Intern pharmacists who hold a certificate confirming competency to vaccinate, following completion of an accredited training program and have completed any additional training requirements, are only able to administer a vaccine under the direct supervision of a fully registered pharmacist immuniser who holds certification to vaccinate.
Pharmacist immunisers must not supply or administer a vaccine and must refer persons to a medical practitioner if:
Information on contraindications and precautions is provided by:
All pharmacist immunisers must have access to these resources at all times when conducting vaccination services.
Pharmacists should refer any patients with a previous history of a serious adverse reaction or severe allergic reaction to a previous dose of a vaccine or one of its ingredients to their general practitioner for assessment to determine whether it will be safe to receive subsequent vaccination.
Pharmacist immunisers can administer combination vaccines provided that they only contain the antigens included in the NSW Pharmacist Vaccination Standards. These vaccines must only be administered to people in the authorised age range and in accordance with the recommendations of the Australian Immunisation Handbook.
Vaccinating children under 5 years of age can be more complex than vaccinating adults, as they often require a number of vaccines at the same time. Most vaccines that are required by children are free through either a state-funded program or the National Immunisation Program (NIP). These vaccines are available from GPs, some council or community health clinics, and Aboriginal Medical Services. Children will also likely receive a medical assessment appropriate to their developmental milestones during those visits.
It is a requirement under the NSW Pharmacist Vaccination Standards to report all vaccines administered (except for MPOX vaccine) to the Australian Immunisation Register and for pharmacist immunisers to check the patient's immunisation history in AIR prior to administering any vaccines.
It is also mandatory under the Australian Immunisation Register Act 2015 to report all National Immunisation Program (NIP) and COVID-19 vaccination encounters to the Australian Immunisation Register (AIR).
Vaccination encounters should be uploaded into AIR preferably within 24 hours from vaccine administration, but must be within 10 business days.
Where a patient experiences an adverse event following the administration of a vaccine, these must be reported. All uncommon, unexpected or serious adverse events following immunisation (AEFI) or any event considered by the clinician to be significant following immunisation must be notified by medical practitioners, pharmacists or other health professionals to the local Public Health Unit (PHU) on 1300 066 055 using the National Adverse Events Following Immunisation (AEFI) reporting form. Additional advice is available on Adverse events following immunisation (AEFI).
Vaccine administration errors include but are not limited to the inadvertent administration of a wrong or unintended vaccine and/or the inadvertent administration of a vaccine that is incorrectly stored, prepared or given outside the Australian Immunisation Handbook’s advice.
Some examples include the supply and administration of:
All NSW immunisation providers, including pharmacist immunisers, must report vaccine administration errors to the PHU on 1300 066 055, irrespective of the outcome of the VAE.
COVID-19 vaccinations must be provided free of charge. The Australian Government is committed to offering every person in Australia access to safe and effective COVID-19 vaccines at no cost. Vaccination providers cannot charge to administer the COVID-19 vaccine. The vaccine is free, and the consultation appointment for patients to receive the vaccination is also free. Charging a patient any costs associated with the administration of the COVID-19 vaccination (including booking fees) is a breach of the requirements under the program.
NIP and state-funded vaccines are free for eligible patients.
NSW pharmacist immunisers are encouraged not to charge eligible patients an administration fee for NIP vaccines, but instead apply for reimbursement through the National Immunisation Program Vaccinations in Pharmacy (NIPVIP).
Pharmacist immunisers may charge patients an administration fee for state-funded or privately purchased vaccines.
Vaccines that are privately purchased and supplied to a patient to take to another provider for administration, for example, a GP, must be stored in accordance with the cold chain requirements as per Section 7.3 of the National Vaccine Storage Guidelines ‘Strive for 5’. Please supply the vaccines to patients only before their appointment with the immunisation provider and advise them not to store vaccines at home in a domestic fridge.
No, checking vaccination records of an individual prior to vaccination and recording of the vaccination encounter onto the AIR are mandatory. You can only administer vaccines once you have access to the AIR. Further information about recording vaccination on the AIR is available on the NSW Pharmacist Vaccination Standards.
Pharmacist immunisers are only authorised to administer rabies vaccine intramuscularly as pre-exposure prophylaxis.
Patients must be 5 years of age and above, immunocompetent and be educated about first aid and the need for medical assessment for any potential exposure to rabies or Australian Bat Lyssavirus (ABLV), regardless of having been vaccinated before.
NSW pharmacist immunisers are not authorised to administer rabies vaccine as post-exposure prophylaxis following a bat exposure in Australia, or another relevant animal overseas.
NSW pharmacist immunisers are not authorised to administer Rabies post-exposure prophylaxis (following a bat exposure in Australia, or another relevant animal overseas). Patients seeking Rabies post-exposure prophylaxis must be immediately referred to a medical practitioner or advised to contact their local Public Health Unit on 1300 066 055. This is of particular significance as delayed/missed opportunities for rabies post-exposure treatment, including the administration of Human Rabies Immunoglobulin (HRIG), can be fatal.
NSW pharmacist immunisers should not administer a rabies vaccine if they cannot confidently address concerns regarding contraindication to vaccination, severe adverse events after vaccination, or complex medical needs. In these circumstances, pharmacists should refer such patients to a medical practitioner. Booster doses of rabies vaccine and VNAb titre blood testing (to test rabies neutralising antibody levels) are recommended for some people who may have ongoing occupational exposure to lyssavirus in Australia or overseas.
Further information about pre-exposure prophylaxis for rabies and ABLV is available in the Australian Immunisation Handbook.
No, only NSW pharmacist immunisers meeting all requirements of the NSW Pharmacist Vaccination Standards (including but not limited to training and vaccine storage requirements) are authorised to supply eligible patients with oral typhoid and oral cholera vaccines for patient self-administration without a medical prescription.
Yes, NSW pharmacist immunisers supplying eligible patients with oral typhoid and cholera vaccines without a medical prescription must check the patient's AIR records prior to vaccine supply and contact the patient to confirm that the vaccine has been appropriately self-administered by the patient and subsequently record the vaccination encounter onto the AIR. If the patient is not contactable, the pharmacist immuniser is not required to record the administration of oral typhoid and cholera vaccines onto the AIR.
NSW Pharmacist immunisers supplying eligible patients with oral typhoid and/or oral cholera vaccines must provide the patient (and or parent/guardian) with comprehensive instruction (such as the Consumer Medicine Information summary) on oral typhoid and cholera vaccines' regimen, storage and preparation of each dose and administration, and instructions on post-vaccination care as per the advice in the digital Australian Immunisation Handbook or the latest TGA Product Information in relation to what to expect following vaccination, and provide advice on when to seek medical attention following each vaccine dose.
Pharmacist immunisers are also required to ask patients whether they experienced any adverse events when confirming appropriate self-administration.