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State Law and Standing Orders for Immunization Services.

Alexandra M Stewart1, Megan C Lindley2, Marisa A Cox1

  • 1Milken Institute, School of Public Health, The George Washington University, Washington, District of Columbia.

American Journal of Preventive Medicine
|December 15, 2015
PubMed
Summary
This summary is machine-generated.

State laws vary significantly regarding non-physician health professionals (NPHPs) administering vaccines. Expanding standing orders programs (SOPs) could improve vaccine access and public health immunization goals.

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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.