A patient came into the pharmacy and ask the pharmacist to “prescribe” a vaccine. If the patient has a drug plan that pays for the vaccine can the pharmacist write the prescription and administer the vaccine? Is this similar to how we bill publicly-funded flu shots.

Billing a prescription to a third party payer does not have any bearing on the scope of practice of pharmacy defined by the Pharmacy Act and Ontario Regulation 256/24. Vaccines (listed in Schedule 3 of the regulation) may be administered under independent authority in accordance with the Administering a Substance by Injection Guideline. Vaccines listed in Schedule I of the NAPRA Drug Schedules require a valid prescription in order to be dispensed prior to administration. 

To receive reimbursement for influenza, which is a Schedule II vaccine, a claim is submitted to ODB via the Health Network System. This requires the pharmacist to enter information similar to that of a prescription, with the pharmacist’s identification in the ‘prescriber’ field (refer to the Ministry of Health and Long- Term Care’s Executive Officer communications). As this is a billing mechanism (which also creates documentation for the patient) it should not be interpreted as prescribing the vaccine, as pharmacists do not have the independent authority to do so.