Monitoring the Session

SB 254

Bill Lets Pharmacy Techs Vaccinate Kids As Young As Three

Died in committee

Verdict: Smells

SmellsInitial review
Sen. Pete FloresRSenate 24
Why it's charged
Caption mismatch

THE TEXT

…“an immunization or vaccination [ medication ] may [ not ] be delegated”…

Bill text, introduced version (I)

The caption speaks only of administration 'by a pharmacist,' but this clause flips a ban and lets pharmacists delegate vaccine administration to certified pharmacy technicians, a change the caption never mentions.

Caption mismatch

Initial review · graded Oct 20, 2026 · Headline, summary and grade are analysis of the bill text, not a finding about any person · How we grade

Caption

relating to the administration of a medication and the ordering and administration of an immunization or vaccination by a pharmacist.

Caption from analyzed text · version I.

Summary

No doctor’s protocol required. Notice to the doctor stretches from 24 hours to 14 days!

The bill lets Texas pharmacists order and give vaccines to anyone age three or older, as long as the shot is FDA-approved or on the federal routine schedule and follows federal advisory committee guidance, and it drops the old requirement of a physician's written protocol. It touches pharmacists, certified pharmacy technicians, parents, and doctors, because it removes the rule against handing vaccine administration to pharmacy technicians and stretches the pharmacist's notice to a prescribing doctor from 24 hours to 14 days. On the ground, a child as young as three could get any covered vaccine at a pharmacy counter, possibly from a technician, without first seeing a doctor.

Labels

Labels: ZOMBIE BILL. Died 2 times: 88R SB 749 (Died in committee) and this bill (Died in committee). Checked against 88R only.BACK FROM THE DEAD. Same text as a bill filed before that died: 88R SB 749 (Died in committee). Filed in 2 sessions, counting this one. Checked against 88R only.TRY NO. 2. Filed in 2 sessions: 88R and 89R. Checked against 88R only.NEVER GOT A HEARING. Filed Nov 12, 2024 and referred to the Senate Health & Human Services committee. No public hearing. The bill died.

Receipt

The receipt

89R-SB254 · 2024-11-12

SOLD BY

ITEM

relating to the administration of a medication and the ordering and administration of an immunization or vaccination by a pharmacist.

WHAT IT DOES

No doctor’s protocol required. Notice to the doctor stretches from 24 hours to 14 days!

The bill lets Texas pharmacists order and give vaccines to anyone age three or older, as long as the shot is FDA-approved or on the federal routine schedule and follows federal advisory committee guidance, and it drops the old requirement of a physician's written protocol. It touches pharmacists, certified pharmacy technicians, parents, and doctors, because it removes the rule against handing vaccine administration to pharmacy technicians and stretches the pharmacist's notice to a prescribing doctor from 24 hours to 14 days. On the ground, a child as young as three could get any covered vaccine at a pharmacy counter, possibly from a technician, without first seeing a doctor.

CHARGES

[x] CAPTION MISMATCHanalysis confidence 45%

THE TEXT

…“an immunization or vaccination [ medication ] may [ not ] be delegated”…

Bill text, introduced version (I)

The caption speaks only of administration 'by a pharmacist,' but this clause flips a ban and lets pharmacists delegate vaccine administration to certified pharmacy technicians, a change the caption never mentions.

TOTAL

No fiscal note in the loaded record.

HISTORY

  1. Received by the Secretary of the Senate
  2. Filed
  3. Read first time
  4. Referred to Health & Human Services
FILED UNDER

BIG PHARMA'S BILL

THE TEXT

…“and Drug Administration or listed in the routine immunization”…

Bill text, introduced version (I)

The bill widens the retail pharmacy channel for vaccines down to age three, tied to federal FDA approval and the federal routine schedule, without a doctor's protocol.

Smells

THANK YOU FOR CHECKING THE RECEIPT

CAMPAIGN PAID FOR BY

CAMPAIGN PAID FOR BY

Donors

Texans for Lawsuit Reform PAC$55KMorris Jaffe$25,000Justin Jaffe$25,000

Not tied to this bill.

Sources

The author's campaign account only. Own money and internal transfers are separate on the member page.

Derived itemized flow · Jul 12, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Texans for Lawsuit Reform PAC$55,000.00

Texans for Lawsuit Reform PAC

$55,000.00

Cash
$55,000.00
Paid by others
$0.00
Total
$55,000.00

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Dec 13, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 100985131, 101008112, 101072110.

Morris Jaffe$25,000.00
Justin Jaffe$25,000.00
Money

Missing data does not establish zero giving. Display amounts are rounded.

×

Texans for Lawsuit Reform PAC

$55,000.00

Cash
$55,000.00
Paid by others
$0.00
Total
$55,000.00

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Dec 13, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 100985131, 101008112, 101072110.

Votes

No floor vote loaded for this bill.

Fiscal

No fiscal note in the loaded record.

How this was graded

Analysis of text version I by claude-opus-5-5, Oct 20, 2026, against the published rubric.

FILED BEFORE

Filed 2 times: 88R and 89R. Checked against 88R only.

88R SB 749

by Sen. Flores, same lead author · Died in committee · same text

Introduced text

Last action, Mar 1, 2023: Referred to Health & Human Services

Relating to the administration of a medication and the ordering and administration of an immunization or vaccination by a pharmacist.

Caption, 88R bill history

Sources

Texas Senate · Filed Nov 12, 2024

02/03/2025 S Referred to Health & Human Services

Texas Legislature Online · Introduced

Data snapshot Oct 26, 2026 at 4:19 AM CDT. Grades, charges, quotes and corrections follow the published record.

Senate committee · Health & Human Services · Final status: Died in committee

Companion

HB 3540 by Harless (identical)

Subjects

Occupational Regulation--Health Occupations

IMMUNIZATIONS

PHARMACIES & PHARMACISTS

Text

The text as introduced · 936 words

89R3938 DNC-F

By: Flores
S.B. No. 254

A BILL TO BE ENTITLED

AN ACT

relating to the administration of a medication and the ordering and

administration of an immunization or vaccination by a pharmacist.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 551.003(33), Occupations Code, is

amended to read as follows:

(33) "Practice of pharmacy" means:

(A) providing an act or service necessary to

provide pharmaceutical care;

(B) interpreting or evaluating a prescription

drug order or medication order;

(C) participating in drug or device selection as

authorized by law, and participating in drug administration, drug

regimen review, or drug or drug-related research;

(D) providing patient counseling;

(E) being responsible for:

(i) dispensing a prescription drug order or

distributing a medication order;

(ii) compounding or labeling a drug or

device, other than labeling by a manufacturer, repackager, or

distributor of a nonprescription drug or commercially packaged

prescription drug or device;

(iii) properly and safely storing a drug or

device; or

(iv) maintaining proper records for a drug

or device;

(F) performing for a patient a specific act of

drug therapy management delegated to a pharmacist by a written

protocol from a physician licensed in this state in compliance with

Subtitle B; [ or ]

(G) subject to Section 554.052(c-1), ordering or

administering an immunization or vaccination to a patient who is at

least three years of age; or

(H) if the patient is younger than three years of

age and is referred to a pharmacist by a physician, administering an

immunization or vaccination to a patient under a physician's

written protocol.

SECTION 2. The heading to Section 554.004, Occupations

Code, is amended to read as follows:

Sec. 554.004. ADMINISTRATION OF MEDICATION ; ORDERING AND

ADMINISTRATION OF IMMUNIZATION OR VACCINATION .

SECTION 3. Section 554.004(a), Occupations Code, is amended

to read as follows:

(a) The board shall specify conditions under which a

pharmacist may administer medication and order or administer [ ,

including ] an immunization or [ and ] vaccination. The conditions

for ordering or administering an immunization or vaccination must

ensure that:

(1) [ a licensed health care provider authorized to

administer the medication is not reasonably available to administer

the medication;

[ (2) failure to administer the medication, other than

an immunization or vaccination, might result in a significant delay

or interruption of a critical phase of drug therapy;

[ (3) ] the pharmacist possesses the necessary skill,

education, and certification as specified by the board to order or

administer the immunization or vaccination [ medication ];

(2) [ (4) ] within a reasonable time after

administering an immunization or vaccination that is prescribed by

a licensed health care provider [ medication ], the pharmacist

notifies the licensed health care provider responsible for the

patient's care that the immunization or vaccination [ medication ]

was administered;

[ (5) the pharmacist may not administer medication to a

patient at the patient's residence, except at a licensed nursing

home or hospital;

[ (6) the pharmacist administers an immunization or

vaccination under a physician's written protocol and meets the

standards established by the board; ] and

(3) [ (7) ] the authority of a pharmacist to administer

an immunization or vaccination [ medication ] may [ not ] be delegated

to a certified pharmacy technician .

SECTION 4. Sections 554.052(a), (b), (c), and (c-1),

Occupations Code, are amended to read as follows:

(a) The board by rule shall require a pharmacist to notify a

physician who prescribes an immunization or vaccination not later

than the 14th day [ within 24 hours ] after the date the pharmacist

administers the immunization or vaccination.

(b) The board shall establish minimum education and

continuing education standards for a pharmacist who orders or

administers an immunization or vaccination. The standards must

include federal Centers for Disease Control and Prevention

training, basic life support training, and hands-on training in

techniques for administering immunizations and vaccinations.

(c) Supervision by a physician is adequate if the delegating

physician:

(1) is responsible for formulating or approving an

order or protocol, including the physician's order, standing

medical order, or standing delegation order, and periodically

reviews the order or protocol and the services provided to a patient

under the order or protocol;

(2) [ except as provided by Subsection (c-1), has

established a physician-patient relationship with each patient

under 14 years of age and referred the patient to the pharmacist;

[ (3) ] is geographically located to be easily

accessible to the pharmacy where an immunization or vaccination is

administered;

(3) [ (4) ] receives, as appropriate, a periodic status

report on the patient, including any problem or complication

encountered; and

(4) [ (5) ] is available through direct

telecommunication for consultation, assistance, and direction.

(c-1) A pharmacist may order or administer an immunization

or [ influenza ] vaccination to a patient who is at least three [ over

seven ] years of age if the immunization or vaccination is:

(1) authorized or approved by the United States Food

and Drug Administration or listed in the routine immunization

schedule recommended by the federal Advisory Committee on

Immunization Practices published by the federal Centers for Disease

Control and Prevention; and

(2) ordered or administered in accordance with the

federal Advisory Committee on Immunization Practices

vaccine-specific recommendations [ without an established

physician-patient relationship ].

SECTION 5. This Act takes effect immediately if it receives

a vote of two-thirds of all the members elected to each house, as

provided by Section 39, Article III, Texas Constitution. If this

Act does not receive the vote necessary for immediate effect, this

Act takes effect September 1, 2025.