By Howard Fischer
Capitol Media Services
PHOENIX -- Unwilling to wait for federal actions, the Arizona Department of Health Services has issued a special order allowing pharmacists to administer the latest round of influenza vaccinations.
As of Tuesday, the the federal Advisory Committee on Immunization Practices has not met this year. yet to meet this year. That's the group that advises the Centers for Disease Control and Prevention which sets immunization schedules.
More to the point, pharmacists need ACIP approval to administer the latest round of flu shots if people do not have a prescription from their own doctor.
So what the health department has done is have Dr. Richard Carmona, the agency's own health director, issue what they call a "standing order'' that allows pharmacists to administer the shot to anyone 3 or older.
It doesn't mean a pharmacist has to provide the vaccine. And it doesn't guarantee insurance coverage or limit costs.
But Dr, Joel Terriquez, medical director for the Division of Public Health Preparedness, said it means that Arizonans who don't have a prescription won't have to wait for federal actions to get protected.
And it's not just about getting vaccinated against the flu. The health department also has issued a similar standing order for those who want the latest COVID-19 vaccine.
"The one fear that comes to mind is people from the community not having the ability to access these vaccines,'' he said in a media briefing on Tuesday. "What we want to do here is facilitate access to those vaccines to people that really want it, that those that like to prevent this type of respiratory infection as we are getting into respiratory season.''
The reason ACIP hasn't met is complicated.
It started with Robert Kennedy Jr., the head of the Department of Health and Human Services, who has repeatedly raised questions about the safety and efficacy of routine immunizations. Earlier this year, he replaced the panel's independent experts.
But a federal judge blocked the move, leaving the ACIP without a quorum -- and without the ability to approve the latest version of flu and COVID vaccines which is needed for pharmacists to administer the shots without a doctor's order.
Terriquez acknowledged that there can be changes in what vaccines and formulas are recommended. But he said her agency is well prepared -- even without ACIP -- to provide guidance to pharmacists to be able to administer them.
"We just don't have a crystal ball to try and figure out what changes could come our way,'' Terriquez said. But he said that's why his agency relies on various health groups, ranging from pediatrics and internal medicine to obstetrics and gynecology.
"All of those have their own recommendations based on literature, based on medical data,'' Terriquez said.
Much of the need for the standing orders traces back to Kennedy.
Late last year, after being named to head HHS, he ordered CDC to halt its publicity campaign encouraging people to get the annual flu vaccine.
In January, he told CBS he supported a recommendation that children not receive the annual flu shots unless they are at high risk for serious illness. But that also left the door open for parents to get an order from a doctor, something he acknowledged could create a hurdle -- and could result in fewer people getting the vaccine.
"Well, that may be, and maybe that's a better thing,'' Kennedy responded.
In a separate interview earlier this year, Kennedy said he stopped getting the annual flu shots in 2005 because of concerns about side effects. And he told USA Today he believes that's why his voice sounds strained and broken, though he admitted he has no evidence.
"Do I know whether that was caused by my annual flu shot? I have no idea,'' he said in his interview. "It's a possibility. It's a potential culprit that I cannot rule out.''
This isn't the first time the health department has issued a standing order.
The agency issued a similar order nearly a year ago after the federal Food and Drug Administration scrapped then-existing guidelines which allowed virtually anyone to get the COVID-19 vaccine without a prescription. Instead, they replaced it with guidance that allows only those 65 and older and those with certain preexisting health conditions to get inoculated absent a doctor's orders.
That, in turn resulted in Banner Health, the state's largest hospital network, deciding it would stop administering the latest COVID vaccine. And it even said its doctors would no longer write prescriptions.
The new order turned that around.
Carmona, a former deputy with the Pima County Sheriff's Department, served as U.S. surgeon general under the George W. Bush administration.
He also dabbled in Arizona politics and was the Democratic nominee for U.S. Senate in 2012 before losing by 3 percentage points to Republican Jeff Flake.
In 2021, then-Gov. Doug Ducey tapped Carmona to be his new senior health adviser on COVID matters despite differences the doctor had with the governor. For example, Carmona disagreed with Ducey's belief that schools and universities should be prohibited from requiring students and staff to wear masks.
But he has kept his Democratic leanings and endorsed Kamala Harris in her unsuccessful bid for president in 2024.
"Vaccines are one of the most important tools we have to protect our community,'' Carmona said in a prepared statement.
"The influenza and COVID-19 vaccines have been proven safe and effective and preventing severe illness, hospitalization, and death,'' he said. "Vaccines help us limit the spread of disease, reduce pressure on our healthcare system, and reduce costs.''
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