SB 808
Department of Legislative Services
Maryland General Assembly
2021 Session
FISCAL AND POLICY NOTE
First Reader
Senate Bill 808 (Senator West)
Education, Health, and Environmental Affairs
Health Occupations – Licensed Dentists – Administration of Vaccines
This bill expands the practice of dentistry to include administration of a vaccine, as
specified. Before a licensed dentist may administer a vaccine, the dentist must complete a
specified board-approved course. To remain eligible to administer a vaccine, a licensed
dentist must complete specified continuing education. The State Board of Dental
Examiners may adopt regulations governing the administration of vaccines by licensed
dentists.
Fiscal Summary
State Effect: The board can adopt regulations using existing budgeted resources.
Revenues are not affected.
Local Effect: The bill does not directly affect local governmental finances or operations.
Small Business Effect: Meaningful.
Analysis
Bill Summary: A licensed dentist may administer an influenza vaccine to a patient who
is at least nine years old in accordance with regulations adopted by the board in consultation
with the Maryland Department of Health (MDH).
For individuals 11 to 17 years old, a licensed dentist may administer a vaccination listed in
the U.S. Centers for Disease Control and Prevention’s (CDC) recommended immunization
schedule if the individual has a prescription from an authorized provider.
For adults, a licensed dentist may administer a vaccination listed in CDC’s recommended
immunization schedule or Health Information for International Travel if the vaccination is
administered under a written protocol that (1) is vaccine specific and (2) meets criteria
established in regulation by MDH, in consultation with the boards of dental examiners,
physicians, and nursing. A prescription is not required to administer these vaccinations to
an individual age 18 or older.
A licensed dentist must report all vaccines administered to the ImmuNet Program and
document at least one effort to inform the individual’s authorized prescriber or primary
care provider that a vaccination (other than an influenza vaccination) has been
administered.
Before administering a vaccine, a dentist must obtain a signed medical history and consent
form. Immediately following administration of a vaccine (except where a life-threatening
emergency is present), a licensed dentist must enter the vaccine, dosage amount, and date
in the patient’s chart, and provide the patient with an immunization card and a separate
document with specified information.
If the President of the United States or the Governor declares a health-related emergency
related to an illness for which CDC has an approved vaccine, a licensed dentist may
administer any vaccine approved by CDC to prevent the illness. During the duration of the
emergency, specified educational and continuing education requirements related to vaccine
administration are suspended.
Current Law: Under the Health Occupations Article, an individual must obtain a license
from the State Board of Dental Examiners in order to practice dentistry, with specified
exceptions. “Practice dentistry” means to (1) perform or attempt to perform any intraoral
dental service or intraoral dental operation; (2) diagnose, treat, or attempt to diagnose or
treat any disease, injury, malocclusion, or malposition of a tooth, gum, or jaw, or structures
associated with a tooth, gum, or jaw if the service, operation, or procedure is included in
the curricula of an accredited dental school or in an approved dental residency program of
an accredited hospital or teaching institution; (3) perform or offer to perform dental
laboratory work; (4) place or adjust a dental appliance in a human mouth; or (5) administer
anesthesia for the purposes of dentistry and not as a medical specialty.
Per Chapters 559 and 560 of 2011, licensed pharmacists may administer an influenza
vaccination to an individual who is at least nine years old, provided the vaccination is
administered in accordance with regulations adopted by the State Board of Pharmacy in
consultation with MDH. Chapters 255 and 256 of 2013 expanded the authority of
pharmacists to administer vaccinations. For individuals 11 to 17 years old, a pharmacist
may administer a vaccination listed in the CDC recommended immunization schedule if
the individual has a prescription from an authorized prescriber. For adults, a pharmacist
SB 808/ Page 2
may administer a vaccination listed in CDC’s recommended immunization schedule or
Health Information for International Travel if the vaccination is administered under a
written protocol that (1) is vaccine specific and (2) meets criteria established in regulation
by MDH, in consultation with the boards of pharmacy, physicians, and nursing. A
prescription is not required to administer these vaccinations to an individual age 18 or
older. Generally, a pharmacist must document at least one effort to inform the individual’s
authorized prescriber or primary care provider that a vaccination (other than an influenza
vaccination) has been administered.
Under MDH Order 2020-12-08-01, any health care practitioner licensed, certified, or
registered under the Health Occupations Article whose scope of practice does not include
administration of vaccines may administer COVID-19 vaccines at vaccination sites if the
health care practitioner has successfully completed training on the administration of the
vaccines and qualified supervisory personnel at the vaccination site determine the health
care practitioner can administer the vaccines under supervision.
Chapter 412 of 2001 established ImmuNet, Maryland’s immunization registry. ImmuNet
is a computerized information and reminder system used to improve the timely and
appropriate delivery of immunizations; provide a coordinated network for reminder notices
when immunizations are due; provide and collect information to be shared by authorized
users; and provide a quality indicator for insurers, health care providers, and public health
purposes. ImmuNet is a web-based database that is free to all Maryland vaccination
providers and is an “opt-out” system; therefore, all immunization information can be
entered unless a parent completes a data-sharing “refusal to permit” form to make his or
her child’s record inaccessible. Chapter 502 of 2019 requires health care providers (or their
agents) to report to ImmuNet all vaccines administered. The requirement does not apply to
a health care provider who administers a vaccine in a nursing facility, assisted living
program, continuing care retirement community, or medical day care program.
Small Business Effect: Small business dental practices benefit from additional
reimbursement for administration of vaccinations. Conversely, other health care providers
that currently administer vaccinations may administer fewer vaccinations under the bill.
Additional Comments: In December 2020, the U.S. Food and Drug Administration
(FDA) approved two COVID-19 vaccines for emergency use. On February 27, 2021, FDA
issued emergency use authorization for a third vaccine. Maryland began distribution of the
vaccines in January 2021.
SB 808/ Page 3
 Additional Information
Prior Introductions: None.
Designated Cross File: None.
Information Source(s): Department of Legislative Services
Fiscal Note History: First Reader - March 1, 2021
rh/ljm
Analysis by: Jennifer B. Chasse Direct Inquiries to:
(410) 946-5510
(301) 970-5510
SB 808/ Page 4


Statutes affected:
Text - First - Health Occupations – Licensed Dentists – Administration of Vaccines: 4-101 Health Occupations, 4-205 Health Occupations, 4-206.5 Health Occupations