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Pharmacy Commission (commission) staff have received several questions related to the prescribing and administration of COVID-19 vaccines. The guidance below is aimed at informing pharmacies and pharmacists of three possible mechanisms by which a pharmacist may administer a COVID-19 vaccine and identifies some key differences between them. The commission does not endorse one mechanism over another but defers to pharmacists and pharmacies to determine the appropriate mechanism applicable to their practice setting.
Statewide Standing Order
On September 4, 2025, the Department of Health issued a statewide COVID-19 Vaccine Standing Order (Statewide Standing Order). The Statewide Standing Order was issued under the Secretary of Health’s authority in RCW 43.70.183 and authorizes health care providers, including pharmacists, to administer COVID-19 vaccines consistent with applicable law and the terms of the standing order.
Pharmacists who use the Statewide Standing Order to administer COVID-19 vaccines must follow the terms of the Statewide Standing Order, including identifying the State Health Officer, Dr. Kwan-Gett M.D., M.P.H., as the prescriber.
More information about the Statewide Standing Order can be found on DOH’s Statewide Standing Order webpage.
Collaborative Drug Therapy Agreements (CDTAs)
A CDTA is a set of written guidelines or protocols that establish the scope of prescriptive authority for a pharmacist. A pharmacist who has established a CDTA with a prescriber is authorized to prescribe or order drug or biological products in accordance with the terms of the CDTA.
Pharmacists and prescribers can establish a CDTA setting out the guidelines under which a pharmacist can prescribe or order the COVID-19 vaccine. This process is separate and apart from the Statewide Standing Order. In other words, a CDTA provides an alternative mechanism to the Statewide Standing Order for a pharmacist to administer the COVID-19 vaccine.
More information on CDTAs can be found on the Commission’s webpage.
Prescriptions Written by Other Practitioners
A third possible mechanism for a pharmacist to administer a COVID-19 vaccine is if a patient is prescribed the COVID-19 vaccine by a practitioner, and a copy of that prescription is presented or sent to the pharmacy. The Statewide Standing Order does not replace or amend the ability of a patient to obtain a prescription from their provider for the COVID-19 vaccine.
Summary
Whether administering a vaccine under the Statewide Standing Order, a CDTA, or a prescription, pharmacists must ensure that administration is consistent with the provision of safe and appropriate medication therapy (WAC 246-945-305(2)). In addition, pharmacies are subject to a legal duty to deliver lawfully prescribed drugs and devices (WAC 246-945-415(2)).
Please see the graphic below to summarize the information presented above:
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