SF4089

Purpose

• Establish and standardize education, training, and display requirements to prevent shoulder injuries related to vaccine administration (SIRVA) and broaden who can administer vaccines, with a focus on improving safety and consistency for vaccine delivery.

Key Provisions

• SIRVA definition and prevention materials

  • Defines SIRVA (shoulder injury related to vaccine administration) as described in federal regulations.
  • Requires every health care setting that administers vaccines (clinics, pharmacies, etc.) to display a poster about proper vaccine administration techniques to prevent SIRVA. The poster must be visible to the public and all vaccine administrators.

• Training for vaccine administration

  • Beginning July 1, 2026, health care personnel who administer vaccines must complete comprehensive, competency-based training on vaccine administration.
  • Training must follow Centers for Disease Control and Prevention (CDC) guidance and cover topics such as vaccine preparation, needle selection, site and route of administration, and SIRVA as a potential serious complication.
  • After completing training, health care personnel must submit evidence of completion to the relevant health licensing board.

• Exceptions

  • The SIRVA training and poster requirements do not apply to veterinary clinics, veterinary hospitals, licensed veterinarians, or licensed veterinary technicians.

• Expanded vaccine administration by dentists

  • Qualified dentists may administer vaccines to patients age 16 and older, but only if they have immediate access to emergency equipment (like oxygen and epinephrine) and have completed a Board-approved vaccine administration education program (per Minnesota Board of Dentistry) that meets 145.676 subdivision 3 requirements.
  • The dentist training program must include topics such as disease and vaccination education, contraindications and precautions, intramuscular administration, risk/benefit communication, adverse event reporting, federal documentation, and vaccine storage/handling.
  • Dentists giving vaccines must follow guidelines from the federal Advisory Committee on Immunization Practices (ACIP) related to vaccines and immunizations.

• Expanded role and duties for pharmacists

  • Pharmacists may initiate, order, and administer influenza and COVID-19 vaccines to all eligible individuals age 3 and older, and all other FDA-approved vaccines to patients age 6 and older, per ACIP recommendations.
  • Pharmacists who administer vaccines must complete training that meets 145.676 subdivision 3 requirements.
  • Pharmacy technicians or pharmacy interns may administer vaccines under the direct supervision of a pharmacist, provided they complete ACPE-approved immunization training or an approved program, and other conditions (e.g., MIIC use to check immunization status, age-specific counseling, and reporting).
  • Pharmacists may delegate certain vaccine-related tasks to trained technicians or interns if specific supervision, reporting, and documentation requirements are met (including use of the Minnesota Immunization Information Connection, MIIC).
  • Additional supervision and safety conditions apply for technicians administering vaccines (in-person supervision, immediate pharmacist availability, CPR certification, CE requirements, and specific training program approvals).
  • Pharmacists may also:
  • Initiate, order, and administer other therapies under protocols or collaborative practice agreements with other licensed prescribers (doctors, dentists, optometrists, podiatrists, veterinarians, or nurse practitioners) for disease prevention, treatment, and follow-up.
  • Document any changes to therapy in the patient’s medical record or report to the treating practitioner.
  • Engage in a range of pharmacy practice activities, including drug storage, record-keeping, patient counseling, and other services necessary for safe and effective drug use.
  • Expanded categories include administering and managing various therapies (such as certain HIV-related therapies and other medications) under protocol or collaborative practice agreements, following applicable rules and documentation requirements.

• Coordination and reporting

  • When vaccines are administered under these expanded authorities, required documentation and reporting to appropriate records and practitioners are mandated.
  • Use of MIIC to assess immunization status is required for vaccine administration by pharmacists, with certain age-based exceptions (e.g., influenza vaccines for ages 9 and older may have an exception to MIIC use).

• Administrative and professional requirements

  • Vaccinators must complete and maintain required certifications (CPR, ACPE-approved immunization CE, etc.) and operate under approved programs or protocols.
  • Records management and documentation requirements apply to changes in drug therapy and vaccine administration.

• Appropriation for SIRVA poster

  • A one-time appropriation in FY 2027 from the general fund to the Minnesota Department of Health to create or approve a SIRVA prevention poster and make it available for display in all settings where vaccines are given.

Implementation Timeline and Funding

• July 1, 2026: Start date for the comprehensive vaccine administration training requirement for health care personnel.
• Fiscal Year 2027: One-time general fund appropriation to fund the SIRVA prevention poster program and its dissemination.

Significant Changes to Existing Law

• Adds a mandatory SIRVA prevention poster requirement in all vaccine- administering settings.
• Establishes a mandatory competency-based vaccine administration training requirement for health care personnel post-July 1, 2026.
• Expands vaccine administration authority to qualified dentists (16+ with proper training and emergency equipment) and broadens pharmacist authority to administer vaccines to a wider age group and under protocols with other health professionals.
• Introduces detailed supervision, reporting, and education requirements for pharmacy technicians/interns who administer vaccines.
• Codifies extensive protocol-based and collaborative-practice-based approaches for initiating, modifying, and discontinuing certain drug therapies in collaboration with multiple licensed professionals.
• Creates a dedicated funding mechanism for educational materials (SIRVA poster) to support dissemination and awareness.

Overall Impact

• Aims to reduce vaccine-related shoulder injuries through standardized training and visible safety materials.
• Improves access to vaccination by expanding qualified professionals who can administer vaccines (dentists and pharmacists) while emphasizing safety, training, and documentation.
• Enhances coordination among health professionals through protocols and reporting requirements to promote safe vaccine and drug therapy practices.

Relevant Terms - SIRVA (shoulder injury related to vaccine administration) - vaccine administration - CDC guidance - ACIP (Advisory Committee on Immunization Practices) - ACPE (Accreditation Council for Pharmacy Education) - MIIC (Minnesota Immunization Information Connection) - vaccine storage and handling - immunization reporting - pharmacist scope of practice - pharmacist-administered vaccines - vaccine administration training - competency-based training - influenza vaccine - COVID-19 vaccine / SARS-CoV-2 vaccine - dental vaccination - emergency equipment (e.g., oxygen, epinephrine) - CDC-defined vaccine administration site and route - vaccine-related protocols and collaborative practice agreements - well-child visit counseling - CPR certification - post-implementation funding for SIRVA poster - health care setting display requirements - federal regulations and guidelines ( CFR, 42 U.S.C. references)