BILL NUMBER: S321A

SPONSOR: ROBACH
 
TITLE OF BILL:  An act to amend the education law, in relation to
pharmacist immunizations

 
PURPOSE:

Authorizes pharmacists and certified nurse practitioners to provide
hepatitis A and hepatitis B immunizations.

 
SUMMARY OF PROVISIONS:

Section 1 of the bill amends subdivision 7 of section 6527 of the educa-
tion law, as amended by, chapter 46 of the laws of 2015 to add hepatitis
A and hepatitis B to the list of diseases for which a licensed physician
may prescribe and order a patient specific order or non-patient specific
regimen to a licensed pharmacist for administering immunizations.

Section 2 of the bill amends subdivision 22 of section 6802 of the
education law, as amended by chapter 46 of the laws of 2015 to add hepa-
              

titis A and hepatitis B to the list of diseases found in the definition
of "administer," for the purposes of section 6801 of the education law.

Section 3 of the bill amends subdivision 22 of section 6802 of the
education law, as added by chapter 563 of the laws of 2008 to add hepa-
titis A and hepatitis B to the list of diseases found in the definition
of "administer,"for the purposes of section 6801 of the education law.

Section 4 of the bill amends section 7 of section 6909 of the education
law, as amended by chapter 46 of the laws of 2015 to add hepatitis A and
hepatitis B to the list of diseases for which a certified nurse practi-
tioner may prescribe and order a patient specific order or non-patient
specific regimen to a licensed pharmacist for administering immuniza-
tions.

Section 5 of the bill is the effective date.

 
JUSTIFICATION:

According to the Centers for Disease Control and Prevention (CDC), hepa-
titis A is a highly contagious, serious liver disease that often mani-
fests as fever, fatigue, loss of appetite, nausea, vomiting, joint pain,
severe stomach pains and diarrhea, and/or jaundice, and can lead to
liver failure or death. The CDC describes hepatitis B as a liver
infection caused by the hepatitis B virus (HB) that is transmitted when
blood, semen, or another body fluid from a person infected with hepati-
tis B enters the body of someone who is not infected. This can happen
through sexual contact; sharing needles, syringes or other drug-injec-
tion equipment; or from mother to baby at birth. For some people, hepa-
titis B is an acute, or short-term, illness but for others, it can
become a long-term, chronic infection. Since 1996, hepatitis A vaccina-
tions have been recommended for adults in the United States, and the
number of cases reported annually has dropped from 31,000 to approxi-
mately 100 nationwide. Approximately 50 percent of adults with hepatitis
A are hospitalized. Chronic hepatitis B can lead to serious health
issues like cirrhosis or liver cancer. It is estimated that there are at
least 850,000 people living with chronic hepatitis B, but according to
the CDC, the number may be as high as 2.2 million.
The CDC recommends that people should get the hepatitis A vaccination if
they are traveling to countries where hepatitis A is common; if they are
a man who has sex with other men; if they use illegal drugs; if they
have chronic liver diseases such as hepatitis B or C; if they are being
treated with clotting-factor concentrates; if they work with hepatitis
A-infected animals or in a hepatitis A research laboratory; or if they
expect to have close personal contact with an international adoptee from
a country where hepatitis A is common. For hepatitis B, the CDC recom-
mends vaccination for all infants; people at risk for infection by sexu-
al exposure, including sexually active people who aren't in long term
monogamous relationships, people seeking treatment for an STD and men
who have sex with men; people whose sex partners have hepatitis; people
who share needles, syringes or other drug paraphernalia; people at risk
for infection by exposure to blood; international travelers to countries
where hepatitis B is common; people with hepatitis C infection; people
with chronic liver disease or HIV; and people in jail or prison.

In New York City, the estimated hepatitis A vaccination rate for chil-
dren ages 11-18 was 93 percent for one dose and 80% for the recommended
two doses in 2016. However, many adults have not been vaccinated and
remain susceptible.

New York is the only state that does not authorize pharmacists to admin-
ister hepatitis A or B vaccinations. Forty-six states plus Washington,
D.C. and Puerto Rico permit pharmacists to give any vaccination approved
by the CDC's Advisory Committee on immunization Practices (ACIP) -
including hepatitis A and B - and three other states (Florida, West
Virginia, and Wyoming) explicitly allow pharmacists to administer the
hepatitis A and B vaccines.

In September 2017, the New York City Health Department reported an
outbreak of hepatitis A among 40 men living in the City, primarily men
who had sex or sexual contact with other men, representing a 10-fold
increase over previous years. The Health Department has recommended that
men who have regular sexual contact with other men receive the vaccine
for the disease. In July 2017, the New York City Health Department
reported that from 2015 - 2016, there was a 9.4% increase in hepatitis B
infections. While these increased numbers may have resulted from
increased and better screenings, the numbers show the need to ensure
access to vaccinations that will prevent hepatitis B.

New York State already allows pharmacists and certified nurse practi-
tioners to administer vaccinations for influenza, pneumococcal, acute
herpes zoster, meningococcal, tetanus, diphtheria or pertussis disease.

Making the vaccinations for hepatitis A and B more widely available will
help quell the current outbreak of the diseases and prevent future
outbreaks.

 
HISTORY:

New bill.

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

None.

 
EFFECTIVE DATE:
This act shall take effect immediately; provided, however, that: (a) the
amendments to subdivision 7 of section 6527 of the education law made by
section three of this act shall not affect the expiration of such subdi-
vision and shall be deemed to expire therewith; (b) the amendments to
subdivision 22 of section 6802 of the education law made by section two
of this act shall be subject to the expiration and reversion of such
subdivision pursuant to section 5 of chapter 116 of the laws of 2012, as
amended, when upon such date the provisions of section three of this act
shall take effect; (c) the amendments to subdivision 22 of section 6802
of the education law made by section three of this act shall not affect
the expiration of such subdivision and shall be deemed to expire there-
with; and (d) the amendments to subdivision 7 of section 6909 of the
education law, made by section four of this act shall not affect the
expiration of such subdivision and shall be deemed to expire therewith.