Sample Immunization Protocol
Pharmacists may enter into an immunization protocol with a Kansas-licensed physician to administer vaccines or authorize pharmacist interns to administer vaccines. The 2021 updates to the Kansas Pharmacy Practice Act require any immunization protocol be signed by the authorizing physician and the administering pharmacist. Copies of the signed protocol should be retained for five years at the location(s) where immunizations are provided, but do not need to be sent to the Board office.
A sample immunization protocol is provided below. This is only an example and is not intended to be a required template. Each physician and pharmacist should form their own agreement for a written protocol which complies with Kansas law.