A review of the RSV vaccine pilot has said while it “demonstrated that pharmacists can effectively administer vaccinations within short start-up periods” it also said “current evidence does not show that this model improved overall vaccine coverage”.
The three main factors referenced to evidence this in a review of the pilot by the UK Health Security Agency (UKHSA) were “the lack of direct comparative data with general practice, limited reach among underrepresented groups, and the highly supported environment in which the pilot was delivered”.
It also said findings from this report “broadly align with those of a systematic review of literature evidence from England on community pharmacies (drawing largely on evidence from delivery of seasonal flu and COVID-19 vaccination) – which noted that there is no evidence to suggest CPs materially increase overall vaccination coverage, and no evidence that they reach populations that would not otherwise access vaccination via their GP.”
Read more: RSV jab pilot to expand by ‘up to’ 200 pharmacies
The UKHSA went on to stress that the “true impact of the pharmacy model on increasing vaccine uptake, especially among underserved populations, remains uncertain and warrants further evaluation.”
A total of 39 community pharmacies were commissioned to be part of the pilot in autumn 2024 in the East of England, to “supplement RSV vaccination for older adults and pregnant women”.
It ran from October 1 2024 to 20 February 2025 across two integrated care boards (ICBs).
Community pharmacies delivered “8,900 RSV vaccine doses”, which was “approximately 12% of all RSV vaccinations delivered across the two pilot ICBs”.
Limiting factors
The UKHSA concluded that there were several factors which limited the “generalisability of the findings and suggest that the pilot outcomes may considerably overestimate the feasibility and ease of expanding the model nationally”.
These factors included that the “mean output per pharmacy (241 doses) was similar to the GP mean (266)”.
The pilot was also designed to help “address populations that were undeserved by or would not otherwise attend” these vaccinations, but they found it just increased “choice of setting for those already likely to take up the offer”.
They found it did not have a large “impact on uptake, overall coverage or inequalities”.
Read more: Govt accepts advice to expand RSV vaccine eligibility
Participating pharmacies also faced “technical, operational and human resource challenges, as well as communication issues as barriers to delivery”.
The selection of pharmacies that were chosen were also sites that were “already well-prepared, experienced, and operationally ready to deliver”.
They also did not record “reflections from the participating GPs in these areas, or from and vaccinated individuals”, which would provide a “balanced view of the impact of the early adopter model”.
Another consideration the UKHSA raised in the report was that the inclusion of community pharmacies in the vaccination process “came late in the planning for the launch of this new vaccination programme”.
“Short turnaround”
There was also “a short turnaround time for the bidding process” for pharmacies to be involved in the pilot.
It was reported that “communication across delivery partners was fragmented with overlapping messages creating confusion” during the pilot, which the UKHSA partly attributed to its “late” rollout.
Several pieces of data recorded during the scheme relating to community pharmacies were also limited in use, as the report noted there was often no comparative data for various equivalent factors around vaccine uptake at GPs.
For example, 73% of people vaccinated at pharmacies “lived within 5 miles of the site” and almost a third “resided less than one mile away”.
Read more: NHSE national RSV campaign points patients to pharmacies
But, there was no “data on distance to provider for those vaccinated at GP sites, limiting the ability to compare geographic accessibility”.
Pharmacists also faced “challenges around payment mechanisms” during the pilot, relating to “coding problems” which was described as a“significant issue”.
The report did note that pharmacies may benefit from being able to build relationships as some pharmacists reported that patients “liked being vaccinated by someone they know and trust”.
They also could have benefited from “opportunistic or walk-in appointments”, but there was no “provided data” on this and no “qualitative feedback” from GPs about their relational benefits in increasing vaccine uptake.
Read more: Plans for ICBs to commission vaccines delayed by a year
The Company Chemists’ Association’s chief executive Malcolm Harrison said: “Achieving this level of impact on short notice is impressive. Even greater benefits could be realised with expanded commissioning, a longer lead-in, and time for services to fully embed.”
Contrary to the UKHSA’s analysis, he added: “Pharmacy-led vaccination programmes have the potential to deliver substantial benefits, particularly by improving access and addressing inequalities amongst underserved communities.”
He concluded by calling for the government to “build on the impact demonstrated in this pilot and commission community pharmacies to administer a whole range of NHS vaccinations”.
It comes after the government expanded the eligibility for the RSV vaccine for “residents in care homes for older adults” in February of this year.
Read more: ‘Commission by age’ for better vaccine uptake, urges CCA
Those eligible will be able to receive the vaccine from April 1, 2026.
The findings of the report also contrast with the Department of Health and Social Care (DH) revealing, in January, that it intended for pharmacists to be allowed to give “any vaccine against an infectious disease caused by a virus or bacteria”.
This was to “enable community pharmacies to provide wider outreach services and support a wider range of national vaccination programmes”.