The Importance of Pharmacy Technicians in Closing the Immunization Gap

Immunizations have been celebrated as one of modern medicine’s greatest achievements. Vaccines have been estimated to have prevented over 154 million deaths, including 101 million infants younger than 12 months.¹ Pharmacists and pharmacy technicians have continued to grow their roles in improving the overall vaccination rate within the US. Community pharmacies have been regarded as one of the most accessible points of health care: Across the US population, 96.5% of patients live within 10 miles of a pharmacy.²

Researchers estimate that pharmacy-administered immunizations were responsible for over 60% of all influenza vaccines in 2023-2024 and over 70% of COVID-19 vaccines administered since December 2020.³ Despite this growing demand, pharmacists continue to operate with limited staffing to provide traditional dispensing activities. Research has found that pharmacies with high dispensary obligations have lower availability for pharmacist-administered vaccination services. Unfortunately, growing demand for convenient immunization access has outpaced what pharmacists can deliver consistently; therefore, some are leaning into their trusted pharmacy technicians for support.^4,5

Pharmacy technicians play critical roles in addressing the immunization gap in our communities by addressing inventory/billing concerns, screening for vaccines, administering vaccines, and tracking vaccine safety. Recently, they played an exceptional role in improving vaccine coverage during the various mass campaigns during the COVID-19 pandemic worldwide.^6-8

Inventory and Billing Management

Before patients receive their vaccines, pharmacy technicians manage the immunization inventory to ensure ease of access. For example, many are charged with ordering vaccines, ensuring vaccines are stored appropriately, and ensuring key vaccines are available on standby. Also, pharmacy technicians ensure that pharmacists have the necessary needles, syringes, and other administrative supplies.⁹ Without such Amazon-like supply chain management, patients would likely experience frustration due to the lack of available vaccines and/or supplies.

Also, technicians have a deep understanding of the various logistical billing practices between various third-party payers. For example, previously a patient would be unable to meet the requirement for a key vaccination under Medicare Part B; therefore, the pharmacy technician would need to bill through the patient’s Medicare Part D. Also, many copayments vary across Medicare Part D plans. Pharmacy technicians have become adept at anticipating and addressing such third-party concerns to allow patients to seamlessly access immunizations.⁹

Vaccine Screening and Administration

Many technicians help patients fill out forms so pharmacists can easily administer vaccines without the need for continued data collection or entry. In a 2022 systematic review of 11 studies, DeMarco et al found pharmacy technicians primarily screened patients for vaccinations by running vaccine forecast reports or using various screening tools.⁴ However, pharmacy technicians highlighted that screening activities actively increased total time per immunization encounter, and workflow adaptations were needed to maintain efficiency.

Due to the growing workload of pharmacists, some states have even piloted the model of technicians administering vaccines themselves. A previous study¹⁰ found that newly trained immunization technicians were able to administer more than 4500 vaccinations (eg, vaccines protecting against notable diphtheria, hepatitis A and B, Haemophilus influenzae, human papillomavirus, polio, measles, etc) within 1 year. Such impact has continued to motivate states such as Idaho, Michigan, Nevada, Rhode Island, Utah, and Washington to allow trained pharmacy technicians to administer vaccinations, setting a precedent for various other states.¹¹ Worldwide, 16 additional countries have authorized similar programs to alleviate competing demands on the pharmacist. Data suggest that such programs have improved pharmacy workflow, job satisfaction, and vaccine uptake without increasing vaccine adverse events. DeMarco et al highlight 2 exclusive workflows that support such immunization-trained registered pharmacy technician models: the high-efficiency model and the flex-and-protect model.¹²

Vaccine Adverse Event Reporting

Pharmacy technicians play a core role in monitoring and reporting adverse reactions to vaccines. Most vaccine-associated adverse reactions are likely to occur within 15 minutes after receiving an injection. Therefore, many technicians lead in monitoring patients to ensure they are able to identify if an adverse reaction has occurred. If a reaction occurs, technicians document the event using the FDA’s vaccine postmarket safety surveillance program, the Vaccine Adverse Event Reporting System.

In addition, technicians play a core role in uploading information into key immunization regional registries.⁹ Many pharmacists currently rely on a patient’s own recollection for such information when patients present at the pharmacy. Regional registries and health system electronic records (EHRs) are known to have more complete immunization records than an internal community pharmacy database for key vaccines. However, researchers noted that if all 3 sources (EHRs, regional registries, and community pharmacy records) are utilized, there is a lower likelihood of duplicative or unnecessary vaccine administration in the pharmacy.¹³

Conclusion

Pharmacy technicians play an exceptional role in improving vaccination coverage worldwide. They continue to help expand vaccine access by increasing the likelihood of receiving a vaccine through coordination or direct administration. Many states are continuing to explore expanding their impact, one technician at a time.

REFERENCES

1. Shattock AJ, Johnson HC, Sim SY, et al. Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization. Lancet. 2024;403(10441):2307-2316. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00850-X/fulltext

2. Berenbrok LA, Tang S, Gabriel N, et al. Access to community pharmacies: a nationwide geographic information systems cross-sectional analysis. J Am Pharm Assoc (2003). 2022;62(6):1816-1822.e2. doi:10.1016/j.japh.2022.07.003

3. Lu PJ, Srivastav A, Hung MC, et al. National and state-specific estimates of settings where adults received influenza, updated COVID-19, and RSV vaccinations, 2023-2024 respiratory virus season, United States. CDC. Updated June 10, 2024. Accessed May 1, 2026. https://www.cdc.gov/vaccines/imz-managers/coverage/national-state-vaccination-estimates.html

4. DeMarco M, Carter C, Houle SKD, Waite NM. The role of pharmacy technicians in vaccination services: a scoping review. J Am Pharm Assoc (2003). 2022;62(1):15-26.e11. doi:10.1016/j.japh.2021.09.016

5. Adams AJ. Extending COVID-19 pharmacy technician duties: impact on safety and pharmacist jobs. J Pharm Technol. 2023;39:134–138. doi:10.1177/87551225231172343

6. DeMaagd G, Pugh A. Pharmacists’ expanding role in immunization practices. October 18, 2023. Accessed March 6, 2026. https://www.uspharmacist.com/article/pharmacists-expanding-role-in-immunization-practices

7. Hursman A, Wanner H, Rubinstein E. Empowering pharmacy technicians as vaccine champions: a pilot study in independent community pharmacies. J Am Pharm Assoc (2003). 2025;65(1):102257. doi:10.1016/j.japh.2024.102257

8. Valeiro C, Silva V, Balteiro J, et al. Pharmacy technicians in immunization services: mapping roles and responsibilities through a scoping review. Healthcare (Basel). 2025;13(15):1862. doi:10.3390/healthcare13151862

9. Powers MF, Hohmeier KC. Pharmacy technicians and immunizations. J Pharm Tech. 2011;27(3):111-116. doi:10.1177/875512251102700303

10. McKeirnan K, Sarchet G. Implementing immunizing pharmacy technicians in a federal healthcare facility. Pharmacy (Basel). 2019;7(4):152. doi:10.3390/pharmacy7040152.

11. Eid D, Osborne J, Borowicz B. Moving the needle: a 50-state and District of Columbia landscape review of laws regarding pharmacy technician vaccine administration. Pharmacy (Basel). 2019;7(4):168. doi:10.3390/pharmacy7040168

12. DeMarco M, Waite NM, Houle SKD, McKeirnan KC. Integrating immunization-trained pharmacy technicians into pharmacy workflow: a qualitative analysis of best practices. J Am Pharm Assoc (2003). Published online March 11, 2026. doi:10.1016/j.japh.2026.103073

13. Lam JH, Singh S, Kuo GM. Comparisons of immunization records between a community pharmacy, a regional registry, and a health system. J Am Pharm Assoc. 2019;59(1):30-34. doi:10.1016/j.japh.2018.09.007