OPINION | South Africa should train all pharmacists to give vaccinations

A health worker administers the Covid-19 vaccine at the FF Robeiro Clinic at the Sammy Marks Square vaccination site in Pretoria, South Africa.

South Africa has started the second phase of the introduction of the Covid-19 vaccine. The aim is to vaccinate key workers, people in community facilities such as nursing homes, people over the age of 60 and other vulnerable groups.

The overall goal of phasing out is to vaccinate 67% of the population (approximately 40 million people) by the end of the year.

But the goals are unlikely to be achieved. The first lap was slow, and while the second picked up speed, vaccination rates remained low. Delays included the procurement and delivery of vaccines, the emergence of new variants, and the suspension of the use of some vaccines due to safety concerns.

In the first phase of the rollout, which was aimed at healthcare workers and other frontline workers, few deployment points were established. These have been significantly expanded for the second phase and are intended to include both public health facilities such as clinics and primary care hospitals and private health care facilities such as doctors and pharmacies.

There are currently 3,481 public pharmacies, 613 institutional public and 306 institutional private pharmacies in the country. That means a very extensive network that is also rural and urban.

However, a successful rollout is not just about the physical points where people can get the vaccinations. It’s also about having a trained workforce to manage it. Currently, healthcare professionals who are allowed to vaccinate are mostly doctors and nurses who are trained to do so according to country regulations.

Pharmacists are not authorized to issue vaccinations according to the vaccination regulations of the country without a corresponding certificate. This means that most of the 17,000 pharmacists in the country cannot be vaccinated if they are not properly trained. Vaccine delivery technique is a skill that is not consistently taught within the country’s pharmacy school.

Some pharmacies will still be part of the rollout plan – those that have clinics on their premises that are run by nurses. And possibly those who have pharmacists who have completed the additional training to qualify them to administer vaccines.

South Africa must bring all pharmacists online. As I have shown in my work, this is achievable. It requires a change in the training of pharmacists. In other countries like the US, UK and Australia, pharmacists have been offering vaccinations for years.

The gap and how to fix it

The curriculum for the current Bachelor of Pharmacy (BPharm) in South Africa is offered by nine universities in the country. It is intended to train pharmacists to become generalists. In order to qualify for vaccinations, South African pharmacists must undergo post-qualification and certification. This is offered as a part-time course.

The system should be revised to overcome this. The changes would include:

  • Modification of the Pharmaceutical Bachelor Degree Curriculum to Include Appropriate Training in Injection Techniques for Vaccine Administration to Meet Current Pharmaceutical Regulations. These require that pharmacists who administer vaccinations are familiar with the use of syringes and administration devices.

  • Modification of the legislation regulating the practice of pharmacy.

Pharmacists already learn a lot about vaccinations in their basic studies. Among other things, diseases that can be prevented by vaccination, vaccines for routine and travel vaccinations, vaccination concepts as well as the logistics of vaccine transport and cold chain management are treated.

The International Pharmaceutical Federation, a non-governmental organization and worldwide representation of the pharmaceutical industry, emphatically supports pharmacists as vaccinators. It encourages countries to update regulations on the administration of vaccines by pharmacists to improve vaccine coverage worldwide.


The Covid-19 pandemic has shown the importance of countries that do not have pharmacists trained in vaccine delivery in their basic training to make the necessary changes.

Pharmacists play an important role in vaccination. As part of current practice in South Africa, pharmacists are involved in the provision of health education, patient counseling and health promotion regarding vaccines, immunization and vaccine preventable diseases.

This role should be expanded to include managing patients’ vaccination schedules and tracking post-vaccination adverse events.

This aspect of pharmacovigilance is critical to monitoring the potential successes and side effects of vaccines and the positive health outcomes of patients after immunization.

Changes to the curriculum would have to be implemented immediately and uniformly at all universities offering the Bachelor of Pharmacy in South Africa.

In the event of the changeover, South Africa could look forward to a large number of adequately trained pharmacist-vaccinates who will join the health system as interns in the future. This would empower the country’s health workforce by increasing the number of vaccinations available for Covid-19 vaccination and long-term routine vaccination services.

The more pharmacists trained and able to deliver vaccines, the stronger the vaccination workforce will be – and the higher the vaccination coverage rate will be.The conversation

Dr. Velisha Ann Perumal-Pillay, Lecturer, Pharmacy Practice, University of KwaZulu-Natal

This article is republished by The conversation under a Creative Commons license. read this original article.

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