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Key facts

• Community pharmacies administer more vaccines in deprived communities compared to affluent ones
• Legislative changes now allow pharmacy technicians to administer Covid and flu vaccinations under a PGD
• Commissioning additional NHS vaccination services in pharmacies could free up over 400,000 GP appointments a year

Learning objectives

After reading this feature you will be able to:

• Understand the growing role of pharmacies in national vaccination programmes
• Recognise barriers and solutions to expanding pharmacy-based NHS vaccinations
• Explore training, workforce and commissioning strategies for sustainable vaccine services in pharmacy.

Community pharmacies have become indispensable to the UK’s vaccination landscape – and according to the Government’s 10 Year Health Plan for England, published in July 2025, pharmacy is set to play an even larger role in immunisation.

In recent years, pharmacies have expanded beyond Covid-19 vaccinations to pilot services for respiratory syncytial virus (RSV) and measles, mumps and rubella (MMR) immunisations. Many also provide locally commissioned or private vaccination services, including shingles, chickenpox and travel jabs.

For the 2025-2026 winter season, NHS England commissioned a trial advanced service allowing community pharmacies to vaccinate children aged 2 to 3 years against flu. Pharmacy is also involved in the NHS HPV catch-up programme. Legislation now enables pharmacy technicians to supply and administer certain vaccines under a patient group direction.

Alastair Buxton, director of NHS Services at Community Pharmacy England, says: "Our economic analysis shows that commissioning a wider range of vaccination services from community pharmacies would deliver a benefit to society of more than £84 million, for a cost of around £16 million.”

By offering highly accessible vaccination services, the sector can make a big impact in reducing health inequalities. According to the Pharmacy Vaccinations Development Group (PVDG), vaccination uptake via pharmacies is higher in deprived communities.

“Analysis conducted by the Office of Health Economics found that for flu vaccinations administered in pharmacies in the most deprived quintile, there is a 16 percent higher use versus the least deprived quintile,” says Buxton.

This pattern suggests that NHS shingles and pneumococcal vaccinations could see increased uptake and reduced inequalities if pharmacies were commissioned more broadly, while also freeing up over 400,000 GP appointments per year.

Pharmacies also attract patients who opt for private vaccinations due to convenience. Dorset pharmacist and NPA board member, Mike Hewitson, says: “Quite a few patients come into the pharmacy for the private shingles vaccine and are prepared to pay for the convenience because they have missed their NHS appointment. Perhaps the GP service wasn’t accessible due to inconvenient appointment times, or there was a lack of appointments in the first place.”

Commissioning gaps are barriers to vaccine services expansion

Despite the clear benefits to public health, vaccination expansion through pharmacies faces challenges. Alwyn Fortune, Royal Pharmaceutical Society policy lead in Wales, stresses that support for pharmacists performing these roles is crucial.

“Clear clinical pathways, consistent commissioning across the UK and better integration with GP and local services would support joined-up care and enable pharmacy teams to deliver a wide range of vaccinations,” he says.

Malcolm Harrison, chief executive of the Company Chemists’ Association (CCA), identifies commissioning gaps as the primary barrier to service expansion. Variation in services makes it difficult for patients to know where vaccines are available. “The NHS has the ability to commission additional vaccine programmes, and when it does so – for instance, with childhood flu – pharmacies respond,” he points out.

Buxton adds that sustainable expansion requires collaboration on service specifications and appropriate funding, while being mindful of workload pressures at the same time. Ensuring sufficient resources will enable pharmacy owners to dedicate staff and time to delivering additional NHS vaccination programmes, he says.

Training embedded in pharmacy practice

Training is already well embedded in pharmacy vaccination practice. UK Health Security Agency (UKHSA) guidance in June 2025 reinforced national minimum standards and a core curriculum for vaccination training.

“Pharmacy teams providing vaccination services have to undertake annual update training and consider whether they need to repeat face-to-face training on injection technique and basic life support, as well as reviewing service specifications and pharmacy SOPs each year,” says Buxton.

Most pharmacists are now experienced vaccinators. Graham Thoms, chief executive of clinical services provider Pharmadoctor, notes that “pharmacists have vaccinated millions of patients already since we created the UK’s first private pharmacy vaccination service for flu in 2003”.

For more complex services such as travel health, comprehensive online training is required. Mike Hewitson points out that most vaccination procedures are similar across various services, manageable within normal pharmacy workflows and take around 5 to 15 minutes to complete.

Service setup has become a straightforward process for private providers. Pharmadoctor offers complete “plug and play” packages, including training, clinical support, consultation software, PGDs, dashboards, marketing and appointment management.

Access models also vary. Pharmacies can combine walk-ins with pre-booked appointments, offering flexibility for patients and their own workflow organisation. Vaccine supply models must adapt to demand, with better integration into the National Booking System (NBS) encouraged to manage NHS and private stock efficiently.

Regulatory amendments now enable the supply of Covid, MMR, RSV and pertussis vaccines from national stocks.

Dealing with vaccine hesitancy

Vaccine confidence is central to immunisation uptake, yet hesitancy is growing. However, research from Imperial College London, published in The Lancet in January 2026, shows vaccination hesitancy can be addressed by providing accurate information.

“Through open dialogue, myth busting, and giving clear, evidence-based information during consultations, pharmacists can help to address vaccine hesitancy and build confidence in immunisation programmes,” says Alwyn Fortune.

A 2022 review found that vaccine hesitancy was more common among individuals from Black, Asian and mixed ethnic backgrounds. The 2021 population census also found that Black/Black British adults had the highest rates of vaccine hesitancy (21 per cent) in Great Britain. It also found that adults living in the most deprived areas are more likely to report vaccine hesitancy (8 per cent) than adults living in the least deprived areas (2 per cent).

To achieve herd immunity, the World Health Organization recommends childhood vaccination rates of 95 per cent. According to the CCA, in 2023/24 no vaccines met this target, putting children at risk of catching severe diseases. Only 83 per cent of five-year-olds received both doses of the MMR jab and just 89 per cent of five-year-olds had received the Hib/Men C vaccine – well below the rate required for herd immunity.

Indeed, the UK has lost its WHO measles elimination status. Over 3,500 cases of measles were recorded in 2024, the most severe outbreak of the virus in almost a decade. “It is natural that people have questions and concerns about vaccines. Community pharmacies are well placed to answer questions, provide reliable information and dispel myths,” says the CCA.

Pharmacy staff members are often live in the area they work in and already hold strong, trusted relationships with local populations, so are “particularly well positioned” to understand culturally relevant factors, the trade body points out.

Tackling vaccine hesitancy involves three key factors:

• Trusted advice: pharmacy staff can address patient concerns and correct misinformation
• Convenience matters: community pharmacies offer flexible access, increasing uptake and opportunities to discuss patients’ nervousness about vaccinations
• Equity: personalised, culturally sensitive guidance helps reach underserved populations with accurate, evidence-based information.

Future opportunities to reduce immunisation inequality

Researchers through the NIHR Health Protection Research Unit, launched in September 2025, are examining pharmacy delivery of RSV vaccines for those aged 75 and above. The study aims to assess uptake, service reach and its potential to reduce inequalities.

The CCA advocates for the full commissioning of NHS vaccination services in pharmacies, starting with shingles and pneumococcal jabs for older adults, and expanding RSV and HPV immunisations. “An obvious first step would be to provide additional NHS vaccines for eligible older adults," says Harrison. "We hope to see the RSV vaccination programme continue to expand and roll out across the country.”

Graham Thoms highlights the potential for private vaccination growth alongside NHS service expansion. For instance, more patients aware of pharmacy capabilities could translate into additional opportunities, as seen with Pharmadoctor’s Covid jab service.

Pharmacy teams will need time to upskill and prepare for expansion. However, Harrison points out that with more widespread commissioning and earlier communication on the scope and timelines of vaccination programmes, “pharmacy teams will be better able to integrate vaccination services into their workload, employ additional staff, extend opening hours or hold specific appointment slots”.

Summary

Community pharmacies are no longer just a convenient option for flu jabs – they are central to the UK’s entire immunisation strategy. With legislative support, robust training, equitable access and well-designed commissioning pathways, they can continue to deliver vital vaccines, reduce health inequalities and relieve pressure on the NHS by building capacity.

Pharmacies have demonstrated they can adapt quickly to meet the needs of millions of patients and could deliver an additional 10 million vaccines each year. This would improve population health and support the needs of underserved patient groups with traditionally lower vaccine uptake.

It looks increasingly likely that the future of the UK’s vaccination and immunisation policy lies in community pharmacies. Teams should prepare themselves: the opportunities are only set to grow.