What you need to know about administering the MMR vax

vaccine vaccination needle

Victoria’s Health Department has issued a communique outlining pharmacists’ obligations under the expanded vaccination program, which starts next week

The Victorian Government is expanding its existing pharmacist immuniser program to include the measles mumps rubella (MMR) vaccine.

It is also lowering the age of access through community pharmacy to 16 years.

The expanded program will begin on 22 October 2018.

“This change reflects the Victorian Government’s commitment to increasing access to vaccination for all Victorians, and ensuring that there are a range of convenient vaccination options available to protect those people most at risk of vaccine-preventable disease,” says the Department of Health.

It says that an external evaluation of the existing pharmacist-administered vaccination program – which included influenza and pertussis vaccines – completed in September 2017 found it safe and effective in improving access to the jabs in Victoria.

“However, the evaluation also raised a number of issues that the department is now addressing. This includes non-compliance with data capture, reporting and low uptake of government-funded vaccines,” the communique says.

It explains that the expansion to allow appropriately trained pharmacists to administer the MMR “is part of Victoria’s broader plan to protect against measles, and will bring the state in line with other jurisdictions that already allow pharmacists to administer measles-mumps-rubella vaccines, and vaccinate 16 and 17 year olds”.

“As of 22 October 2018, Victorian pharmacist immunisers are authorised to administer measles-mumps-rubella vaccine to individuals aged 16 years and over,” says the communique.

They are not authorised to provide the vaccination for travel purposes; people aged 15 years and under; inpatients in hospitals, and/or people with contraindications defined in the current edition of the Australian Immunisation Handbook.

It highlights that pharmacists must have consent when vaccinating 16 and 17-year-olds.

“In addition to measles-mumps-rubella vaccine, pharmacist immunisers are authorised to administer influenza and pertussis-containing vaccines to individuals aged 16 years and over,” says the communique.

“A parent or guardian can provide consent for an individual under the age of 18 years. If the parent or guardian is not available, the pharmacist must ensure that the individual has the capacity, capability and sufficient maturity to understand what is proposed.

“Pharmacists need to complete the pre-vaccination screening checklist included in the Australian Immunisation Handbook (current edition).

“If a pharmacist determines that the individual does not have the maturity or understanding to receive the vaccination, they should refer the individual to their GP.”

Pharmacists are expected to maintain competency through CPD and are required to report all vaccines administered to the Australian Immunisation Register, regardless of whether or not the vaccine is NIP-funded or not.

“It is also important to ask individuals if they would like their doctor/health provider notified that they’ve received the vaccine.

“Victoria is the only state in Australia where pharmacist immunisers can administer government-funded vaccines through the NIP. Pharmacist Immunisers should continue to order and administer government-funded vaccines to those most at-risk of vaccine-preventable diseases. “

Lastly, the communique outlines that while pharmacists can charge a service fee for the administration of a government-funded vaccine, they must disclose before administration that these can be provided free through bulk-billing GP surgeries.

“You must inform the individual that the fee you’re charging is for the administration of the vaccine, not the cost of the vaccine.

“If the individual is not eligible for government-funded vaccines, a private market vaccine may be administered.”

Seeking consistency

The advice comes as Federal, State and Territory Health Ministers observed at a COAG Health Council meeting last week that a nationally consistent approach to pharmacist administered vaccination is desirable.

This move was welcomed by the Pharmacy Guild, and now also by the PSA.

PSA President Dr Shane Jackson said, “We applaud the Health Council’s initiative to build on the success of pharmacist vaccinations.

“Research has shown internationally and locally that pharmacists are considered highly accessible and they can boost vaccination rates, contributing to a reduced burden on our already over-burdened healthcare system.”

A national approach to pharmacist administered vaccination will reduce confusion, ensure better access for patients to quality vaccination services and utilise the pharmacy workforce appropriately, he says.

“Regulation of pharmacist immunisers varies from state to state. It doesn’t make sense that pharmacists can only vaccinate for meningococcal disease in Tasmania and pertussis in some states such as South Australia, Victoria and Queensland.”

Pharmacists have provided vaccinations since 2014, and across all states and territories since 2016, leading to increased vaccination rates, including many people being vaccinated for the first time, PSA notes. Independent research commissioned by PSA has revealed almost two-in-three Australians believe pharmacists should be able to administer a broader range of vaccinations.

PSA says it has consistently called for:

  • equitable access for consumers to a wider range of pharmacist administered vaccines across all States and Territories;
  • consistent regulation of pharmacist immunisers across all States and Territories;
  • increased consumer access to the National Immunisation Program (NIP) for all vaccines permitted to be administered by pharmacist immunisers in all States and Territories;
  • enhanced recognition of the role of pharmacist immunisers and the evidence-based benefits they provide to consumers, the health system, and to public health; and,
  • incorporation of pharmacist immunisers in Commonwealth and State/Territory immunisation campaigns, particularly the annual influenza immunisation campaign.

The COAG Health Council has tasked the Australian Health Protection Principal Committee to establish a working group which will consider and recommend options for a nationally consistent approach for pharmacist administered vaccinations.

“We look forward to working with the Australian Health Protection Principal Committee on this much-needed initiative,” Dr Jackson said.

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