Time for harmonization: Pharmacists as immunizers across Canadian jurisdictions

Background Improving vaccination coverage remains a global priority for reducing the health burden and social impact linked to at least 29 infectious diseases for which there are effective vaccines. While childhood vaccinations remain essential, an aging population means that the need for life-course vaccination programs that target adults is increasing. Pharmacists are particularly well suited to overcoming many of the challenges associated with vaccinating adult populations, hence the ongoing development of legislation for pharmacists as immunizers (PAIs) in Canada and abroad. This article provides an overview of the current Canadian landscape for pharmacists administering vaccines, highlights similarities and differences in legislation and regulation and discusses both challenges and opportunities for pharmacists who provide vaccination services. PAIs in Canada have expanded since 2007, when BC became the first province to allow pharmacist-administered vaccinations. Since that time, Canada’s decentralized pharmacy regulatory environment—where decision making takes place largely on a provincial/territorial (P/T) level—has resulted in P/T differences in how quickly and to what extent PAI authority has been implemented. The result is a heterogenous PAI landscape across Canadian jurisdictions, with several interacting variables determining which, if any, vaccines a pharmacist can administer, to whom and under what funding model.