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A pharmacist who is certified by the State Education Department (SED) to administer immunizations is authorized to administer immunizing agents to prevent seasonal influenza to patients 2 years of age or older, and to administer immunizing agents to prevent pneumococcal disease, meningococcal disease, acute herpes zoster (shingles), tetanus, diphtheria or pertussis disease to patients 18 years of age or older. Administration of immunizations may be pursuant to either a patient specific order or a non-patient specific order.

Pharmacist Immunization Certification Application Requirements

Pharmacists seeking to administer immunizing agents must obtain a separate certification from SED. To become certified, a pharmacist must:

  • be currently licensed and registered in New York State;
  • submit a completed Pharmacist Immunization Certification Form with the application fee to SED;
  • provide evidence that he/she has completed an approved immunization course within the past three years; and
  • provide evidence he/she is currently certified in Cardio Pulmonary Resuscitation (CPR) or Basic Life Support (BLS). “On-line” or “virtual” courses will not be accepted.

Do not submit original certificates. Please submit copies only.

Note: If your approved immunization course was completed more than 3 years ago, and you have been actively immunizing in another jurisdiction, you must submit a signed statement to SED that includes the following information: a statement that you have been actively administering immunizations; the name of state where you have been actively immunizing; and the time period during which you have been actively immunizing in that state.

Application

The form for applying for this certification is available here.

  • Do not submit original immunization certificates. Please submit copies only.
  • If submitting a CPR or BLS card, please remember to sign the back of your card.

Limited (Intern) Permit Immunization Certification Application Requirements

A pharmacy student seeking BOTH a limited (intern) permit AND the authority to administer immunizing agents must ensure that all sections of the limited (intern) permit application are completed:

  • Complete Section I of the Pharmacist Form 5 - Application for a Limited (Intern) ;
  • Submit the form to the dean or other appropriate official of his or her registered pharmacy program to complete Section II and Section III. Include proof of Certification of Administration of Immunization Training including evidence of being currently certified in Cardio Pulmonary Resuscitation (CPR) or Basic Life Support (BLS). Do not submit original certificates. Please submit copies only;
  • Submit the completed form and documentation to SED.

NOTE: Immunization Certification will be added to your Limited Permit and will not automatically transfer over to your pharmacy license. Thus, you will be required to submit a Pharmacist Immunization Certification Form, fee, and, all required supporting documentation in order to obtain immunization certification as a licensed pharmacist.

Certification of Immunization Administration Training from a Pharmacy Program Registered by the State Education Department as Licensure Qualifying

(Form PH20-I) may be used:

  • By current pharmacy intern limited permit holders seeking immunization certification. In such instances, the dean or other appropriate official of the registered pharmacy program is responsible for completing this form.
  • By registered pharmacy programs seeking to submit certification of immunization administration training for multiple applicants simultaneously. In such instances, the dean or other appropriate official of the registered pharmacy program may use this form to attest to the completion of immunization administration training for multiple applicants in lieu of individually submitting Section II of Form 5 for each of them.

Additional Information