Influenza vaccinations through community pharmacies
Case studies from Portugal and UK
In 2007, changes were made to health legislation to allow pharmacies to undertake a wider role in primary health care. This included the ability to administer influenza (flu) vaccinations to patients in community pharmacies.
To support this new role, the Associoção Nacional das Farmácias (ANF) developed a campaign package ahead of the 2008-09 winter flu season. The package included practical training for pharmacists, influenced by the American Pharmacists Association (APhA), a public awareness campaign and supporting materials for pharmacists and patients.
In the first year, training was given to 1,914 pharmacists from 1,273 pharmacies (48% of the total). This had risen to 3,289 pharmacists from 1,728 pharmacies by 2011.
Over the 2008-09 flu season, pharmacies vaccinated over 159,000 patients, with almost half of them being treated during the first 10 days of October 2008. Pharmacies vaccinated an average of 206 patients each.
The accessibility of community pharmacies has led to a major change in the way the public is vaccinated. Prior to 2008, around half of all flu vaccinations were delivered in health centres. By 2011, this had fallen to 26%, with pharmacies delivering 42%.
In 2011, in order to help reach the World Health Organization target of vaccinating over 75% of over-65s, the Portuguese Government started offering free flu vaccinations to its older population. The impact of this on pharmacy services has yet to be fully assessed.
In 2005, some community pharmacies in England first started to receive flu vaccination training funded by the UK National Health Service (NHS). It was quickly shown that by involving community pharmacies, the NHS could boost flu vaccination uptake in areas that had previously been well below the WHO recommended target level.
In the UK, the average uptake of flu vaccinations has remained at 72-75% for several years, just below the WHO target. In order to increase uptake, the NHS commissioned pharmacies across the whole of London to delivery flu vaccinations for the 2013-14 season. More than 1,500 pharmacists from 1,100 pharmacies in 32 London Boroughs were accredited to deliver the service.
In the UK, the majority of flu vaccinations are delivered under a legal arrangement known as Patient Group Directions (PGDs). These allow specified treatments, including prescription medicines and vaccines (such as for flu) to be delivered to a defined group of patients (such as over-65s or those in "at risk" groups) without the need for each patient to have an individual consultation with a prescriber. Each PGD is authorised by a senior doctor and a senior pharmacist at a relevant health authority or medical agency. These PGDs can cover services that are delivered under the NHS (state-funded) or where patients pay privately for their own treatments.
Pharmacy support organisations have increased their flu programmes for community pharmacies in recent years, reflecting the convenience and popularity of the service with customers. In 2013-14, there were 115 pharmacists from 99 pharmacies who were using a flu support package from Alphega which includes a PGD, branded marketing materials and business guidance. This was nearly three times the number using the package in 2011-12. Some of these pharmacies may also have been providing similar NHS-funded services at the same time.