No longer the profession which ‘doesn’t touch people’, pharmacists are now one of Australia’s leading vaccinators. 

So how did we get here in 10 short years? And where are we going next?

Australian Pharmacist looks back on how it all started – chronicling the entire pharmacy vaccination timeline in the table below – and  where pharmacist vaccination is heading in the future.

Beginning with a bang

The Queensland Pharmacist Immunisation Pilot (QPIP) Phase 1 kicked off on 1 April 2014, running for the duration of flu season in 2014 (1 April–30 September), with pharmacists administering influenza vaccinations to 10,889 participants. Key to QPIP’s success was the rapid mobilisation of the pharmacy profession.

Following an invitation from then chief health officer Dr Jeannette Young in late 2013 for the profession’s lead bodies, including PSA, to collaborate on an immunisation trial to ‘help us to determine if a new method of health care delivery is safe and effective for Queenslanders’ –  there was very little time to get the original pilot started, said QPIP lead Professor Lisa Nissen FPS.   

‘We only had around 4 months to get everything up and running, including training, development, software, research, ethics approvals, steering groups and recruitment of sites,’ she said. ‘Both the profession and the pharmacists in Queensland were incredible.’ 

The results of Phase 1 were remarkable. Among the 8,000 participants who took part in the post-vaccination survey, 93% were happy to receive their vaccination from a pharmacist going forward. 

QPIP Phase 2, which ran from March 2015 to April 2016, rolled out across 200 pharmacies, with the trial expanded to include the measles and pertussis vaccines – setting the stage for pharmacists as a multi-vaccination workforce. 

Information sharing with other jurisdictions helped to ensure rapid uptake of pharmacist immunisation nation-wide.

‘We were actively meeting with health departments to share our experiences and outcomes, said Prof Nissen. ‘There was a rolling implementation of influenza vaccination/MMR/dTpa across states because the results and implementation were shared early and transparently.’

Running a large-scale pilot that allowed the safety and effectiveness of pharmacist immunisation to be assessed was also crucial to its acceptance, said Dr Jean Spinks, who co-authored a systematic review with Prof Nissen on the impacts of allowing pharmacists to administer influenza vaccines.

‘Once the results were in from Queensland, it took around 2 years for all the jurisdictions to switch over,’ she said. 

Community acceptance of the new vaccinating workforce was also crucial. 

‘There was trust in the profession to provide that service safely, which also provided evidence to the government that pharmacist vaccination was accepted by consumers.’

8 jurisdictions doing things differently

While all states had adopted influenza vaccination for pharmacists – as well as pertussis and MMR in most jurisdictions – each state and territory implemented policy differently based on local health system needs.

Victoria was the first (2016) to provide unrestricted access to NIP-funding  for permitted vaccines. Tasmania ran a childhood meningococcal vaccination campaign in response to a local outbreak in 2018 (albeit only temporarily) and five Queensland government departments funded employee influenza vaccine programs in community pharmacies (2017).

AP has counted at least 26 changes to regulatory tools in eight jurisdictions that took place between 2015 and early 2020. But the biggest change was yet to come.

A significant boost(er)

What really propelled pharmacist vaccination into the stratosphere was the COVID-19 pandemic.

While pharmacists were not among the first COVID-19 vaccinators, the campaign to protect Australians really got going once community pharmacists were added to the COVID-19 vaccination workforce. 

Pharmacists such as Prof Nissen, who was seconded from the Queensland University of Technology into Queensland Health’s COVID-19 team for 18 months, helped to grow and cement pharmacists’ reputation as vaccinators of choice.

‘I set up mass vaccination clinics across the state, developing training programs for health professions to enable them to vaccinate, leading policy and regulation formulation and scope of practice and workforce development,’ she said.

The COVID-19 vaccine rollout proved to be a significant milestone for pharmacist vaccination, – allowing pharmacists to significantly contribute to population health and show their value as a ready and available workforce, said Dr Spinks.

‘It wasn’t just the workforce, it was also the supply and the distribution channels. Community pharmacy offers both, providing a bigger efficiency gain,’ she said.

‘The accessibility to the community and the preparedness of pharmacists to step into the public health emergency with their skills, delivering 10 million vaccines, is unbelievable. Imagine if they were not a workforce in place at that time,’ added Prof Nissen.

As of March 2024, community pharmacists have administered nearly 12 million COVID-19 vaccines, with many more being administered by pharmacists in vaccine hubs, general practice and outreach services.

What does the future hold for pharmacist vaccination?

This year, we saw further confidence in pharmacist vaccination through the rollout of the National Immunisation Program Vaccinations in Pharmacy (NIPVIP) program. Pharmacists can now provide full-funded vaccinations, with most jurisdictions subsequently widening the range of vaccinations that pharmacists can administer.

Now that a significant barrier to access has been reduced, we should see an increase in vaccination uptake in the coming years, said Dr Spinks.

‘You’re going to go to the doctor if you can get your vaccine for free, rather than going to the pharmacist and having to pay out-of-pocket costs,’ she said.

‘But now you can get the same subsidised service in a pharmacy, along with the increased accessibility, that may mean that more people get vaccinated.’

It hasn’t all been smooth sailing, with certain hurdles yet to be overcome. ‘The lack of national consistency is a challenge that is yet to be addressed nationally, not just in terms of vaccination but across the board,’ said Dr Spinks. ‘There’s benefit in harmonising scope of practice change across jurisdictions.’

However, QPIP helped to usher in the development of further pharmacy pilots, such as the Queensland Health Urinary Tract Infection Pharmacy Pilot (UTIPP-Q) – which has similarly expanded almost nation-wide.

‘Having larger, broader changes at a state level enables these types of pilots to happen because regulation updates are required when changing scope of practice,’ she said.

Looking forward, Dr Spinks anticipates pharmacist prescribing will likely be as normalised, accepted and lauded as pharmacist vaccination within the next decade. 

‘These things do take time, but the more of these pharmacy prescribing programs are put in place, the process should become easier and faster to accept.’

While leading the implementation of Australia’s first pharmacist vaccination pilot was ‘undoubtedly the proudest professional moment’ of Prof Nissen’s life, she also sees it as a launching pad for our further scope of practice development in prescribing and other areas. 

‘Pharmacists are an incredibly underutilised resource in the health system,’ she said. ‘We have much more to give!’