OBJECTIVES : Influenza vaccination by pharmacists is effective in France since 2019, but has been ongoing for several years in other countries. We conducted a systematic literature review (SLR) to assess the public health and economic impact of influenza immunization by pharmacists to inform what could be the expected outcomes in France. We also looked at the number of influenza vaccinations performed in French community pharmacies (CPs) over the last two influenza seasons.

METHODS : A SLR was conducted on April 27^th 2021. PubMed, Embase and the NHS EED database were searched for articles published between 2016 and 2021. Outcomes of interest included change in coverage rate (VCR) and economic impact of the policy (expressed in $I 2020). The full protocol was approved in PROSPERO (CRD42021246681). The Assurance Maladie database was consulted to inform the number of reimbursed influenza vaccinations in French CPs.

RESULTS : A total of 18 studies were included over the 532 identified. Studies were conducted in the US, UK, Ireland, Canada, Switzerland and Portugal. Immunization by pharmacists increased influenza VCR up to 9.0% in adult and up to 10.7% in elderly populations. This intervention was cost saving in Nova Scotia (Canada) and Switzerland with a net benefit of $I4.22 and $I11.03 per vaccination respectively. Additionally, vaccination in CPs versus general practitioners was less costly in Canada and UK ($I10.63 vs $I11.32 and $I22.04 vs $I25.54 respectively). The policy started slowly in France, with 251 and 106,810 vaccination acts reimbursed in 2019/20 and 2020/21 respectively.

CONCLUSIONS : Influenza immunization by pharmacists either as administrators and/or educators has shown to improve VCR while remaining cost saving. Increase in VCR was observed across all ages and populations compared to settings where this service was absent. Results of this intervention in France should be further explored and could be extended to COVID-19 vaccines.