Immunization Authority and Protocol for a Minor
A 16-year-old presents to your pharmacy without a parent or guardian and requests a flu shot. The pharmacy is enrolled in the Texas Vaccines for Children (TVFC) program. The pharmacist on duty is certified to immunize. The patient says he is emancipated and provides a court document showing emancipation. He also says he is allergic to eggs but has never had a severe reaction. The pharmacy's protocol allows immunizations for patients 7 years and older. The pharmacist is unsure whether to vaccinate. The patient is insistent and says he needs the vaccine for school. What are the legal and clinical considerations?
1. Under Texas law, can a pharmacist immunize this patient without parental consent?
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Under Texas Occupations Code §55.003 and 22 TAC §295.1, a pharmacist may administer immunizations to a person 7 years of age or older. However, for minors, the pharmacist must obtain parental consent unless the minor is emancipated. An emancipated minor may consent to their own medical care. The pharmacist should verify the emancipation document. The pharmacist must also follow the protocol, which may require parental consent for minors. The pharmacist should document the emancipation status and the consent.
2. What should the pharmacist do regarding the egg allergy?
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The pharmacist should assess the egg allergy. According to CDC guidelines, persons with a history of egg allergy who have only experienced hives after exposure may receive the vaccine. If the reaction was more severe, the pharmacist should refer to an allergist. The pharmacist should follow the protocol for managing adverse reactions, including having epinephrine available. The pharmacist should document the allergy and the assessment. The pharmacist should also check the TVFC program requirements for egg allergy.