Do community pharmacists add value to routine immunization programmes? A review of the evidence from the UK

Background: Community pharmacies are an important setting for the provision of preventative health services in the UK. There has been debate over the value of delivering routine immunizations in a pharmacy setting, though government policy supports this initiative and in 2015 the first nationally commissioned community pharmacy vaccination service was launched for seasonal influenza vaccination. The impact of these vaccination services needs to be evaluated to inform future policy. Methods: We conducted a comprehensive review of peer-reviewed studies and unpublished evaluations of community pharmacy-based vaccination services implemented in the UK between 2000 and 2015. We assessed evidence of their impact on acceptability, uptake, cost-effectiveness and addressing inequalities. Results: We identified 28 evaluations of pharmacy immunization programmes in the UK, only three of which were published in peer-reviewed journals. These showed no evidence of increased vaccination uptake, and weak evidence of widening access to individuals who had not previously been vaccinated. There was good evidence that pharmacies were acceptable and convenient venues for vaccination. Cost-effectiveness was not assessed in any of the included studies. Conclusions: Our review challenges an assumption that pharmacy provision of immunizations will simultaneously improve patient choice, increase uptake and widen access. These are important findings for policy makers.