The New South Wales Government has announced a significant expansion of its influenza vaccination program, permitting qualified pharmacists to administer flu shots to children as young as two years old. The move, welcomed by the Pharmaceutical Society of Australia (PSA), aims to increase immunisation rates among young families, reduce barriers to access and ultimately curb the seasonal surge in influenza cases. With vaccination coverage among the six-month to five-year age group declining in recent years, health authorities are calling on all immunisation providers—GPs, nurse practitioners and pharmacists—to collaborate in safeguarding New South Wales communities this winter.
Background: Declining Vaccination Rates in Young Children
Flu vaccination rates among NSW children aged six months to five years have fallen by nearly 10 percentage points over the past three seasons, according to NSW Health data. Experts attribute the decline to pandemic-related disruptions, vaccine hesitancy fueled by misinformation, and logistical challenges that make GP-clinic visits difficult for busy families. Although the National Immunisation Program funds free influenza vaccines for children under five, accessibility has remained uneven, particularly in regional and rural areas where medical practices may be scarce.
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Why Pharmacist-Delivered Vaccination Matters
Pharmacists are among the most accessible healthcare professionals in Australia. Nearly every suburb and town hosts a community pharmacy, making it easier for families to receive vaccinations outside of traditional clinic hours. The PSA points out that pharmacists have already become key players in adult immunisation: since 2021, pharmacist-administered influenza vaccines for those aged 18 and over have grown by 60 percent, helping to raise overall adult vaccination rates above 80 percent in some demographics. Extending pharmacist vaccination rights to younger age groups promises to replicate that success for children.
Regulatory Change: Removing Red Tape
Under previous regulations, pharmacists in NSW were permitted to vaccinate patients aged 10 and older against influenza, provided they held an approved immuniser qualification. The Minns Government’s directive expands that age threshold downward to two years, aligning NSW with other Australian jurisdictions such as Victoria and Queensland that already permit pharmacist administration to younger children. In practical terms, the regulation change simply adjusts the “schedule of eligible patients” in the Public Health Act, allowing immuniser-qualified pharmacists to inoculate children without requiring a GP referral or standing order.
PSA Endorsement and Call to Action
PSA President Luke Kelly praised the Government’s decision as a “crucial step” toward enhancing equitable access to vaccines. “Pharmacists are accessible, knowledgeable, and trusted immunisers, delivering more vaccinations than ever before,” Kelly said. He urged all pharmacist immunisers across the state to “fully utilise their skills and expertise to drive influenza vaccination uptake this winter.” The PSA has rolled out updated training modules on pediatric immunisation techniques, adverse-event management and parent communications to ensure pharmacists are fully prepared for the expanded age range.
Implementing the Program: Pharmacy Logistics and Training
Community pharmacies that choose to offer childhood flu vaccination must meet a series of readiness benchmarks. These include dedicated immunisation consulting areas with privacy screens, refrigeration systems capable of maintaining vaccine cold-chain integrity, and emergency kits equipped with anaphylaxis management supplies. Pharmacist immunisers must complete a PSA-accredited pediatric immunisation workshop, which covers injection technique on young children, strategies to reduce discomfort, and protocols for obtaining informed parental consent. Additional online refresher courses on influenza virology, vaccine composition and contraindications ensure pharmacists are equipped to answer parental questions confidently.
Benefits for Families: Convenience and Co-Vaccination Opportunities
By enabling flu shots for two- to nine-year-olds at local pharmacies, parents gain greater flexibility in scheduling immunisations. Many pharmacies offer extended hours, including evenings and weekends, and do not require advance appointments for vaccinations. This flexibility is particularly beneficial for working parents and families juggling childcare responsibilities. Moreover, pharmacies that also offer other routine immunisations—such as the combined measles-mumps-rubella (MMR) vaccine or adolescent booster shots—can set up co-vaccination clinics, allowing children to receive multiple vaccines in a single visit. Such “one-stop shop” models not only improve overall vaccine coverage but also reduce missed opportunities for essential childhood immunisations.
Public Health Implications: Reducing Influenza Transmission
Influenza remains a leading cause of childhood hospitalisations in Australia. Each year, thousands of children under five are admitted to hospital with flu complications, including pneumonia, dehydration and secondary bacterial infections. Expanding access to flu vaccines through pharmacies can mitigate these outcomes by raising coverage before the peak of the season. A modelling study conducted by the University of Sydney estimates that a 10 percent increase in vaccination rates among two- to five-year-olds could prevent up to 1,200 hospital admissions and save AU$8 million in healthcare costs annually.
Addressing Misinformation and Vaccine Hesitancy
Despite clear benefits, some parents remain hesitant to vaccinate young children against influenza. Common concerns include fears about adverse reactions, misconceptions that the flu is “just a bad cold,” or beliefs that natural immunity is preferable. To counteract misinformation, the PSA has partnered with NSW Health to produce evidence-based communication materials, including infographics, short videos featuring pediatricians and pharmacists dispelling common myths, and social-media campaigns promoting the safety and efficacy of flu vaccines in young children. Pharmacies are encouraged to display these materials in-store and share them via their digital channels.
Pharmacist-GP Collaboration: A Team-Based Approach
While pharmacists can now offer flu shots to two-year-olds and older, GPs and nurse practitioners continue to play a vital role—particularly for infants aged six months to under two years, who still require immunisation in a clinical setting. The PSA emphasises that pharmacy vaccination services are designed to complement, not replace, general practice. In many areas, pharmacies have established referral pathways to local GPs: if a child under two presents for a flu shot, or if a child has complex medical history, the pharmacist refers the parent to a GP for assessment and vaccination. This coordinated approach ensures vulnerable infants receive appropriate care while alleviating pressure on busy medical clinics.
Equity in Regional and Remote Areas
Rural and remote communities often face shortages of medical practitioners, leading to reduced immunisation access. Community pharmacies in these regions—already trusted healthcare hubs—are now well positioned to fill immunisation service gaps. The PSA is working with NSW Rural Health Network to support remote pharmacists in obtaining immuniser qualifications, setting up cold-chain equipment, and overcoming logistical hurdles such as vaccine supply disruptions. Mobile pharmacy units, sometimes operating from vans or pop-up clinics at community events, are also being mobilised to reach Indigenous populations and other underserved groups.
Funding and Cost Considerations
Influenza vaccines remain funded under the National Immunisation Program (NIP) for all children aged six months to five years, meaning there is no out-of-pocket cost for eligible children receiving the vaccine at participating pharmacies. Pharmacists bill Medicare directly for the service, while the cost of the vaccine itself is covered by the federal government. The PSA has secured temporary transitional funding from NSW Health to assist smaller pharmacies in rural areas with equipment grants and training subsidies, ensuring equitable rollout across the state.
Measuring Success: Data Collection and Reporting
To monitor the impact of expanded pharmacist vaccination, NSW Health and the PSA will track key performance indicators, including:
• Number of influenza vaccines administered by pharmacists to two- to nine-year-olds
• Changes in overall vaccination coverage rates in the two-to-five-year and six-to-nine-year age cohorts
• Regional distribution of vaccines administered, with attention to rural and remote uptake
• Adverse event reporting rates and safety monitoring outcomes
Pharmacies will report vaccinations through the Australian Immunisation Register (AIR) in real time, ensuring that children’s records remain up to date and that school-entry requirements can be verified accurately.
Community Feedback and Anecdotal Evidence
Early adopter pharmacies in Sydney’s inner west and Newcastle have already reported enthusiastic community response. One pharmacist, Sarah Nguyen of Marrickville Pharmacy, described the atmosphere on her first weekend clinic: “We had parents bringing in siblings aged two through ten—one family even got their entire household of six vaccinated in a single morning. The smiles, the relief, the thank-you notes—it felt like a real win for public health.” Parents cited convenience, shorter wait times and trust in their local pharmacist as key motivators.
Challenges and Future Directions
While the initial rollout has been promising, challenges remain. Some pharmacies report supply-chain delays in securing pediatric-formulated pre-filled syringes, and peak-season demand can outstrip staffing capacity for extended immunisation clinics. To address this, the PSA is working with vaccine distributors to prioritise shipments to high-demand areas and encouraging pharmacies to pre-schedule clinics during school holidays. Looking ahead, the PSA will advocate for extending pharmacist vaccination rights to other childhood immunisations—such as the human papillomavirus (HPV) and meningococcal vaccines—to further strengthen community immunity.
Conclusion
By empowering pharmacists to vaccinate children aged two and above against influenza, New South Wales takes a forward-looking step in expanding access, reducing barriers and protecting its youngest residents from seasonal flu. The collaboration between the Minns Government, NSW Health and the Pharmaceutical Society of Australia exemplifies a collective commitment to public health innovation. As the winter season approaches, families across the state now have a convenient, no-cost option to ensure their children are fully protected—whether during a quick pharmacy trip on the way home from work or as part of a family vaccination outing. With ongoing data monitoring, targeted community outreach and sustained professional training, the expanded program promises to strengthen immunisation coverage, reduce hospitalisations and solidify pharmacists’ role as trusted immunisers in the fabric of NSW’s healthcare system.
