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Waiver Allows Some Retired Physicians and Nurses and Other Health Care Professionals to Administer the COVID-19 Vaccine 

ISSUED 02/05/2021 -- REVISED 03/22/2021

On January 28, 2021, the U.S. Acting Secretary of Health and Human Services issued a fifth amendment to Section V of the Declaration under the Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against COVID-19 (PREP Act).

The fifth amendment added additional categories of qualified persons authorized to administer COVID-19 vaccines in all jurisdictions where the PREP Act applies. Specifically, it authorizes physicians, advanced practice registered nurses, registered nurses and practical nurses:

  • who have held active licenses to prescribe, dispense or administer vaccines under any law of any state within the last five years, and
  • whose licenses are currently inactive, expired or lapsed, and
  • whose licenses, at the time of the lapse or expiration, were
    • active in good standing, and
    • >not revoked, suspended, under investigation or on the List of Excluded Individuals/Entities,

to administer COVID-19 vaccines without having to renew or reactivate their lapsed/inactive/expired licenses.

On March 12, 2021, a seventh amendment to Section V of the Declaration was issued, adding several more professionals, including: pharmacists, pharmacy interns, midwives, respiratory therapists, dentists, physician assistants, podiatrists, optometrists and veterinarians. See Pennsylvania Expands List of Health Care Professionals That May Administer COVID-19 Vaccines (March 22, 2021) for waivers related to these professions as they relate to actively-licensed practitioners and students in healthcare profession training programs.

Before administering COVID-19 vaccines, the amendments require the former licensee to complete the Centers for Disease Control's (CDC) COVID-19 Vaccine Training Modules and be observed by a practicing healthcare professional who has experience in administering intramuscular injections. The "observer" is responsible for documenting that the retired licensee is experienced in vaccination and is competent in the administration of the COVID-19 vaccine.

The PREP Act Declaration preempts any Commonwealth law or licensing board regulation prohibiting a retired licensee who meets the requirements of Section V from administering COVID-19 vaccines without a license.

For the sake of clarity, the Department of State requested, and the Governor approved, a temporary suspension of the renewal and reactivation provisions set forth in 63 P.S. §§ 213, 271.3, 422.10, 422.25, and 664 and 49 Pa. Code §§ 16.15, 21.131, 21.156,  25.271, to enable physicians and nurses whose Pennsylvania licenses lapsed, expired or were inactive within the last five years to administer COVID-19 vaccines without reactivating or renewing their licenses, provided they meet the specific qualification requirements of Section V and document completion of the CDC's COVID-19 Vaccine Training Modules and the required observation set forth above.

Similar temporary suspensions have been approved for: certified nurse midwives (63 P.S. § 422.35; 49 Pa. Code § 18.3); respiratory therapists and physician assistants under the State Board of Medicine (63 P.S. §§ 422.13a, 422.36a, 422.36; 49 Pa. Code §§ 18.181, 18.145, 18.309) and State Board of Osteopathic Medicine (63 P.S. §§ 271.10, 271.10a, 271.10b; 49 Pa. Code §§ 25.163, 25.504, 25.509); dentists (63 P.S. § 129; 49 Pa. Code §§ 33.105-33.106); podiatrists (63 P.S. §§ 42.9, 42.12-42.13, 42.19; 49 Pa. Code §§ 29.14), optometrists (63 P.S. §§ 244.5, 244.8); and veterinarians (63 P.S. § 485.19; 49 Pa. Code § 31.13).

In addition, veterinarians, respiratory therapists and optometrists whose Pennsylvania licenses have lapsed, expired or were inactive within the last five years must also satisfy training requirements beyond what is already imposed under the PREP Act Declaration and amendments. Specifically, they must meet the same PREP Act requirements that are imposed on certain pharmacists and pharmacy interns as described inSection V ofthe Declaration; namely, they must take and complete a 20-hour ACPE-approved vaccination training program that includes hands-on injection technique and the recognition and treatment of emergency reactions to vaccines.

These suspensions apply solely to COVID-19 vaccine administration and shall last for the duration of the PREP Act Declaration and any amendments (including the fifth and seventh amendments to Section V), or for the duration of the Governor's Disaster Emergency Declaration, whichever is longer, plus an additional 90 days thereafter, unless terminated sooner.