Fast forward to pharmacy technicians being authorized to administer immunizations. In 2017, Idaho was the first state to approve technician immunizations. Other states quickly followed their lead. As pharmacists and also pharmacy technicians, we know that technician roles are expanding and technician-administered immunizations are here to stay. However, most boards of pharmacy do not allow technicians to administer vaccines on their own. That raises the question:
Who is liable for a technician-administered immunization?
This is a new regulatory environment that will likely change, but let’s take a look at what we already know.
Technician vs. pharmacist liability
Although technicians are allowed to administer vaccines in most states, my home state of Florida is one of them. However, they must be supervised by a pharmacist. This gives you, as a pharmacist the responsibility and right to ensure that technicians are properly and safely vaccinating at your facility.
However, financial liability for administering vaccines to a healthcare provider is limited by the National Viral Injury Compensation Program (VICP). The program, which was established in 1986 and covers vaccine-related injuries from 1988 onwards, is a “no fault alternative” to traditional tort systems.
This depends on the vaccine and may include liability in the event of vaccine reactions or shoulder injuries. It can also cover reactivation of the disease for immunodeficient patients who have received live vaccines. The VICP and liability are important to remember:
Even if VICP denies a claim, the patient can still file a civil suit, although this is rare.
Not all vaccines are covered. This list does not include vaccines such as Japanese Encephalitis or Yellow Fever.
The COVID-19 vaccination is not covered by the VICP. However, it is covered by the Countermeasures Injuries Compensation Program (CICP).
The VICP doesn’t protect you against disciplinary action from the Board of Pharmacy. California, for example, explicitly states in a letter to doctors that any incorrect administration or distribution COVID-19 vaccine may result in disciplinary action.
How to protect yourself against liability
Although it is not clear who will ultimately be held responsible for incorrectly administered vaccines, there are steps you can take to increase vaccine safety and decrease liability in your pharmacy.
Before allowing technicians to administer vaccines independently, it is a good idea to watch each technician do it. It is also a smart idea to make sure they are fully conversant with other aspects of vaccine administration. This includes vaccine formulations (e.g., preventing shoulders injuries), proper storage and handling, and when to refer patients to the pharmacist (e.g., if a patient has an adverse response to a vaccine).
Establishing a program of initial orientation for technicians after they have completed their vaccine training course will help ensure consistency and provide documentation that they were properly trained and supervised. A vaccine orientation program, just like sterile compounding, where all employees must be trained, orientated, competent tested, and media-fill tested before they can work independently, regardless if they have any prior experience, can help everyone feel confident about the ability of the vaccinators.
It’s a good idea if you have any specific concerns to raise with your pharmacy manager, regional manager or both. They can help you weigh in, address them and rescind duties as necessary. It is better to send an email than to tell them in person. This will ensure that there is a record of your concerns being raised with management. If there are any concerns about the technician administering vaccines it is up to the pharmacist to take over and give the vaccine.
The bottom line
With technician-administered vaccines quickly becoming a standard of practice in community pharmacies across the country, now is a good time to assess your procedures to ensure patient safety and also to minimize liability. Your facility will be successful if it has a well-designed competency and orientation program. It also needs to communicate effectively with the technicians who administer vaccines.