What works and what doesn’t when advancing pharmacist-led vaccination around the world

Canada’s public awareness campaigns encouraging the public to seek out pharmacy-based vaccination have been listed as a best practice in a new report by the International Pharmaceutical Federation (FIP). The report tracks the global picture of pharmacy-based vaccination policies and practices, and what barriers and challenges remain.While a total of 56 nations have pharmacy-based vaccination, only 43 allow pharmacists to deliver the vaccination. In the other 13 countries, other healthcare professionals must be present to administer vaccines in pharmacies. In 29 countries, pharmacists can prescribe vaccines, as well as administer them. Other nations are working to broaden pharmacists’ scope in delivering vaccines.Those regions without pharmacy-based vaccination frameworks already in place are continuing with vaccination by other, non-pharmacist healthcare professionals, “with limited or no discussions on pharmacist involvement,” the report reads.Canada is ranked among countries where pharmacists can administer a comprehensive range of vaccines, even if this differs between Canadian jurisdictions. According to the report, “Canada is working towards greater harmonisation of pharmacist roles across provinces, addressing current variations in vaccine authorisation, prescribing, and funding.”The report lists best practices to encourage pharmacy-based vaccination, including targeted public awareness campaigns to address vaccine hesitancy and countering misinformation. Other best practices include:Introducing pharmacy-based vaccination regulations gradually to build public support and show the benefits of increased access. Australia and Germany used this method of incremental change.Providing structured training programs for pharmacists to build public and professional competence, such as in Saudi Arabia and Belgium.Integrating vaccination records into national electronic health systems. Belgium, Ireland and Portugal have this to improve coordination of care with other healthcare professionals.Encouraging interprofessional collaboration to help address resistance from other healthcare professionals. This is being done in France and Greece, the report notes. The most reported barrier to pharmacy-based vaccination is lack of government or health system support, especially in countries where no legal framework for pharmacy-based vaccination exists. Remuneration was a major barrier in countries where pharmacists aren’t allowed to administer a wide range of vaccines. Often these countries are missing a robust regulatory framework for pharmacy-based vaccination and also don’t have structured payment mechanisms for vaccination.Another barrier comes from other healthcare professions: physicians and nurses who resist expanding pharmacists’ scope of practice. Their concerns relate to clinical oversight, training and competition, but the report notes that Canada has addressed this through structured agreements and joint training programs. Medical associations in Romania and Hungary continue to oppose vaccination by pharmacists. “While initial resistance from doctors and nurses has been observed in several countries, ongoing dialogue, regulatory changes, and demonstrated effectiveness have helped build trust and acceptance,” the report states, citing France, Israel and Brazil as examples of countries where physicians were initially reluctant but now are more supportive of vaccination by pharmacists.The report provides a snapshot (see figure 4, below) of pharmacy-based vaccination in seven countries, with the caveat that not all local regions of a country have the same policies. Australia, for example, is similar to Canada in that regulations differ in different states, with South Australian pharmacists leading in scope of practice for pharmacist vaccinators. A snapshot of pharmacists’ scope of practice across jurisdictions is available on the Canadian Pharmacists Association website.FIP has a surveillance atlas that provides more information on pharmacy-based vaccination around the world. In 2023, FIP released a statement about pharmacy-based vaccination across the lifespan. It included recommendations for governments, FIP members, universities and individual pharmacists to support it. The new FIP report, called “Policy progress, stakeholder engagement and challenges in pharmacist-led vaccination,” can be found on the FIP website.

What works and what doesn’t when advancing pharmacist-led vaccination around the world

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