This page provides information regarding context and rationale for the Pharmacy Use Only section of the medSask Vaccine Screening and Consent Form. For direction on managing the screening process for vaccines, see this Guide.
  • During the immunization process, while a licensed pharmacy technician with Advanced Method Technician Certification or pharmacy intern with Advanced Method Student Certification may administer vaccines approved by the Ministry, the pharmacist must ensure an assessment occurs for each vaccine recipient.
    • The assessment must include screening for therapeutic appropriateness and for the presence of contraindications and precautions prior to administering any drug by any advanced method. This must be done at each visit.
  • See “Administered By” tab for more information about roles and scopes of pharmacy professionals and interns related to vaccination.
 Reference
Last Updated

14 Sep 2021

  • This applies to vaccines that are publicly funded under certain criteria. When an individual is eligible for a publicly funded vaccine, pharmacists must provide the individual with the option to access the vaccine from Public Health.  Note that this is not required for the Seasonal Influenza Immunization Program nor the COVID-19 Immunization Program as these programs specifically permit pharmacies to administer publicly funded vaccines.
    • Refer to SIM Chapter 10 – Biological Products and Chapter 7- Special Populations for eligibility of vaccination through the Public Health program.
    • Examples:
      • Hepatitis B Vaccine
        • SK residents born on or after January 1, 1984 are eligible to receive Hepatitis B (HB) Vaccine. While most would have received routine HB vaccine in Grade 6, if records are unavailable and the individual does not recall receiving the HB series, they are eligible to receive through Public Health with no out-of-pocket expense.
      • Pneumococcal Vaccine
        • Scenario: 58 year old individual with nephrotic syndrome and no pneumococcal vaccination as an adult
        • CIG recommends the following pneumococcal vaccination for adult patients with nephrotic syndrome:
          • 1 pneumococcal conjugate 13-valent (Pneu-C-13) vaccine
          • 1 pneumococcal polysaccharide 23-valent (Pneu-P-23) vaccine at least 8 weeks after Pneu-C-13
          • 1 booster dose of Pneu-P-23 at least 5 years after the first Pneu-P-23 dose
        • According to SIM, publicly funded pneumococcal vaccination for adults with renal disease (including nephrotic syndrome) includes two doses of Pneu-P-23 with the second dose 5 years after the first.
        • In this example, while some healthcare providers may recommend one Pneu-C-13 and two Pneu-P-23 doses, only the Pneu-P-23 doses are publicly funded.
    • If the individual is eligible for publicly funded vaccine, the pharmacist must inform the individual:
      • of their eligibility,
      • that they could receive the vaccine without charge from Public Health, and
      • that there will be charges for the supply and administration of the vaccination from the pharmacy, and that the individual will not be reimbursed by the Ministry for such charges. 
References
Last Updated

25 Sep 2021

As per Part L of the SCPP Regulatory Bylaws, a licensed pharmacist who administers a drug to a patient must make and retain a record in the pharmacy of the following:

  1. the patient’s name and address;
  2. the name of the drug and total dose administered;
  3. for an advanced method or vaccination by any method, identification of the manufacturer, lot number and expiry date of the drug;
  4. for an advanced method, the route of administration, dosage and the location on the body where the drug was administered;
  5. the name of the licensed pharmacist administering the drug;
  6. the date and the time of administration;
  7. any adverse events; and
  8. the price, if there is a charge for administration

DIN is on the form and, while not a requirement, provides a further check to ensure the correct product is being administered.

The form does not include the price if there is a charge for administration as this is typically documented in pharmacy dispensing software.

Reference
Last Updated

25 Sep 2021

See infographic for clarification of roles in the process of administering publicly funded vaccines.

                                          Authority to Administer Vaccines

Title Authorized to Administer Publicly Funded Vaccines
(COVID-19 and Influenza)
Authorized to Administer Non-Publicly Funded Vaccinesa
Fully Licensed Pharmacists with valid AMC Yes Yes
Licensed Pharmacy Technician with valid AMTC Yes when supervised by a fully licensed pharmacist with valid AMC in community practice. No
Temporary Emergency Licensed Pharmacist with valid AMCb

Yes when supervised by a fully licensed pharmacist with valid AMC in community practice.

Not eligible to supervise other COVID-19 vaccine immunizers.
Yes when supervised by a fully licensed pharmacist with valid AMC in community practice.
Formerly Licensed Pharmacist with valid training decided by SCPP Yes when supervised by a fully licensed pharmacist with valid AMC in community practice. No
Pharmacist Extended Interns and Pharmacist Student Interns with valid Advanced Method Student Certification (AMSC)c Yes when supervised by a fully licensed pharmacist with valid AMC in community practice. No


Includes influenza vaccine that is privately purchased (such as high dose for an individual >65 years of age not in a long-term care or personal care home)
b See SCPP COVID-19 Immunizer FAQs for definitions, tasks that can be performed and supervision requirements.

c See SCPP COVID-19 Immunizer FAQs for full list of eligible pharmacy students.

References
Last Updated

16 Nov 2021

  • Ensure the vaccine recipient is within the authorized age group of the vaccine being provided.
  • Pharmacists are authorized to administer vaccines to individuals 5 years and older in accordance with the age limits under SIM, CIG, and the vaccine’s official product monograph.
    • Check SIM, CIG and monograph for approved ages for each vaccine. Note that for some vaccines, approved age may vary among different brands of the same antigen.
      • E.g. hepatitis A vaccine:
        • Avaxim®- pediatric dosing is 12 months to 15 years of age
        • Havrix- pediatric dosing is 12 months to 18 years of age
References
Last Updated

25 Sep 2021 

Timing with Respect to Vaccine Doses in a Series
  • Many vaccines require >1 dose, which is considered a vaccine series.
  • Doses within a vaccine series should be given according to the interval(s) recommended by SIM and CIG.

Intervals Longer than the Recommended Interval

  • E.g. 2nd dose is supposed to be given 4 weeks after the 1st and individual presents at 10 weeks
  • For almost all vaccines, there is no need to restart a series if the interval has been exceeded; provide the dose as soon as possible and continue with the series if not complete.
    • Exceptions to this include cholera & travellers’ diarrhea vaccine and rabies vaccine. See vaccine-specific chapters in CIG for more information.

Intervals Shorter than the Recommended Interval

  • E.g. 2nd dose is supposed to be given 4 weeks after the 1st dose and individual presents at 3 weeks
  • In most cases, the vaccine dose should be deferred until the time of the recommended interval (in this, case 4 weeks).
  • For some vaccines, a minimum interval has been determined that may be shorter than the recommended interval. Note: minimum intervals are mostly available for publicly funded vaccines and may not be determined for non-publicly funded vaccines.
    • Minimum intervals, when available, are found in vaccine-specific chapters of CIG as well as SIM Chapter 5 and Chapter 10.
  • Generally, recommended intervals should be used to administer vaccine doses. Minimum intervals need to be considered:
    • to determine dose validity if vaccines are not administered at the recommended interval, or
    • in situations in which the risk of infection is higher such as unplanned travel or outbreak situations.
Timing with Respect to Other Vaccines

Inactivated Vaccines

  • Inactivated vaccines can be administered concomitantly or at any time before or after the administration of any other live attenuated or inactivated vaccine using different injection sites and separate needles and syringes.
    • Preferably use two different limbs but if need to inject >1 vaccine into the same limb, separate the two injection sites by at least 2.5 cm (1 inch).
    • EXCEPTION: Different formulations of vaccine that protect against the same disease (e.g. pneumococcal vaccine) should not be administered concomitantly.

Live vaccines

  • Live vaccines given by the parenteral route may be administered concomitantly with all other vaccines during the same visit, using different injection sites and separate needles and syringes. 
    • EXCEPTION: Live varicella-containing vaccine should be not administered at the same time as smallpox vaccine; separate immunizations by at least 4 weeks.
    • Preferably use two different limbs but if need to inject >1 vaccine into the same limb, separate the two injection sites by at least 2.5 cm (1 inch).
  • In general, if two live parenteral vaccines are not administered concomitantly, there should be a period of at least 4 weeks before the second live parenteral vaccine is given.
    • If live parenteral vaccines are given too close together, the immune response to the second live parenteral vaccine may be affected by the first live parenteral vaccine and is considered invalid; the second vaccine should be repeated at the recommended interval.
  • Live oral or intranasal vaccines may be administered at any time with other live or inactivated vaccines, regardless of their route of administration.
References
Last Updated

25 Sep 2021 

Remind vaccine recipients to report a serious reaction as soon as possible rather than waiting until the next visit.

If the individual reports an adverse reaction to a vaccine: 

  • If the reaction is reportable:
    • Complete a national AEFI form.
      • A user guide is available for assistance.
    • Pharmacies are to submit AEFI reports related to publicly funded vaccines (COVID-19 and influenza) to their local Public Health Office.
      • After filing the report, communication should be received by the reporter from the MHO regarding the recommendation for further immunization.
      • The MHO recommendation may also be available in the Immunization tab in the eHR Viewer. See instructions of where to find here.
        • The MHO recommendation is to be provided to the individual by the reporter of the AEFI and documented on their file (if not in eHR). Refer individual to Public Health if any further questions.
      • Pharmacies are to submit AEFI reports related to non-publicly funded vaccines to Health Canada, the prescriber (which may be a pharmacist) and the primary care practitioner (if different from prescriber).
        • The prescriber or primary care provider is to make a decision going forward (continuing the series, etc.).
          • This decision should be provided to the individual and documented on their file.
COVID-19 Vaccine

Adverse Events of Special Interest (AESI)

  • The Public Health Agency of Canada requires reporting of specific Adverse Events of Special Interest (AESI) following immunization with any COVID-19 vaccine.
  • The national AEFI form has been revised to include a section on COVID-19 AESIs (9e), which lists several reactions. However, the list of reactions designated as AESIs is evolving and users of the form are directed to Brighton Collaboration for the most current list of COVID-19 AESIs.
  • Complete the national AEFI form; indicate the AESI in Section 9e and provide details in Section 10.
  • Submit immediately to local Public Health Office.
Vaccine(s) Implicated
  • If more than one vaccine was administered on the same day and it is clear to which vaccine the reaction can be attributed (e.g. extensive local reaction on right arm when two vaccines were administered in separate arms), indicate the implicated vaccine here.
  • Leave blank if it is not possible to determine the causative vaccine.
References
Last updated

25 Sep 2021

  • A pharmacist who administers a vaccine must provide the vaccine recipient with a Record of Immunization Card. Sample wallet cards and immunization record forms can be found at Immunize Canada.

  • For publicly funded vaccines, the pharmacist must provide the vaccine recipient with the documentation specified by the DPEBB (e.g. Record of Influenza Immunization Wallet Card, Record of COVID-19 Immunization Wallet Card). 
    • NOTE: 
      • For the 2021-2022 Influenza Immunization Program, pharmacies are encouraged to not provide wallet cards for all immunizations. Wallet cards can be issued in the following scenarios:
        • The client requires a second vaccine dose. The wallet card can be issued to remind them of when they got their first dose, so they can plan their second dose (e.g. children under 9 years old who have not had an influenza vaccine before);
        • The client requests the wallet card and the risk of fraudulent use is low, at the pharmacist’s discretion.

      • For the COVID-19 Immunization Programpharmacies should continue to issue wallet cards for 1st doses of COVID-19 vaccine. Wallet cards should not be reissued if the patient loses or forgets their original wallet card. 
Reference
Last  updated

17 Nov 2021

Publicly Funded Vaccines (COVID-19 and Influenza)
  • Specific notification of primary care providers is not required for publicly funded vaccines.
    • Administration of COVID-19 Vaccine is recorded in eHR Viewer.
    • Administration of publicly funded influenza vaccine is recorded in PIP. (Pharmacists are required to submit on the day of immunization such that the entry in PIP represents administration.)
Non-Publicly Funded Vaccines
  • The prescriber (for Schedule I drug administration) or the vaccine recipient’s primary care provider (for Schedule II drug administration) must be notified of vaccines that have been administered.
  • While these vaccines are recorded in PIP, this represents dispensing and provision of the vaccine to the individual and not administration. Administration may take place on a different day and/or by another provider. Therefore, the prescriber or primary care provider must be notified when administration takes place. 
Reference
Last updated

25 Sep 2021