V

accination is a key public health intervention and a pillar of primary health care and universal health coverage, with life course immunization ensuring continuous protection across all ages. Vaccination not only prevents disease, but also increases healthy life expectancy, reduces long term disability, and preserves functional ability. It contributes to herd immunity and helps to combat antimicrobial resistance.

Vaccination also reduces healthcare costs and lowers the burden of diseases, boosts economic productivity, and reduces absenteeism. Vaccination not only saves lives, it builds a healthier, more productive world for all.

Through their accessibility, expertise, infrastructure, and trusted relations with the community, pharmacies are uniquely placed to provide vaccination services and contribute to these strategic priorities and objectives all around the world.

Pharmacy based vaccination has had a significant impact on immunization coverage rates, particularly in countries where pharmacists are authorized to administer and prescribe vaccines.

 

 

 

 

 

Best practice countries with pharmacy based vaccination

 

In France, between January 2021 and January 2023, pharmacists administered over 26.3 million doses of COVID-19 vaccines, more than 52% of all doses in the country.

 

In the USA, by September 2023, pharmacists had administered 67.7% of all COVID-19 vaccine doses.

 

In Australia, the integration of pharmacy based COVID-19 vaccination services has bolstered overall vaccine uptake, with community pharmacies administering approximately 50% of ongoing COVID-19 vaccinations in certain regions. In 2000, community pharmacists administered approximately 22% of all influenza vaccines.

 

In the United Kingdom the vaccinations administered by pharmacies for people over 65 years of age, increased by 8.15 times between 2015 and 2022, resulting in a vaccination rate of 82.3% in the 2022 season.

 

In Ireland, 23% of those who were vaccinated at a pharmacy received vaccination for the first time, and of those, 83% were at risk patients.

 

 

 

 

 

 

Pharmacists can support life course immunisation efforts in several ways.

 

• Pharmacists are instrumental in advocating for vaccination and vaccination programmes through public campaigns and one on one interactions with patients.
• Pharmacists can prescribe vaccines based on agreed protocols.
• Pharmacists can also dispense vaccines based on agreed protocols.
• They can also be involved in vaccine safety surveillance monitoring for any post-vaccination adverse events, also called pharmacovigilance.
• Pharmacists also manage the vaccine supply chain, ensuring that vaccines are stored and handled correctly, including appropriate cold chain management.
• Beyond direct patient care, pharmacists contribute to vaccine research, development, production and regulatory activities from clinical studies to ensuring quality control. Pharmacists play a vital role at every stage of the vaccine life cycle.
• They record and maintain vaccination records, counsel patients on their vaccination status.
• Administering vaccines safely as part of their role, as is managing potential adverse reactions, including anaphylaxis.
• They also build vaccine confidence and address vaccine hesitancy.
• They promote equity in vaccination services by reaching hard to reach or high risk populations.

 

In countries where pharmacists aren’t allowed to vaccinate, patients are often required to obtain a prescription from their GP, have the vaccine dispensed at a pharmacy and then return to the GP or a nurse for administration. This process not only introduces unnecessary delays and complexity, but also increases the risk of patient complacency and error.

 

In contrast, in countries where pharmacy based vaccination is available and pharmacists can prescribe and administer vaccines to eligible individuals, the process becomes much easier and shorter, contributing to increased vaccine uptake and vaccination coverage.

 

 

 

 

 

According to FIP data, pharmacy based vaccination was present in just 19 countries and territories in 2016. By 2020, this number had increased to at least 34 countries and territories. The trend continued with at least 40 countries and territories implementing pharmacy based vaccination by 2022, and the figure rising to at least 56 in 2024.

 

Out of those 56 countries, in 44 of them, pharmacists are authorized to administer vaccines, while in other, the administration is done at the pharmacy by another healthcare professional like a nurse.

 

In addition, in an increasing number of countries, pharmacists are playing a pivotal role in public health by prescribing vital vaccines. In other words, people can be vaccinated at a pharmacy without the need for a medical prescription when clear eligibility criteria and protocols have been established. This also contributes to reducing the burden on general practice and primary care.

 

As of April 2024:

• pharmacists in 25 countries can prescribe influenza vaccines,
• 21 countries allows pharmacists to prescribe COVID-19 vaccines,
• 19 countries have enabled pharmacists prescribing for pneumococcal vaccinations and
• 4 countries for vaccines against the respiratory syncytial virus, or RSV.

 

However, for these four vaccine preventable diseases, the clinical eligibility and risk groups are largely the same, and pharmacists should be able to prescribe and administer all four vaccines.

 

 

 

 

 

 

Vaccination education for pharmacists – Upskilling for task shifting

Incorporating vaccination education into pharmacy undergraduate programs is key to preparing pharmacists for a growing role in vaccination services. This approach is expanding the number of pharmacists and pharmacies equipped to offer these services worldwide.

 

Since 2016, the number of countries offering vaccination training for pharmacists has grown from 12 to 64, a 433% increase. At the undergraduate level, training has risen from 6 to 19 countries, while post-registration and continuous professional development training has increased from 11 to 41.

 

 

 

 

 

 

 

Economic value of pharmacy based vaccination and remuneration for services

 

Vaccination delivers significant value not just in health outcomes but also in humanistic and economic terms, enhancing productivity for individuals and societies to ensure the sustainability of these pharmacy services, robust funding for vaccination strategies and sustainable remuneration models for all providers, including pharmacies, is essential. This approach will promote equitable access, incentivize service delivery and acknowledge the investments made by pharmacies and pharmacists.

 

A clear example of this is seen in Portugal, where vaccination coverage rates increased by 32% when adults over 65 could access flu vaccinations on the same terms as those in National Health Service primary care units, without needing a prescription or facing administration fees.

 

 

 

 

 

Access to data and vaccination records by pharmacists

 

Access to data and vaccination records is also key to successful pharmacy based vaccination. Governments should foster the full integration of community and hospital pharmacies in healthcare systems by creating the regulatory and operational conditions for Inter-professional collaboration, including read and write access to shared patient health records and vaccination records. Developing an electronic registry for immunisation, accessible by pharmacists, will enable them to monitor vaccine uptake and advise on specific vaccines, particularly to individuals from risk groups. It will also help monitor the impact of pharmacy based vaccination on immunisation rates.

 

Recent FIP data suggests that vaccination records are fully accessible in only ten countries (13.7%,) whereas partial access to these records is observed in 18 countries (24.7%).

 

 

 

 

 

 

Leveraging pharmacists increases vaccination coverage rates

 

Some key policy enablers can help support the establishment of pharmacy based vaccination.

These include:

 

• Collaborating with policymakers and healthcare professionals to develop or update legislation and regulations to provide a framework that supports pharmacy based vaccination.
• Enhancing pharmacy education curricula to include education and training on vaccination, while supporting trained pharmacists to stay up to date with the latest advancements in vaccination.
• Setting technical and professional guidelines and standard operating procedures to empower pharmacists to provide the best services
• Empowering pharmacists to become key stakeholders in national vaccination policies and technical advisory groups.
• Providing the appropriate infrastructure that enhances interprofessional collaboration to ensure the effectiveness of vaccination strategies across all providers, namely through access to vaccination records.
• Having strong supply chain management for vaccine orders and procurement, as well as appropriate storage conditions and equipment for vaccine administration and disposal, and timely anaphylaxis management and rescue.
• Providing appropriate funding and sustainable remuneration models for the provision of pharmacy based vaccination services.