Under the Medicines, Poisons and Therapeutic Goods Regulation 2008, pharmacists are authorised to administer certain vaccines without a prescription. This authorisation is subject to training, premises and record keeping requirements as set out by the Chief Health Officer in the ACT Pharmacist Vaccination Standards (Vaccination Standards).
Pharmacist vaccinations are aimed at complementing existing immunisation services and improving public access to immunisation in the ACT.
An authorised pharmacist may vaccinate people against COVID-19, influenza, pertussis (whooping cough) and measles, mumps and rubella (MMR) in the ACT provided they comply with the Vaccination Standards. An intern pharmacist may also vaccinate against these diseases provided that they do so in accordance with the Vaccination Standards and under the supervision of a pharmacist authorised to administer the vaccine.
ACT pharmacists administering a vaccine must ensure that they meet the necessary training, premises and record keeping requirements to ensure that effective safeguards are in place for the administration of vaccines to health consumers.
Pharmacists may only administer the following vaccines:
- Influenza vaccine;
- Diphtheria, tetanus, a‑cellular pertussis (dTpa) vaccine;
- Measles-mumps-rubella combination vaccine (MMR); and
- A vaccine for COVID‑19 included on the Australian Register of Therapeutic Goods.
Table 1 – Approved Substances of the Vaccination Standards contains the full list of each approved vaccine, the route of administration and the conditions associated with each vaccine.
Pharmacists may administer an influenza vaccine to patients aged 10 years or over and dTpa and MMR vaccines to patients aged 16 years or over.
Pharmacists may only administer a COVID-19 vaccine to patients at an age that the vaccine is approved for or is provisionally approved for use by the Therapeutic Goods Administration (TGA). Currently, the minimum patient age provisionally approved by the TGA for use of COVID-19 vaccines is as follows:
- AstraZeneca vaccine – 18 years
- Pfizer vaccine – 12 years
- Moderna vaccine – 12 years.
If any of these COVID-19 vaccines becomes approved for use in children younger than 10 years of age, pharmacists may only administer the vaccine to patients aged 10 years or over.
In addition, pharmacist vaccinators must administer the COVID-19 AstraZeneca vaccine in accordance with the Australian Technical Advisory Group on Immunisation (ATAGI) clinical guidance on use of COVID-19 vaccine in Australia. The most recent ATAGI clinical guidance dated 17 June 2021 is that the Pfizer (Comirnaty) COVID-19 vaccine is preferred over the AstraZeneca vaccine for people aged less than 60 years.
This means that pharmacists may administer the AstraZeneca vaccine to persons aged 18 to 59 years, but only after preferential consideration of the Pfizer vaccine for that person and with written informed consent from the patient. Pharmacists should explain the risks and benefits of the AstraZeneca vaccine to patients prior to obtaining informed consent.
The Australian Government has published Information for health care providers to help consumers make informed decisions about the COVID-19 AstraZeneca vaccine (current online version). Pharmacists should refer to this resource when explaining the risks and benefits of the AstraZeneca vaccine and are encouraged to use the Australian Government Consent form for COVID-19 vaccination (current online version) when obtaining patient consent.
Registered pharmacists and intern pharmacists can only administer vaccines once they have completed appropriate training. Only training programs that comply with the Australian Pharmacy Council’s Standards for the Accreditation of Programs to Support Pharmacist Administration of Vaccines (current version) will be considered compliant in accordance with Part A of the Vaccination Standards.
In addition to the above training, registered pharmacists and intern pharmacists may only administer a COVID-19 vaccine if they have evidence of successful completion of the Australian Government COVID-19 vaccination training program.
Pharmacists will also need to maintain current first aid and cardiopulmonary resuscitation (CPR) certificates, and a current certificate for the Australasian Society of Clinical Immunology and Allergy (ASCIA) anaphylaxis e-training for pharmacists.
Temporary refresher training requirements during the COVID-19 emergency
As a result of the COVID-19 emergency and in recognition of the additional demand on constrained resources, the pharmacist refresher training requirements have been temporarily amended. A pharmacist whose CPR certificate or First Aid Training expires during the COVID-19 declared emergency period is taken to be complying with the pharmacist training requirements.
The amended refresher training requirements are in place as some training providers were unable to deliver first aid or CPR training in 2020. This created challenges for pharmacists who were already qualified immunisation providers to meet the requirements for renewing mandatory first aid and CPR training.
As face-to-face training is now available in the ACT in 2021, and as the access issues faced during 2020 are unlikely to reoccur in a sustained way, the ordinary refresher training requirements will recommence from 1 September 2021. A transition period to 31 August 2021 has been provided to enable pharmacists to ensure they have adequate time to undertake any required training.
From 1 September 2021, vaccinating pharmacists must have current First Aid and CPR qualifications in order to be authorised to administer vaccinations.
Premises and procedural standards
Immunisation services provided by pharmacists must only be provided in a safe, clean environment for the benefit of both the pharmacist and patient.
All vaccinations must be conducted in accordance with the Australian Immunisation Handbook (current online edition). The Australian Immunisation Handbook is available from: https://immunisationhandbook.health.gov.au/.
The administering pharmacist must obtain written informed patient consent prior to vaccine administration. Pharmacists and pharmacies must also maintain appropriate premises standards and patient health records in accordance with the Vaccination Standards.
In addition to complying with the Vaccination Standards, pharmacists are encouraged to adopt or follow professional guidelines, such as the Pharmaceutical Society of Australia’s Practice Guidelines for pharmacists providing immunisation services or the Pharmacy Guild of Australia’s Guidelines for conducting pharmacist initiated and administered vaccination services within a community pharmacy.
All patients must remain on the premises for at least 15 minutes post-vaccination for observation. The seating area provided for patients must be easily monitored by an authorised pharmacist who has successfully completed the pharmacist training requirements.
The administering pharmacist or pharmacy, where possible, should provide a copy of the vaccination details to the patient and the patient’s nominated general practitioner. Pharmacists or pharmacies must also supply a record, no less than annually (including electronic record) to the Chief Health Officer about pharmacist vaccination events.
Pharmacists must electronically record each vaccination event on the Australian Immunisation Register (AIR) as soon as possible following administration, consistent with the Australian Government’s Australian Immunisation Register Amendment (Reporting) Bill 2020, which mandated reporting to the AIR from 1 March 2021.
The record keeping, training and premises requirements set out by the Pharmacist Vaccination Standards apply to the administration of all vaccines, regardless of why a consumer may be seeking a vaccine.
Supervision of intern pharmacists
An intern pharmacist may only administer a vaccine under the supervision of a pharmacist authorised to administer the vaccine. It is expected that the supervising pharmacist be in the same location, but not necessarily the same room as the intern when the vaccine is being administered.
Adverse events following immunisation
An administering pharmacist must be competent to manage anaphylaxis post vaccination, including the use of adrenaline consistent with the Australian Immunisation Handbook (current online version). The pharmacist must ensure that an ambulance is called to attend to the patient in the event of anaphylaxis.
Adverse events following immunisation are a notifiable condition under the ACT Public Health Act (1997).
All uncommon, unexpected or serious AEFI, or any event considered to be significant following immunisation, including anaphylaxis, must be notified by medical practitioners or other health professionals to the ACT Health Immunisation Unit.
In the ACT, suspected AEFI should be reported to the Immunisation Unit, Health Protection Service using the Immunisation Adverse Event Reporting Form (online form), or by contacting the Health Protection Service, Immunisation Unit on (02) 5124 9800. If you are a pharmacist and would prefer to print out a form to fax or email to us, please click here. The Immunisation Unit reports all notifications to the Australian Adverse Drug Reaction System (ADRS) at the Therapeutic Goods Administration. Australia-wide annual reports on AEFI surveillance are published by the Australian Government.
Further information on reporting adverse events following immunisation is available on the ACT Health website.
All AEFIs must be recorded in the patient’s vaccination record and reported to the patient’s GP and the ACT Health Immunisation Team.
Additional conditions and information for a COVID-19 vaccine
Pharmacists should administer a COVID-19 vaccine that is not included in the Australian Immunisation Handbook according to the Australian Technical Advisory Group on Immunisation (ATAGI) Clinical guidance on use of COVID-19 vaccine in Australia.
A pharmacist must be able demonstrate evidence of successful completion of the Australian Government COVID-19 Vaccination Training Program. All dealings with a COVID-19 vaccine must be in accordance with the Australian Government COVID-19 Vaccination Program
The COVID-19 (chadox1-s) (AstraZeneca) vaccine will become available at participating pharmacies as part of the Australian Government COVID-19 Vaccination Program when stocks are made available.
Most influenza vaccines and all dTpa vaccines provided in pharmacies are funded privately, and some pharmacies may charge a fee for administration.
Some patients may be eligible to receive vaccines at no cost under the National Immunisation Program (NIP) or other ACT Government program. Pharmacists should advise patients of their eligibility to receive the vaccine from their nominated general practitioner (GP) or participating NIP immunisation service.
The NIP funded influenza vaccine is available for eligible patients >65 years at participating pharmacies.
The COVID-19 (chadox1-s) (AstraZeneca) vaccine will become available at participating pharmacies at no cost to patients when stock is made available by Australian Government.
This document has been prepared for information only, please refer to the Medicines, Poisons and Therapeutic Goods Regulation 2008 available on the ACT Legislation Register for full legislative requirements.
For further information, please visit the Health Protection Service website or contact the Pharmaceutical Services Section of the Health Protection Service on firstname.lastname@example.org or (02) 5124 9208.
The links below provide resources for ACT pharmacies providing vaccinations: