1. A. Registration.

   1. (1) A licensed pharmacist shall submit a registration to the Board on the form that the Board requires.

   2. (2) The registration form shall include verification from the licensed pharmacist of the following:

      1. (a) That the pharmacist has completed a practical training program of at least 20 hours that is approved by the Accreditation Council for Pharmacy Education and includes education on:

         1. (i) Hands-on injection techniques;
         2. (ii) Clinical evaluation of indication and contraindications of vaccines;
         3. (iii) The recognition and treatment of emergency reaction to vaccines; and
         4. (iv) Guidelines and recommendations of the Centers for Disease Control and Prevention regarding vaccinations in effect on December 31, 2024; and
      2. (b) Possession of an active certification in basic cardiopulmonary resuscitation obtained through in-person classroom instruction.

   3. (3) A registration authorizing a licensed pharmacist to administer vaccinations expires with the expiration of the license to practice pharmacy unless the licensed pharmacist has completed:

      1. (a) Two hours of continuing education credits related to vaccinations; and
      2. (b) All other requirements for licensure renewal.
   4. (4) A licensed pharmacist may not administer vaccinations until the licensed pharmacist receives a written confirmation from the Board accepting the licensed pharmacist's registration.

2. B. A licensed pharmacist may order and administer a vaccination in accordance with a protocol that meets the requirements of Regulation .06 of this chapter to an individual who is at least 3 years old provided that:

   1. (1) The vaccine is:

      1. (a) An influenza vaccine;
      2. (b) A COVID vaccine; or
      3. (c) Used in response to a public health emergency; and

   2. (2) If the vaccination is administered to an individual under the age of 18 years, the pharmacist shall:

      1. (a) Inform the child vaccination patient and the adult caregiver who is accompanying the child of the importance of well-child visits with a pediatric primary care provider; and
      2. (b) Refer the child vaccination patient to a pediatric care provider when appropriate.

3. B-1.

   1. (1) A pharmacist may order and administer a vaccination in accordance with a protocol that meets the requirements of Regulation .06 of this chapter to an individual who is at least 7 years old provided that:

      1. (a) The vaccine:

         1. (i) Is recommended by the Center for Disease Control and Prevention Advisory Committee on Immunization Practices; or
         2. (ii) Approved or authorized by the U.S. Food and Drug Administration; and

      2. (b) If the vaccination is administered to an individual under the age of 18 years, the pharmacist shall:

         1. (i) Inform the child vaccination patient and the adult caregiver who is accompanying the child of the importance of well-child visits with a pediatric primary care provider; and
         2. (ii) Refer the child vaccination patient to a pediatric care provider when appropriate.

   2. (2) The recommendations of the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices cited in this regulation refer to federal statutes, rules, and guidance:

      1. (a) In effect on December 31, 2024; or
      2. (b) At a later date to account for any new vaccines recommended by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices after December 31, 2024.
4. B-2. A licensed pharmacist may order and administer to an adult a vaccination in accordance with a protocol that meets the requirements of Regulation .06 of this chapter that is listed in the Center for Disease Control and Prevention’s Health Information for International Travel.
5. C. A pharmacist shall report to the ImmuNet Program established under Health-General Article, §18-109, Annotated Code of Maryland, a vaccination administered by the pharmacist to an individual.

6. D. A pharmacist shall:

   1. (1) Have proof of active certification in basic cardiopulmonary resuscitation readily available.
   2. (2) Provide the patient with a vaccine information statement issued by the Centers for Disease Control and Prevention;
   3. (3) Obtain a signed consent form from the patient or custodial parent; and
   4. (4) Observe the patient for a period of at least 15 minutes after administration of the vaccine for adverse effects including syncope.
7. E. A pharmacy student in a Pharmacy Experiential Program, who has successfully completed a Board-approved certification course, may administer vaccinations under direct supervision of a licensed pharmacist who meets requirements in §A of this regulation.

Authority: Health Occupations Article, §§12-101, 12-102(b), 12-508, and 12-6A-10, Annotated Code of Maryland

Effective date:

Regulations .01—.07 adopted as an emergency provision effective December 16, 2005 (33:1 Md. R. 34); adopted permanently effective April 24, 2006 (33:8 Md. R. 734)

Regulation .03A amended effective July 2, 2007 (34:13 Md. R. 1151)

Regulation .08 adopted effective July 2, 2007 (34:13 Md. R. 1151)

Chapter revised effective August 1, 2009 (36:15 Md. R. 1167)

Regulation .03 amended as an emergency provision effective October 1, 2011 (38:24 Md. R. 1495); amended permanently effective January 23, 2012 (39:1 Md. R. 18)

Chapter revised effective April 28, 2014 (41:8 Md. R. 472)

Regulation .02B amended as an emergency provision effective November 20, 2025 (52:25 Md. R. 1266)

Regulation .03 amended as an emergency provision effective November 20, 2025 (52:25 Md. R. 1266)

Regulation .03D amended effective December 31, 2018 (45:26 Md. R. 1246)

Regulations .04— .08 amended as an emergency provision effective November 20, 2025 (52:25 Md. R. 1266)