Case study: Pharmacists & flu vaccines in Portugal

Gary Finnegan

Gary Finnegan

October 10th, 2013

Gary Finnegan

‘When it comes to pharmacy-based flu vaccination, Portugal has led the way in Europe. Huge numbers of pharmacists have been trained, vaccination rates are up, and the public is happy. What can others learn?’

Pharmacists-and-flu-vaccines-in-Portugal2In 2007 new Portuguese legislation was passed allowing pharmacists to expand their work into a number of areas, including immunisation. A major training drive was launched in 2008 leading to the first nationwide pharmacy-based flu immunisation campaign during the 2008/2009 flu season.

Now, five years on, Portugal is becoming a case study for how to roll out vaccination in pharmacy while safeguarding public safety.

“Some European countries – for example, the UK, Ireland, France and Switzerland – have requested detailed information on our experience in Portugal, either because they are already providing this service through pharmacies, or because they are planning to initiate something similar,” said Suzete Costa, Executive Director of the Centre for Health Evaluation & Research (CEFAR).

She added that Portuguese authorities and pharmacist groups have been asked to present the Portuguese case study at several conferences.

Immunisation in pharmacies is well-established in the US and Australia but is in its cy in Europe.

Read: ‘Pharmacists can play a key role in immunisation’



In preparing for the 2008/2009 flu season, Portugal’s National Association of Pharmacies (ANF) developed a training programme on immunisation which was swiftly rolled out across the country.

In the first year, 11 training sessions on Pharmacy-Based Immunisation Delivery and 66 sessions on Basic Cardiac Life Support were planned. Almost 2,000 pharmacists from 1,273 pharmacies – representing half of all Portuguese pharmacies – completed the basic course, with 83% of these also completing the life support course.

During flu season, around half of the participating pharmacists shared their records with the ANF. This showed that 93.5% of all pharmacy-based immunisations were performed by pharmacists and at least 160,000 people were vaccinated in pharmacies during the campaign.

Most patients were over 65 years (63.8%) and a small majority (54.4%) were female. The average number of patients vaccinated per pharmacy was 206.

According to ANF data for the 2008/2009 flu season, there was no record of anaphylaxis among people immunised in pharmacies. A patient survey showed that people vaccinated in community pharmacies were highly satisfied with the experience and would recommend it to others. This is in line with similar studies in the US where pharmacy-based flu vaccination is well established.


Meeting targets

Up to one in four people who were vaccinated during flu season received their flu vaccination in a pharmacy. This is a considerable contribution to reaching flu immunisation targets.

Portugal had been meeting an earlier target of 50% flu vaccination coverage among people aged 65 and older but the newer 75% target set by EU health ministers in 2010 is more challenging.

However, the ANF says this represents an opportunity for Portuguese pharmacists to take the lead and contribute to hitting the newer, more ambitious goal.

Meanwhile, it is expected that immunisation training for pharmacists will continue to expand in the coming years as more pharmacists begin to offer the service. Pharmacists in Portugal are also calling for this training to be integrated into the undergraduate curriculum of university pharmacy courses in order to adapt to “changing times and changes in practice”.

Would you have a flu vaccine at your local pharmacy?