Pharmacists Need Legal, Training Support to Advance Vaccination

Pharmacists have long been recognized as accessible community vaccinators, but new research highlights how regulatory and training gaps continue to limit their impact on public health advancement, according to a study in Currents in Pharmacy Teaching & Learning.¹

“Vaccination remains one of the most effective public health interventions for preventing infectious diseases and reducing morbidity and mortality rates throughout all stages of life across all populations,” wrote the authors of a report from the International Pharmaceutical Federation (FIP).² “Yet, despite its proven effectiveness, adult vaccination coverage varies considerably across vaccines and countries, often remaining below recommended public health targets.”

In Nigeria, this public health challenge is particularly acute, as vaccine-preventable diseases such as measles and diphtheria continue to pose devastating threats. For instance, in 2021, Nigeria recorded over 10,000 measles cases, the highest number globally, alongside a recent diphtheria outbreak that has claimed hundreds of lives, primarily among unvaccinated children.¹

Although the country struggles with over 2.2 million zero-dose children and complex horizontal fragmentation in health sector governance, community pharmacists remain highly accessible, trusted first points-of-contact who are willing to bridge these gaps. Yet, despite 91% of Nigerian community pharmacists expressing a strong interest in administering vaccines, only 24.4% currently offer immunization services.

READ MORE: Competing Vaccine Schedules Leave Pharmacists Navigating Confusion

Overcoming the Legal, Regulatory Barriers

The primary hurdle preventing pharmacists from achieving their full public health potential is the absence of a supportive legal and policy framework. Although pharmacy practice in Nigeria is governed by the Pharmacy Council of Nigeria Act 2022, no explicit national policy currently authorizes or protects community pharmacists as independent immunizers, resulting in limited formal recognition.¹

This regulatory gap is not unique to West Africa. A global systematic review using the Consolidated Framework for Implementation Research (CFIR) shows that policy and law barriers, including liability and restricted authority, frequently hinder pharmacist-led vaccination in countries like Lebanon, Jordan, and Austria.³

To resolve these disparities, regulatory advocacy must align national policy to include community pharmacies in national immunization strategies. In contrast, countries with flexible frameworks, such as the US, Canada, and the United Kingdom, have utilized statewide protocols and legislative updates to grant pharmacists broader clinical autonomy.^1,3,4

This expanded authority directly correlates with improved immunization rates, demonstrating a proven path forward for developing nations.⁴

Elevating Professional Education, Training

Standardized education represents the second crucial pillar of support needed to advance pharmacy-based immunization. Currently, academic curricula in Nigeria cover pharmaceutical logistics and vaccine production but lack hands-on, practical training in vaccine administration.¹

This reflects a broader trend across Africa, where limited access to vaccination education remains a key barrier. To address this, organizations like the Association of Community Pharmacists of Nigeria have partnered with public health agencies to provide post-graduate clinical training workshops in administration techniques, cold-chain management, and cardiopulmonary resuscitation.

Deans of West African pharmacy schools are also advocating for a standardized 6-year PharmD program, which would naturally integrate experiential vaccination training. Implementing systematic training not only elevates a pharmacist's physical capability to vaccinate but also fosters the clinical confidence necessary to make proactive recommendations.^1,3

FIP highlights that educational institutions must utilize global readiness tools to evaluate their institutional and regional policies, preparing a collaborative, interprofessional workforce ready to execute public health initiatives.²

Collaborative Care, Implementation Strategies

When pharmacists are empowered with appropriate training and legal backing, the positive outcomes on public health are undeniable. A global meta-analysis of randomized controlled trials demonstrated that involving pharmacists as immunizers, advocates, or both significantly increases overall immunization uptake.⁴

Involving pharmacists led to a statistically significant rise in vaccination rates, particularly for influenza. This impact was starkly demonstrated during the COVID-19 pandemic in the US, where trained pharmacists and pharmacy technicians administered 45% of all COVID-19 vaccines, acting as the ultimate frontline experts.^4,5

Similarly, mobile outreach programs, such as those led by the University of California, Irvine, have successfully distributed thousands of routine vaccines, illustrating how community pharmacies can improve vaccine equity in underserved populations.⁵

To maximize these benefits, pharmacies can implement structured communication and collaboration tools. Frameworks like the Situation Background Assessment Recommendation (SBAR) model help structure clinical exchanges between pharmacists and physicians, ensuring patient safety and continuity of care.²

Pharmacists must also manage the “3 Cs” of vaccine hesitancy (complacency, confidence, and convenience) by directly addressing patient misconceptions and tailoring educational outreach. By resolving policy, educational, and operational barriers, pharmacists can transform from simple dispensers to active guardians of public health.^2,3

“There have been numerous interventions to increase vaccination coverage and pharmacy education in Nigeria, but the country still faces numerous and formidable public health challenges,” concluded the authors of the current study.¹ “Political and economic barriers must be addressed to empower pharmacists as vaccinators and expand access to vaccinations in Nigeria.”

READ MORE: Immunization Resource Center

REFERENCES

1. McKeirnan K, Alhayek J, Truter I, et al. The role of vaccinating pharmacists in public health advancement in Nigeria. Curr Pharm Teach Learn. 2026;18(10):102725. doi:10.1016/j.cptl.2026.102725

2. Masyitah N, Adebayo G, Ekpotu P, et al. Supporting pharmacists in vaccination communication: a toolkit for pharmacists. March 2026. Accessed August 19, 2026. https://www.fip.org/file/6512

3. Abdulselam M, El-Awaisi A, Nasr ZG, et al. Barriers and facilitators for pharmacist-led vaccination services: a systematic review using the Consolidated Framework for Implementation Research (CFIR). Explor Res Clin Soc Pharm. 2025 Nov 25;21:100687. doi: 10.1016/j.rcsop.2025.100687

4. Le LM, Veettil SK, Donaldson D, et al. The impact of pharmacist involvement on immunization uptake and other outcomes: an updated systematic review and meta-analysis. JAPhA. 2022;62(5):1499-1513.e16. doi:10.1016/j.japh.2022.06.008

5. National Immunization Awareness Month: the emergence of pharmacists as a primary provider of vaccines. UC Irvine School of Pharmacy & Pharmaceutical Sciences. August 11, 2023. Accessed August 19, 2026. https://pharmsci.uci.edu/2023/08/11/national-immunization-awareness-month-the-emergence-of-pharmacists-as-a-primary-provider-of-vaccines/