or

(ii) pursuant to a protocol or collaborative practice agreement as defined by section

151.01, subdivisions 27b
and 27c, and participation in the initiation, management,

modification, administration, and discontinuation of drug therapy is according to the protocol

or collaborative practice agreement between the pharmacist and a dentist, optometrist,

physician, physician assistant, podiatrist, or veterinarian, or an advanced practice registered

nurse authorized to prescribe, dispense, and administer under section
148.235
. Any changes

in drug therapy or medication administration made pursuant to a protocol or collaborative

practice agreement must be documented by the pharmacist in the patient's medical record

or reported by the pharmacist to a practitioner responsible for the patient's care;

(6) initiating, ordering, and administering influenza and COVID-19 or SARS-CoV-2

vaccines authorized or approved by the United States Food and Drug Administration to all

eligible individuals three years of age and older and all other United States Food and Drug

Administration-approved vaccines to patients six years of age and older according to the

federal Advisory Committee on Immunization Practices recommendations.
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A pharmacist

administering vaccines under this clause must have completed training that complies with

the requirements in section 145.676, subdivision 3.
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A pharmacist may delegate the authority

to administer vaccines under this clause to a pharmacy technician or pharmacy intern who

has completed training in vaccine administration
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that complies with the requirements in

section 145.676, subdivision 3,
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if:

(i) the pharmacist and the pharmacy technician or pharmacy intern have successfully

completed a program approved by the Accreditation Council for Pharmacy Education

(ACPE) specifically for the administration of immunizations or a program approved by the

board;

(ii) the pharmacist utilizes the Minnesota Immunization Information Connection to

assess the immunization status of individuals prior to the administration of vaccines, except

when administering influenza vaccines to individuals age nine and older;

(iii) the pharmacist reports the administration of the immunization to the Minnesota

Immunization Information Connection;

(iv) if the patient is 18 years of age or younger, the pharmacist, pharmacy technician,

or pharmacy intern informs the patient and any adult caregiver accompanying the patient

of the importance of a well-child visit with a pediatrician or other licensed primary care

provider; and

(v) in the case of a pharmacy technician administering vaccinations while being

supervised by a licensed pharmacist:

(A) the supervision is in-person and must not be done through telehealth as defined

under section
62A.673, subdivision 2
;

(B) the pharmacist is readily and immediately available to the immunizing pharmacy

technician;

(C) the pharmacy technician has a current certificate in basic cardiopulmonary

resuscitation;

(D) the pharmacy technician has completed a minimum of two hours of ACPE-approved,

immunization-related continuing pharmacy education as part of the pharmacy technician's

two-year continuing education schedule; and

(E) the pharmacy technician has completed one of two training programs listed under

Minnesota Rules, part
6800.3850
, subpart 1h, item B;

(7) participation in the initiation, management, modification, and discontinuation of

drug therapy according to a written protocol or collaborative practice agreement between:

(i) one or more pharmacists and one or more dentists, optometrists, physicians, physician

assistants, podiatrists, or veterinarians; or (ii) one or more pharmacists and one or more

physician assistants authorized to prescribe, dispense, and administer under chapter 147A,

or advanced practice registered nurses authorized to prescribe, dispense, and administer

under section
148.235
. Any changes in drug therapy made pursuant to a protocol or

collaborative practice agreement must be documented by the pharmacist in the patient's

medical record or reported by the pharmacist to a practitioner responsible for the patient's

care;

(8) participation in the storage of drugs and the maintenance of records;

(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and

devices;

(10) offering or performing those acts, services, operations, or transactions necessary

in the conduct, operation, management, and control of a pharmacy;

(11) participation in the initiation, management, modification, and discontinuation of

therapy with opiate antagonists, as defined in section
604A.04, subdivision 1
, pursuant to:

(i) a written protocol as allowed under clause (7); or

(ii) a written protocol with a community health board medical consultant or a practitioner

designated by the commissioner of health, as allowed under section
151.37
, subdivision 13;

(12) prescribing self-administered hormonal contraceptives; nicotine replacement

medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant

to section
151.37, subdivision 14
, 15, or 16;

(13) participation in the placement of drug monitoring devices according to a prescription,

protocol, or collaborative practice agreement;

(14) prescribing, dispensing, and administering drugs for preventing the acquisition of

human immunodeficiency virus (HIV) if the pharmacist meets the requirements in section

151.37, subdivision 17
; and

(15) ordering, conducting, and interpreting laboratory tests necessary for therapies that

use drugs for preventing the acquisition of HIV, if the pharmacist meets the requirements

in section
151.37, subdivision 17
.

Sec. 4.
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APPROPRIATION; SIRVA PREVENTION POSTER.
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$....... in fiscal year 2027 is appropriated from the general fund to the commissioner of

health to:

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(1) create or approve a poster to educate health care personnel and the public about

proper vaccine administration techniques to prevent shoulder injury related to vaccine

administration (SIRVA); and

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(2) make this poster available for display in all health care settings where vaccines are

administered.

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This is a onetime appropriation.

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