A significant change to the Standards of Practice for Pharmacists and Pharmacy Technicians (SPPPT)—approved by Council to take effect February 1, 2025—will allow pharmacists, with the appropriate training, authority to administer drugs by injection to individuals two years of age or older.
Standard 7.7.3(a)(ii) of the new SPPPT states that a regulated member must not administer an injection for a drug or vaccine to a child younger than two years of age.
Standard 7.7.2(b)(iii) of the new SPPPT states that a pharmacist must, when administering a drug or vaccine by injection, ensure the pharmacist has all the required training specific to the age of the patient, route of administration, and the drug or vaccine being administered by injection.
Pharmacists with authorization to administer drugs by injection must have successfully completed a Canadian Council on Continuing Education in Pharmacy (CCCEP) competency-mapped accredited immunization and injection training program that includes content for administering injections to children between two and five years of age before administering injections to those in this age group. This training is included in many of the current programs but is also available as a separate course for those authorized pharmacists who have previously completed a course but did not receive training in this area.
In ACP’s current standards, regulated members cannot administer an injection for a drug or vaccine to a child younger than five years of age. Council approved this change after considering public need and a review of the policies of other pharmacy regulators across Canada.
Public need
Vaccination rates are trending downward for many patient groups, prompting ACP to explore opportunities to improve access to immunizations. Pharmacists have frequently reported that family members of their patients who are under age five struggle to access immunization services in a timely manner. Families reported frustration with having to take younger children to one provider and older children to another provider. As immunization services for younger children are limited, children under five years of age may not be receiving recommended vaccinations.
Review of pharmacy regulators
ACP’s review revealed that Manitoba, Ontario, Quebec, New Brunswick, Nova Scotia, Prince Edward Island, and Newfoundland all authorize pharmacists to administer injections to children as young as two years of age for influenza and COVID-19 immunizations. Ontario and Nova Scotia authorize pharmacists to provide COVID-19 immunizations to children as young as six months. Prince Edward Island has no minimum administration age limit for pharmacists when a drug or vaccine is prescribed by a medical practitioner or nurse. British Columbia authorizes pharmacists to administer injections to children four years and older.
Alberta, Saskatchewan, and the Yukon are the only jurisdictions that currently require children be at least five years of age to receive injections from a pharmacist.
Education available
A list of current Canadian Council on Continuing Education in Pharmacy (CCCEP) accredited programs is available on the Immunizations and Injections page of the CCCEP website. Multiple accredited programs either provide training specifically for children under five years old as part of the primary course curriculum, or as a separate program focusing on this population.
Pharmacists and pharmacy teams who plan on providing injections for children between two and five years of age after February 1, 2025, are encouraged to take steps to prepare themselves for this change. This may include updating site policies and procedures, and ensuring that authorized pharmacists have the training and competencies needed to provide injections to this population.
For more on the new SPPPT and the new Standards for the Operation of Licensed Pharmacies, refer to the standards page.
