Five tips for increasing uptake of respiratory vaccines

Every fall, community pharmacists are on the frontline of respiratory illness prevention, facing a triple threat of influenza, respiratory syncytial virus (RSV) and pneumococcal disease. These pathogens disproportionately impact the same high-risk older patients with underlying chronic conditions. Add COVID-19 to the mix, and the urgency is clear. Despite safe, effective vaccines being available for all four conditions, adult uptake remains far below targets.1-4 The good news? Pharmacists are among the most trusted and accessible healthcare providers in Canada—and are uniquely positioned to change this situation.This is a particularly timely moment. Across Canada, the scope of pharmacy professionals to administer vaccines continues to expand—and the momentum is growing. The National Advisory Committee on Immunization (NACI) has released updated influenza guidance for 2026–2027,1 new RSV vaccine recommendations for adults,2 updated pneumococcal guidance recommending high-valency conjugate vaccines,3 and fall 2026 updated guidance for COVID-19 vaccines.4 Here are five practical tips to help you increase vaccine uptake this respiratory season.1. Know your full respiratory vaccine toolkit—and keep it currentStaying current on all four respiratory vaccines is the foundation of confident counselling. A few key updates for 2026: for influenza, NACI continues to recommend prioritizing high-dose, or adjuvanted inactivated vaccine for adults 65 years or older.1 For pneumococcal disease, Pneu-C-20 and Pneu-C-21 are now the preferred options—a single dose is recommended regardless of prior pneumococcal vaccination history, as long as at least one year has passed since the last dose.3 For RSV, NACI now recommends RSV vaccines for adults 75+, as well as for adults 60+ who live in long-term care or have high-risk medical conditions. For healthy adults between 60–74, RSV vaccination is an individual decision. Keep an eye on the products too; the various RSV vaccines all have slightly different age and risk-based approvals.For COVID-19, NACI’s updated fall 2026 guidance continues to strongly recommend annual vaccination for adults 65 or older, long-term care residents, pregnant individuals, those with underlying conditions and healthcare workers. Notably, a second dose per year is now strongly recommended for adults 65–79 with underlying medical conditions (an expansion from previous guidance), as well as for adults 80 years or older and those who are moderately to severely immunocompromised.4A quick 15-minute team review of all available respiratory vaccines at the start of the season helps build a strong foundation of confident and competent practice. See Table 1 for a quick reference summary of vaccines for all four respiratory illnesses.2. Integrate vaccine assessment into every patient encounterReactive vaccination—waiting for patients to ask—is a missed opportunity. Your most powerful tool is the care you are already providing. Every medication review, prescription pickup and counselling encounter is a chance to assess vaccination status. Flag patients who are 65 or older and those with chronic conditions such as heart disease, chronic obstructive pulmonary disease (COPD), diabetes or immunocompromising conditions—these groups overlap significantly as prime candidates for all the respiratory vaccines. Assume every patient you encounter is underimmunized unless confirmed otherwise; immunization records are often incomplete, and the burden of tracking them down should not fall on the patient. A proactive outreach effort ahead of the season—a text message, phone call or note on the prescription bag—can capture patients you haven’t seen recently.3. Use a presumptive ask—and make vaccine co-administration routineKnowing when to ask is only half the equation. How you ask matters just as much. Use a presumptive statement rather than an open-ended question: “I’d like to give you your flu shot today” lands differently than “Would you like a flu shot?” The first assumes you are there to help; the second invites a “no” reply. Research consistently shows that a direct recommendation from a trusted healthcare professional is one of the strongest predictors of vaccine uptake.5Co-administration is another practical strategy worth building into your workflow: NACI confirms that respiratory vaccines can be co-administered. A patient who comes in for their flu shot can leave with their pneumococcal vaccine, their RSV vaccine, or all three in the same visit. Document your recommendations and align your team so the ask happens consistently, every time.4. Have the conversation that moves the needleHesitancy is real, and statistics alone rarely change a patient’s mind. What works better is a brief personalized conversation that connects vaccination to something the patient already cares about. For a patient managing heart failure or COPD, mention that influenza and pneumococcal disease can trigger serious exacerbations, and vaccination is one of the most effective things they can do to stay out of hospital over the winter. For an older adult hesitant about RSV vaccine because it is newer, validate their concern. Say something like “That’s a fair question,” then explain that RSV vaccine works through the same well-established mechanisms as other vaccines they have already received. For patients experiencing vaccine fatigue, acknowledge their concerns, then focus on the one or two vaccines most relevant to their risk profile rather than presenting the full list at once. Keep it brief: a confident warm recommendation followed by “Would you like to book it today?” is often all it takes. Patients trust pharmacists—use that trust intentionally to enhance vaccine uptake.5. Leverage your full scope—and make it visiblePharmacists’ scope for vaccine administration has been expanding steadily across Canada—and the momentum is growing. Ontario’s July 2026 expansion adding RSV, pneumococcal and other vaccines to pharmacist and pharmacy technician administration authority is the latest example of a national shift toward pharmacy as a primary immunization destination. Wherever you practise, know exactly what you are authorized to administer, and to which age groups—then make sure your patients know it too. Update your signage, website and social media before the season starts. A simple poster in your dispensary—”Flu, RSV, pneumococcal, COVID-19 vaccines, all available here”—can start conversations that may never happen otherwise. Vaccination is a team sport. When everyone from the pharmacist to the technician to the assistant knows what’s available and which patients to refer for vaccination, the results show it.SummaryIncreasing respiratory vaccine uptake does not require a complete overhaul of your practice—it requires intentionality. You already have what it takes: the training, the trust and the touchpoints. The patients who will benefit most are already walking through your doors. With the right approach, you can make sure more of them leave protected.Shelita Dattani (sdatrx@gmail.com) is a practising pharmacist, principal at SDatRx Health Consulting, Ottawa, ON, and Chair of the Adult Vaccine Alliance (AVA), a national multisector coalition advocating for adult immunization funding, awareness and access in Canada. She holds adjunct appointments at the University of Ottawa in the Faculties of Pharmaceutical Sciences and Medicine. Shelita is passionate about disease prevention, immunization and chronic disease management as pillars of a stronger healthcare system.Disclosure: Shelita Dattani has received honoraria for speaking engagements from Sanofi, Pfizer, Merck, Moderna and GSK. She serves as Chair of the Adult Vaccine Alliance (AVA), which receives funding from pharmaceutical manufacturers including Pfizer, Merck, and GSK through its secretariat, Praxus Health. She has also participated in advisory boards for pharmaceutical companies with products relevant to the vaccines discussed in this article.References:National Advisory Committee on Immunization (NACI). Statement on seasonal influenza vaccines for 2026-2027. Ottawa: Public Health Agency of Canada; 2026. (accessed May 29, 2026).National Advisory Committee on Immunization (NACI). Updated guidance on respiratory syncytial virus (RSV) vaccines for older adults and for adults at high risk of severe RSV disease. Ottawa: Public Health Agency of Canada; 2026. (accessed May 29, 2026).National Advisory Committee on Immunization (NACI). Recommendations on the use of pneumococcal vaccines in adults, including Pneu-C-21. Ottawa: Public Health Agency of Canada; November 15, 2024. (accessed May 29, 2026).National Advisory Committee on Immunization (NACI). Guidance on the use of COVID-19 vaccines for fall 2026. (accessed May 29, 2026).Waite NM, Houle SKD, Toppari K, et al. Willingness of Canadian community pharmacists to adopt a proactive life-course approach to vaccination services. J Am Pharm Assoc 2024;64(4):102073. doi: 10.1016/j.japh.2024.102073.

Five tips for increasing uptake of respiratory vaccines

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