Significant advance in pharmacist-initiated vaccine age regulation

From today (1 March 2023) Queensland pharmacists can vaccinate patients aged 6 months and older against influenza.

This nation-leading legislative change, tabled by Queensland Minister for Health and Ambulance Services, Yvette D’Ath on Monday, removes age restrictions for pharmacist-initiated influenza and COVID-19 vaccinations. Pharmacists can now administer as per the age guidance in the Australian Immunisation Handbook or as determined by the Therapeutic Goods Administration.

The amendment recognises the important role of pharmacists as immunisation providers and their key involvement in the roll out of the COVID-19 vaccination program.

The PSA has been heavily involved in consultation with the Queensland Government around these changes, said PSA Queensland State Manager Nicole Floyd MPS.

‘The PSA has been advocating for the removal of age restrictions for all vaccines since the Queensland Pharmacy Immunisation Pilot finished  back in 2016,’ she said.

Queensland pharmacists will also be able to provide National Immunisation Program funded influenza vaccines to all eligible patients during the 2023 influenza season, including infants and young children.

‘When it comes to vaccine-preventable diseases, the government knows access is important to improving uptake, so they want to use the vaccinating workforce as much as they can,’ Ms Floyd said. 

According to James Buckley MPS, pharmacist manager at Live Life Pharmacy Group in Port Douglas, there is strong community demand for pharmacists to vaccinate the nation’s youngest.

‘Every year we get parents asking who we can and can’t vaccinate,’ he said. ‘They always come in asking if everyone can be booked in.’

Now that the Extended Practice Authority – Pharmacists Version 3 has been updated, Mr Buckley is looking forward to providing as many influenza vaccinations as he can.

‘I think it’s a great opportunity for pharmacists to provide more services for the community,’ he said.‘It’s convenient and now we can actually vaccinate whole families.’

Practical considerations and training

According to the Australian Immunisation Handbook, the ‘vastus lateralis muscle in the anterolateral thigh’ is the recommended site for intramuscular vaccination in patients under 12 months of age.

Distraction techniques in this age cohort include:

• swaddling and/or holding the infant securely, but not tightly
• shaking a noisy toy or playing music
• getting older children involved to ‘blow the pain away’, with bubbles, for example 
• allowing parents to breastfeed during the vaccination process
• giving infants a sweet-tasting fluid, such as sucrose drops, immediately before the injection if parental consent is obtained.

However, pharmacists who have been vaccinating patients aged 5 years and over against influenza and COVID-19 already have a ‘wealth of experience’ administering vaccines to younger patients, said Ms Floyd.

You learn the skills required to vaccinate young patients very quickly, agreed Mr Buckley. ‘We’ve already got activities, stickers and rewards set up,’ he said.

Reassuring parents and training pharmacy staff to create a friendly and relaxing environment is also key.

‘Everyone who came into the COVID-19 clinics for patients aged 5 and older walked out with a sticker and a high five,’ he said.

While it’s part of pharmacist vaccination training to administer vaccines to all age groups, Ms Floyd said pharmacists may choose to do refreshers in immunisation as part of their continued professional development.

Pharmacists who opt to complete PSA’s Immunisation Online Refresher Course will also have 24-month’s access to the Annual Immunisation Update. 

The 2023 version, due for release shortly, will have a new section dedicated to childhood vaccination, including ‘positioning for infants and young children, distraction techniques, administering intramuscular vaccines, and consent’, said Kerri Barwick MPS, PSA General Manager – Education, Training and Knowledge Development.

More can be done

While the updated legislation is an important first step, Ms Floyd said PSA will continue to advocate for a nationally consistent scheme. 

‘This is a great outcome and we thank the State Government for their progressive approach to pharmacist vaccination, however there is still more to do,’ she said.

‘Qualified pharmacist immunisers should be able to vaccinate against all vaccine preventable diseases, for all ages groups, in all locations where there is a need.’