Canadian data suggest community pharmacies improve flu vaccine uptake

Rates of influenza vaccination are higher in places that allow community pharmacists to provide the vaccinations, research conducted in Canada shows.

Older person receiving flu vaccine

Influenza vaccination rates are modestly higher in provinces where the vaccinations can be provided by pharmacists, research conducted in Canada shows[1]

Researchers led by Jeffrey Kwong from the University of Toronto studied the impact of policies that allow provinces in Canada to provide flu vaccination in community pharmacies. Alberta was the first to implement this policy in the 2007–2008 flu season, but since 2009–2010 other provinces have followed suit.

The team found that, compared with provinces and time periods without the policy, areas that allowed pharmacy-based vaccination schemes had an average 2.2% higher coverage (30.4% versus 28.2%).

“The relatively modest impact observed in Canada may be due to the presence of universal funding for influenza vaccines in many of the provinces that implemented pharmacist policies, or perhaps it is because we only examined the first few years of these policies in Canada, and it is possible that their impact may increase over time,” says Kwong.

The data came from the 2007–2014 Canadian Community Health Survey, an annual telephone survey of people’s healthcare use, health status and determinants of health. Among a total of 481,526 respondents, the researchers found that those living in provinces with a pharmacist policy were 5% more likely to take up seasonal flu vaccination.

In England, 595,467 flu vaccinations were delivered by 7,195 community pharmacies during the 2015-2016 flu season, according to the NHS Business Services Authority[2]
. Since September 2015, community pharmacists have received NHS funding for delivering the vaccine to high-risk patients, such as pregnant women, older people and people with long-term health conditions. However, the scheme has been met with resistance from some GPs who say it has fragmented vaccine delivery and has led to lost income for GP practices.

Kwong says he is not aware of a similar negative reaction from GPs in Canada. A practising GP himself, he says that he is happy for his patients to receive their vaccine from the pharmacist as it relieves his time. However, Kwong notes that his team’s study was not able to pinpoint where people received their vaccine.

“Nevertheless, we did see a higher percentage of people receiving the vaccine if they lived in a province where they were able to receive it at a pharmacy,” he says. “This could be due to greater awareness around influenza vaccines because of additional promotion by pharmacies. Increased awareness could translate into higher coverage, whether the vaccine was given at a pharmacy, a public health clinic, or a physician office.”

Kwong adds that pharmacist vaccine delivery can also increase the system’s capacity to deal with another influenza pandemic.

Overall, during the course of the study, flu vaccination rates fell in Canada but there was substantial interprovincial variability. Uptake has also dropped in England, with only around a third of people with a long-term condition receiving the vaccination in 2015–2016. GP leaders, , including Richard Vautrey, deputy chair of the British Medical Association’s GP committee, have attributed this fall to the introduction of the pharmacy scheme[3]

Rekha Shah, chief executive of Pharmacy London, who leads on flu immunisation for local pharmaceutical committees in the capital, argues that the drop would have been even greater if pharmacists were not able to deliver a vaccination service.

“People have reported back in thousands that they find the pharmacy service much more convenient and are accessing the vaccination much earlier in the season and this brings its own benefits too,” she says.

Shah says that many people getting their flu vaccination from the pharmacist have never been vaccinated before.

“There are many particular groups, such as those in work or who look after young children and carers, who find it much easier to get their jab from a pharmacy. Without a pharmacy service, some of these report that they may well not have got round to getting themselves vaccinated at all,” she says.

“In the face of the competition from pharmacies, GP practice teams have also become much more proactive in their approach to engage their patients for a flu jab — a little competition is healthy and the result is great for the NHS.”


[1] Buchan SA, Rosella LC, Finkelstein M et al. Impact of pharmacist administration of influenza vaccines on uptake in Canada. CMAJ 2016. doi: 10.1503/cmaj.151027

[2] NHS Business Services Authority. Advanced Service Flu Report.Available at: (accessed 9 August 2016)

[3] Madsen M. NHS recommissions controversial pharmacy flu vaccination scheme. Pulse. 9 May 2016. Available at: (accessed 9 August 2016)

Last updated
The Pharmaceutical Journal, Canadian data suggest community pharmacies improve flu vaccine uptake;Online:DOI:10.1211/PJ.2016.20201556

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