The leader in COVID-19 shots? Nova Scotia.

FEBRUARY 2023 – Almost one in four (23%) of COVID-19 vaccines are administered in a pharmacy.

By the end of provincial governments’ fiscal year in 2022 (March 31)—which coincidentally is about year after vaccinations began in March 2021 in most provinces—approximately 18 million vaccinations took place in pharmacies out of a total of 79 million. It was an incredible feat for the profession, given the logistics involved (including cold chain management and supply allocations).

Which provinces were most successful in overcoming the logistical barriers?

To get at that answer, the Canadian Foundation for Pharmacy considered the peak number of participating pharmacies, documented in its COVID-19 chart, and divided that into the claims data from its latest Services Chart to calculate the average number of vaccinations per participating pharmacy.

Which province recorded the highest count of COVID-19 shots per pharmacy?

Nova Scotia, by far.

Nine out of 10 (285 out of 315) pharmacies in Nova Scotia were administering the vaccines at some point and they submitted an estimated 1,350,000 claims by the end of March 2022, resulting in an average of 4,700 claims per participating pharmacy. (Note the claims are an estimate because Nova Scotia has yet to release its final number for COVID-19 vaccinations in pharmacies for fiscal year 2021-22. As captured in CFP’s COVID-19 chart, more than 1.3 million claims had been submitted as of March 21, 2022.)

Nova Scotia’s result of 4,700 is well over double the national average of 2,000 per participating pharmacy (which ended up being about 80% of all pharmacies in Canada).

Logistically speaking, Nova Scotia was the only province to successfully launch a centralized booking system, used by all vaccination sites. In addition to bookings, the CanImmunize app—purchased by government just months before vaccinations began—recorded patients’ consent, reported to the Public Health database, allocated supplies based on demand and billed for vaccine administration.

The Pharmacy Association of Nova Scotia worked closely with government to ensure the app met the needs of pharmacies as well as mass immunization sites and was instrumental in onboarding pharmacies. Last but not least, the decision was made early on to that pharmacies would eventually become the primary vaccination sites (unlike some provinces, which decided that mass immunization clinics would drive their campaigns).

New Brunswick ranks second after Nova Scotia, with an average of 3,700 COVID-19 shots per participating pharmacy (93% of all pharmacies, or 218 out of 234). They submitted at least 800,000 claims. (Note the claims are an estimate since final claims data was combined with data for influenza vaccines. As recorded in CFP’s COVID-19 chart, more than 800,000 claims had been submitted as of April 22, 2022.)

Like Nova Scotia, New Brunswick’s Regional Health Authority knew they could not roll out enough mass vaccination clinics to get the job done. Government hired a pharmacist to help with planning and serve as liaison with the New Brunswick Pharmacists’ Association. Another key and coincidental enabler that helped build capacity in pharmacies: pharmacy technicians gained the authority to immunize.

Alberta and Ontario are the two remaining provinces ahead of the national average of 2,000:

• 3,000 vaccinations per participating pharmacy in Alberta, with an estimated 1,430 pharmacies participating (91%) and 4.3 million claims submitted.
• 2,400 vaccinations per participating pharmacy in Ontario, with a participation level of 62% (2,957 pharmacies) and 7.2 million claims recorded for fiscal year 2021-22.

The remaining averages per province are:

• 1,800 per participating pharmacy in Saskatchewan, based on 382 pharmacies (85%) and 628,000 claims;
• 1,800 per pharmacy in Prince Edward Island, with 84,500 claims submitted by 48 of the province’s 50 pharmacies (96%);
• 1,400 per pharmacy in Manitoba, with 446,000 claims and 322 participating pharmacies (71%);
• 1,250 per participating pharmacy in B.C., with an estimated participation rate of 70% (about 1,000 out of 1,425) and 1.2 million claims;
• 1,200 per pharmacy in Québec, based on billings for 1.8 million claims from 1,465 participating pharmacies (76%); and
• 900 per pharmacy in Newfoundland and Labrador, where an estimated 160 pharmacies participated (78%) and submitted 146,800 claims. (Note that pharmacists did not start administering COVID-19 vaccines until June 1, about three months later than other provinces.)

Note: Numbers have been rounded for easier reporting.