As many parents prepare to have children immunized before the start of the school year, a bill that could expedite the vaccination process has an uncertain future.
State law allows certified pharmacists to administer immunizations to adults age 18 and older, but vaccinations for those 17 and younger must be performed under the supervision of a primary care physician.
State Rep. Seth Grove, R-Dover Township, has introduced legislation to allow the state's more-than 6,000 certified pharmacist immunizers to vaccinate minors ages 7 to 17, a move he said would make immunization more convenient and accessible.
Last year was the first year the Department of Health enforced a new law mandating some vaccinations, including pertussis (whooping cough), for school entry. The deadline on the law's effective date was delayed because of overcrowding at doctors' offices and parental failure to ensure their children were immunized in time, Grove said.
"The kids can't go to school unless they get the vaccinations," he said. "(The Department of Health) had to push the effective date back twice because kids weren't getting vaccinated. They didn't want all of these kids not going to school."
It's probably too late for the coming school year, but Grove said he's hoping the bill, House Bill 776, will go before the full House for a vote this fall.
The bill was voted out of the House Professional Licensure Committee by a vote of 19-5, with one member not voting, on Feb. 25. Among the dissenters was Grove's York County colleague Rep. Keith Gillespie, R-Springettsbury Township.
The bill also faces strong opposition from pediatricians and medical groups.
Paramedic background: Gillespie said his background as
a paramedic is the basis of his concerns about the bill. During his career as a first-responder, he saw serious reactions to medication, he said.
While pharmacists have some knowledge of reactions, they should be certified in advanced cardiac life support if they are going to administer vaccinations for children, he said.
"Even though the chances are rare, I would hate to roll the dice and ... then they do happen," Gillespie said.
In the Pennsylvania Medical Society's position paper, writer Scot Chadwick said board-member response was "overwhelmingly negative."
"Children do have adverse reactions to immunizations, and the prospect of a severe reaction occurring in a department store pharmacy is pretty disturbing," he wrote. "Further, some adverse reactions are delayed, raising the very real prospect that a pediatrician could get an urgent call in the middle of the night from a frantic parent about an immunization the physician didn't even know had been administered."
Chadwick wrote that Grove's bill "is a step toward the fragmentation of health care delivery, which serves no one's best interests."
But while some doctors have taken a stand against the bill, York's largest health system, WellSpan Health, supports the increased access to vaccines.
Rick Ayers, director of public relations and marketing, said the company's position is that people "should have access to the services, programs and care that they need to become healthy and to stay this way."
"... Pharmacists are capable of providing this important service and, they already do in adults," he said.
The company does believe it's important, though, for patients to tell their primary care provider about any vaccines they get from a pharmacy, so that information can be added to medical records, he said.
Who benefits: Grove said the primary care physicians and pediatricians dislike the bill because "obviously, the more options there are, there are less people who (visit their offices)."
Immunization-certified pharmacists must be trained in CPR and have, as pharmacists, access to the drug epinephrine to administer if there's an adverse reaction, said Pat Epple, CEO of the Pennsylvania Pharmacists Association.
She said serious reactions are very rare, and opponents of Grove's bill are inflating the likelihood. But pharmacists don't take lightly the possibility of a reaction, she said. Recently vaccinated young people would have to stay in the pharmacy for about 20 minutes to make sure they don't react, she said.
"Pharmacists know more about their medications ... and the reactions to those medications than most physicians do," she said. "They would do the same thing ... administer epinephrine."
Epple's group "wholeheartedly endorses" the bill, she said, because it would increase accessibility to vaccinations.
"There are a lot of folks who need to get vaccines ... and aren't able to get them," she said. "They can't get into physician, or they don't have money. A pharmacy is just another option, and more affordable than a physician appointment."
Pharmacist-delivered vaccinations would augment physicians, she said, not sidestep them.
Pharmacists are already permitted to deliver vaccinations to children in 34 states, she said.
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