Under the Medicines, Poisons and Therapeutic Goods Regulation 2008, pharmacists are authorised to administer certain vaccines without a prescription.
The ACT Pharmacist Vaccination Standard (Vaccination Standard) made by the Chief Health Officer set the conditions and criteria under which a registered pharmacist may initiate administration of the particular vaccines.
An authorised pharmacist may vaccinate people against conditions listed in Appendix 1 – (Approved substances) of the Vaccination Standard provided they comply with all aspects of the Vaccination Standard including the ages and vaccine types specified.
An intern pharmacist may also vaccinate against these conditions provided they do so in accordance with the Vaccination Standard and under the supervision of a pharmacist authorised to administer the vaccine.
The Vaccination Standard also includes the requirements pharmacist must meet including training, premises and record keeping requirements. These requirements are in place to ensure that effective safeguards are in place for the administration of vaccines to health consumers. Please see the Vaccines Standard for the full requirements.
The Vaccination Standard aims to complement other immunisation services and improve public access to immunisation in the ACT.
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 Standard.
In addition to the above training, registered pharmacists and intern pharmacists may only administer a vaccine if they have successfully completed an accredited training program for all vaccines they intend to administer. Accredited training for individual vaccines is available from accredited providers.
Pharmacists must also 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.
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 the Australian Government Department of Health and Aged Care website.
Vaccine storage must be consistent with the National Vaccine Storage Guidelines ‘Strive for 5’.
The administering pharmacist must obtain valid patient consent prior to vaccine administration. Pharmacists and pharmacies must also maintain appropriate premises standards and patient health records in accordance with the Vaccination Standard.
Pharmacists should 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.
The pharmacist must either observe, or direct an appropriately trained staff member to observe, the person for 15 minutes post-vaccination to monitor and respond to any adverse 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.
Pharmacists are strongly encouraged to ask a person if they identify as Aboriginal or Torres Strait Islander, and this information should be recorded in the clinical records. While all health service providers are strongly encouraged to ask if a person identifies as Aboriginal or Torres Strait Islander, the reporting of this information is voluntary and is not linked to a pharmacist’s authority to supply and administer vaccines.
Adverse events following immunisation
An adverse event following immunisation (AEFI) is any untoward medical occurrence that follows immunisation. AEFI may be caused by the vaccine(s) or they may occur by coincidence (they would have occurred regardless of the vaccination). Adverse events are not limited to an anaphylactic response and may include other physiological responses such as localised bruising or swelling at the site of injection, migraine, or fainting.
AEFIs are a Notifiable Condition under the Public Health Act 1997 and must be reported to the Health Protection Service Immunisation Unit. If requested by the person, or in the event of an unexpected or serious AEFI, the pharmacist should also report the AEFI to the person’s nominated medical practitioner.
If a pharmacist immuniser becomes aware of an AEFI, the pharmacist immuniser must notify ACT Health's Immunisation Unit, by telephone on (02) 5124 9800 or by completing an online adverse event reporting form. Additional information about AEFIs, including pharmacist reporting obligations, is available from the ACT Health website.
Most vaccines provided in pharmacies are funded privately and will attract a fee. Pharmacies may also charge a fee for administration.
Some patients may be eligible to receive certain vaccines at no cost under the National Immunisation Program (NIP) or other ACT Government program. Pharmacists should advise eligible patients of their options for receiving the vaccine at no cost. While NIP vaccines are free, there may be a fee charged for administration.
Participating pharmacies can offer eligible patients specific NIP or COVID vaccines at no cost.
The NIP funded influenza vaccine is available for eligible patients >65 years at participating pharmacies.
The COVID-19 vaccines are available at participating pharmacies at no cost to patients when stock is made available by Australian Government.
Travel health consultations
Pharmacists are an important source of health advice for travellers. In any scenario when a pharmacist supports a traveller’s pre-travel healthcare needs, it is important that the traveller receives a comprehensive assessment and advice based on their individual needs. They may require referral to, or further communication with, a GP or travel medicine practitioner.
Further advice for pharmacists is available on the role of pharmacists as providers of travel vaccinations and travel health advice page.
Administration of medicines for injection by pharmacists
The Medicines, Poisons and Therapeutic Goods Act 2008 and the Medicines, Poisons and Therapeutic Goods Regulation 2008 Schedule 1, Part 1.9 (Pharmacists and employees) authorises pharmacists to administer medicines, including medicines for injection. This includes all medicines for injection in:
- schedule 2 and schedule 3 of the Poisons Standard without prescription; and
- schedule 4 and schedule 8 in accordance with the prescription issued by an authorised prescriber to the patient.
Pharmacists for whom administering medicines for injection is within their scope of practice, must ensure they have completed an accredited pharmacist administering medicines by injection course, and should complete any other specialised training to administer a specific medicine by injection if required.
Injectable services provided by pharmacists should only be provided in a safe, clean environment for the benefit of both the pharmacist and patient. These services should be provided in a closed consultation room.
Pharmacists administering medicines for injection should electronically document the administration of the medicine.
Administration of long-acting injectable buprenorphine by pharmacists
Pharmacists undertaking the administration of long-acting injectable buprenorphine (LAIB) must only administer in accordance with a prescription.
Pharmacists administering a LAIB injection must ensure they have completed an accredited pharmacist administering medicines by injection course; and should:
- complete Opioid Maintenance Treatment in the ACT - Pharmacist Training Program provided by Canberra Health Services; and
- complete accredited clinical training, , covering:
- pharmacology and pharmacokinetics of buprenorphine,
- compare available formulations, including dose titration.
- correct administration techniques
- practical considerations for providing a LAIB service.
- recognition and management of side effects
- documenting the service; and
- undergo supervised practical injection training for administration of LAIB.
- this may be facilitated using a blended model including - attend and observe a public clinic (Canberra Health Service, Alcohol and Drug Service at Building 7 at The Canberra Hospital can facilitate this via appointment only) or observe a private prescriber/nurse currently providing this service.
Pharmacists administering LAIB should electronically document the administration of the medicine and provide documentation to the patient’s LAIB prescriber.
The ACT Health Policies and Procedures guidelines for Opioid Maintenance Treatment in the ACT will be updated to support these changes to practice, following engagement with stakeholders.
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: