Unlocking the Full Power of Pharmacists in the Fight for Equitable Immunisation
This World Immunisation Week, we explore the role pharmacists play in immunisation uptake and awareness
by Grace Grange, Research Officer
The World Health Organisation‘s World Immunisation Week is a call to action to reimagine how we deliver one of the most powerful public health tools of our time: vaccination.
With vaccines available for more than 20 life-threatening diseases, including diphtheria, measles and influenza, they currently prevent up to five million deaths every year. Immunisation underpins global health security and offers one of the best health investments in terms of value for money. Yet, equitable access and uptake of vaccinations remain persistent challenges. Often underutilised, pharmacists are uniquely positioned to step in and reshape the public health landscape.
It’s well recognised that pharmacists are considered experts in medicines due to their in-depth knowledge and extensive training around how drugs work, interact and affect different patient groups. Pharmacists are central to a patient’s initial treatment and ongoing care, and play an integral role in medicines management, ensuring the right medicine is given to the right patient, at the right dose and right time, optimising outcomes using a tailored approach. In hospitals and health systems, in addition to their clinical responsibilities, they help develop guidelines and choose which medicines should be available based on safety, effectiveness, and cost.
The pharmacist’s role also extends to immunisation, where they have been crucial to the safe and effective delivery of immunisation programmes around the world for many years.
- Vaccine administration – Pharmacists are involved in vaccine administration in a variety of settings (community, primary and secondary care), including flu, COVID-19, HPV, and travel vaccines.
- Screening and recommendations – Pharmacists assess patients’ immunisation status, identify gaps, and recommend appropriate vaccines based on age, health conditions, and risk factors.
- Vaccine storage and handling – Pharmacists ensure vaccines are stored and handled appropriately to maintain efficacy and safety, for example, maintaining cold chain requirements.
- Record keeping and reporting – Pharmacists may support immunisation documentation and record keeping, as well as reporting of adverse effects, contributing to public health surveillance.
Reimagining the pharmacist’s role in immunisation: more than medicine experts
Beyond these roles, pharmacists have so much more to offer in terms of supporting and increasing immunisation uptake. They are embedded within the heart of communities, highly accessible and trusted healthcare professionals, who provide a crucial link between healthcare systems and civil society.
Pharmacists combine deep medicines expertise with a rare, grounded understanding of their communities, positioning them not just within the health system, but at the frontline of its transformation.
They’re well placed to use targeted and tailored approaches, particularly to reach under-represented and vulnerable groups, reducing inequalities in uptake. This is especially relevant to improving education and awareness of vaccines, as well as tackling misinformation and vaccine hesitancy, which are key challenges.
The COVID-19 pandemic exacerbated challenges around public confidence and trust in vaccinations, but it was also a time when pharmacists had the opportunity to demonstrate the broader role they play in addressing these issues.
The Three Cs of Misinformation
To meaningfully improve immunisation uptake, it requires a human-centred approach with strategies focused on tackling the three ‘C’s.
- Confidence – Countering misinformation, building public trust and using culturally relevant communication to support informed decision-making around vaccinations.
- Convenience – Increasing access to immunisations (for example, offering convenient times, locations and removing cost barriers) and ensuring that reliable information is readily available.
- Complacency – by engaging communities through culturally competent messaging that highlights the importance of vaccination and the risks of vaccine-preventable diseases. In addition, engaging younger and healthier populations who often are complacent to their vulnerability and their role in protecting those who are more vulnerable through herd immunity.
Each of these components will vary between different communities and population groups, requiring a deep understanding of the particular context and tailored approaches to ensure success. Pharmacists are in a strong position to lead on this, ultimately resulting in a change in behaviour and an increase in uptake.
My experience: going beyond the traditional role of a pharmacist
During COVID-19, I had the opportunity to lead on real-world change as a pharmacist embedded in a local government public health system, improving immunisation uptake in under-represented and vulnerable groups.
This experience revealed the broader role and leadership potential of pharmacists in immunisation.
Championing conversations in the community
Working with the Royal Society of Public Health, a one-day vaccine champion training course was developed to equip over 100 non-clinical individuals (GP receptionists, community and faith leaders, the wider health and social care workforce, teachers, and pharmacy staff) to confidently engage in positive conversations about vaccines to encourage uptake during COVID-19.
The session included a brief overview of how vaccines work and the evidence, a ‘myth-busting’ session to address how to respond to misinformation, an introduction to behaviour change models, and motivational interviewing (a communication approach that helps people explore their ambivalence about change).
Building trust with marginalised communities
I worked with local community leaders to educate on the importance of immunisation and to address specific misinformation and vaccine hesitancy within marginalised communities. Many from these communities were functionally illiterate, so educational videos were created that were shared on the local WhatsApp group, and we also provided answers to common questions in a way that was easy to understand.
Reaching the asylum seeker community
On-site vaccination clinics were set up at local asylum seeker accommodations, supporting individuals from diverse global backgrounds, many of whom faced systemic barriers to accessing vaccines in their countries of origin. To enhance uptake, it was crucial to provide opportunities for open dialogue, address concerns and misinformation, and build trust through culturally relevant, accessible communication (where possible, in patients’ fluent languages). Delivering this required thoughtful planning to meet the varied language and cultural needs of residents in a respectful and inclusive way.
Innovating to reach the often unseen workforce
Seafarers often spend many months at sea without access to their home healthcare systems and, therefore, were overlooked as a priority population for COVID-19 vaccinations despite them being high-risk due to them travelling to multiple countries. A programme was set up so that when ships docked in the local government area, the local primary healthcare team would board the ships to administer vaccinations.
This required careful planning and coordination, particularly around vaccine handling and storage (e.g. ensuring temperature control for vaccines), but also providing access to reliable information and advice and addressing any concerns around vaccines prior to the clinics.
A Call to Action: Unlocking the full potential of pharmacists in immunisation
It is clear that the pharmacist’s potential roles and capabilities in immunisation uptake and awareness go far beyond vaccine handling and administration. There is a need for governments and policy-makers to further recognise and enable the pharmacy workforce to work to their potential in supporting immunisation uptake. To ensure this potential is fully harnessed and used effectively, we must:
- Recognise and advocate for pharmacists‘ integration into broader roles in immunisation uptake, including collaboration with other sectors and healthcare professionals.
- Address regulatory challenges, including country-specific policies, which enable and empower pharmacists to reach their full potential in this field.
- Advocate for investment in sustainable funding models to maximise opportunities and strategies for pharmacists to improve immunisation awareness and uptake across all communities, ensuring equity in access and support, which in turn will help address inequalities in uptake and build resilience within health care systems.
- Foster collaboration and shared learning between professions and sectors within the healthcare system, but also between healthcare professionals, patients and other organisations (e.g. education, health and social care, faith)
If we are serious about achieving immunisation for all, then we must move beyond traditional roles and fully embrace the pharmacist not just as a provider, but as a public health leader. Every missed vaccination is a missed opportunity for equity, protection, and trust.