State Law and Standing Orders for Immunization Services

Area of Science:

• Public Health Law
• Immunization Policy
• Health Services Research

Background:

• Standing orders programs (SOPs) are crucial for increasing vaccine uptake.
• Effective SOPs require legal authorization for broad delegation of immunization services.
• Lack of legal permission hinders non-physician health professionals (NPHPs) in providing preventive services.

Purpose of the Study:

• To determine state law permissibility of standing orders programs (SOPs) for immunization practice.
• To assess legal authorization for NPHPs to assess, prescribe, and administer vaccines.
• To identify variations in laws governing NPHPs' scope of practice in immunization.

Main Methods:

• Legal analysis of laws in all 50 states and D.C. from 2012-2013.
• Examined laws for medical assistants, midwives, advanced practice nurses, registered/practical/vocational nurses, physician assistants, and pharmacists.
• Assessed authorization for vaccine assessment, prescription, administration, patient populations, and settings.

Main Results:

• Significant variability exists in state laws concerning NPHPs and immunizations.
• No state law comprehensively authorizes all NPHPs for all aspects of immunization practice.
• Laws specify limitations on vaccine types, patient eligibility, and required supervision for NPHPs.

Conclusions:

• Legal variations pose challenges to achieving public health immunization goals.
• Expanding SOP authorization across all states can enhance vaccine delivery.
• Increased NPHP authority in immunization is essential for improving vaccination rates.