Injection and Inhalation

The scope of pharmacy professionals continues to expand with the addition of Respiratory Syncytial Virus (RSV) vaccine to the list of vaccines that can be administered by injection to patients 5 years of age and older on December 12, 2023.

The RSV vaccine currently marketed in Canada, Arexvy, is approved for use in adults aged 60 years and older to prevent lower respiratory tract disease caused by respiratory syncytial virus. If a person doesn’t qualify for the free RSV vaccine (available to residents 60 years of age or older in long-term care homes, Elder Care Lodges, and retirement homes licensed to provide dementia care services), they can still purchase the vaccine from the pharmacy with a prescription from their doctor or nurse practitioner. Pharmacists cannot prescribe the vaccine.



Frequently Asked Questions

The Respiratory Syncytial Virus (RSV) vaccine was added to Schedule 3 of the regulations, giving injection-trained Part A pharmacists, registered pharmacy students, interns and pharmacy technicians the authority to administer the RSV vaccine to patients 5 years of age and older.

Influenza vaccines were also added to Schedule 3; the existing conditions of administration to patients 2 years of age and older and in accordance with accordance with Ontario’s Universal Influenza Immunization Program continue to apply.

COVID-19 vaccines will be under Schedule 3 as of April 1, 2024, when the current exemption under the Regulated Health Professions Act (RHPA) allowing pharmacy professionals to administer these vaccines will be revoked.

  • Part A pharmacists, registered pharmacy students and interns with injection training are authorized to administer substances listed in O. Reg. 202/94 by injection (Schedule 1) and inhalation (Schedule 2) for treatment purposes to assist patients with managing their medication therapy
  • The substances listed in Schedules 1 and 2 were updated and the AHFS Classifications were removed
    • Some substances are still limited to the purpose of patient education and demonstration only
    • Some substances are still limited to I.M. and S.C. routes of administration
    • Substances that are administered intranasally, for emergency use, or are no longer marketed in Canada, were removed
  • The I.V. route of administration via an established central or peripheral venous access device was added
    • Pharmacists cannot initiate venous access
    • Administration must be done in collaboration with a physician or nurse practitioner
    • Additional training and skills assessment must be completed to demonstrate competency

Schedules 1 and 2 were first enacted in October 2012 and updates to the list of substances came into effect on July 1, 2023. These updates were in response to the Minister of Heath’s request in May 2019, for which the Board approved and submitted the regulatory amendments in November 2019. As such, any substances marketed in Canada after this date were not considered. As part of the consultation process, a number of organizations, including professional associations and regulatory bodies were consulted, along with subject matter experts in pharmacy, medicine and public health. Details of the College’s open consultation, which closed on October 26, 2019, can be found on the College’s Expanding Scope of Practice Consultation webpage.

No. Pharmacists should retain their own documentation as evidence that they have completed theoretical and practical training, as well as an assessment of their competency, prior to engaging in this area of practice. This information can be included in their Learning Portfolio and provided if requested (by a patient, employer, the College, etc.). This information will not appear on the public register, Find a Pharmacy or Pharmacy Professional and the Glossary of Terms has been updated to explain that “Trained to administer injections” means the pharmacy professional has declared completion of an OCP-approved injection training course to administer subcutaneous (SC) and intramuscular (IM) injections. SC injections are administered in the fat layer underneath the skin (for example, insulin). IM injections are delivered into the muscle (for example, a flu shot). The substances a pharmacist or pharmacy technician are permitted to administer by injection are listed in Schedule 1 and Schedule 3 (Vaccines) of Ontario Regulation 202/94.