Senator Holly Thompson Rehder's Legislative Column for Feb. 24, 2023

Friday, February 24, 2023

Reducing Regulations for Rural Health Care

Did you receive a flu shot this year? Where did you get it? If you’re like a lot of people, you stopped in at your local pharmacy to get it while you were running your other errands. The fact that you were able to get your routine flu shot at the local drug store is a relatively new thing. It wasn’t always this easy.

Prior to 2020, pharmacists generally could only administer vaccines under individual protocol agreements with a physician. When COVID hit and the state of emergency came into play, the Trump administration made it possible to get routine vaccines directly from local pharmacists. Suddenly, folks didn’t have to make an appointment with the doctor to get their vaccines. This made a difference across Missouri, especially in our rural communities. Seniors could now get immunized for shingles at the corner pharmacy while picking up their monthly medications.

Being able to get routine vaccinations from pharmacists turned an often troublesome task into just one more thing on our to-do list. Unfortunately, this new-found convenience is about to end. The Trump-era vaccine rules are set to expire. This year, I filed legislation to make these exemptions permanent in Missouri. Senate Bill 41 would allow pharmacists to continue to administer routine vaccinations without the need for individual protocol agreements with physicians. In the three years the exemption has been in effect, we have seen tremendous success. If this legislation becomes law, pharmacists will still have protocol agreements with the physicians, patient safety is still at the forefront, but it removes some onerous regulations that were in place before 2020. I’m happy to report SB 41 was passed out of the Senate this week and has moved to the House of Representatives.

I first tried passing this legislation last year but was not able to get it across the line. This year, I’ve worked closely with the state medical association and pharmacists to overcome lingering objections. The perfected version of the bill excludes typhoid, rabies, tuberculosis, smallpox and a few other conditions requiring closer supervision by a physician, but routine vaccines will continue to be available directly from pharmacists.

Getting this bill out of the Senate wasn’t easy. Anytime the topic of vaccines come up, there’s going to be push-back. There’s a lot of strongly held opinions about COVID vaccines on both sides of the topic, and some folks simply don’t trust vaccines in general. I am for individual freedom. As Americans, we should have the right to choose to be vaccinated or not. That’s your business. But if there’s one thing we learned through the pandemic, it’s that pharmacists are fully capable of giving shots. Allowing pharmacists to administer routine vaccinations increases access to basic health care services, without additional cost to the taxpayer. That’s especially important in rural areas, where health care clinics are few and far between and patients often have to travel, or wait, to receive services.

My legislation doesn’t require anyone to get a vaccine. It also doesn’t prevent us from continuing to seek care from our physician. Senate Bill 41 simply preserves a health care choice that many of us have found incredibly convenient. As a conservative, I’m all about freedom of choice and reducing bureaucratic regulations. This legislation accomplishes both goals, and I’m proud to move it farther along the legislative process.

Contact Me

I always appreciate hearing your comments, opinions and concerns. Please feel free to contact me in Jefferson City at (573) 751-2459. You may write me at Holly Thompson Rehder, Missouri Senate, State Capitol, Rm 433, Jefferson City, MO 65101, send an email to or visit