Home Regulations & Standards COVID-19: Information for Pharmacy Professionals

COVID-19: Information for Pharmacy Professionals

Page Updated May 26, 2023

Latest updates:

- Updated information on prescribing and dispensing publicly funded Paxlovid added.

Important Reminders:

- As the pandemic continues to evolve, registrants are reminded to review and keep up-to-date on guidance from the Ministry of Health, including monitoring their Microsoft Office 365 email account for updates.

This page provides the latest updates on COVID-19 for pharmacy professionals and is updated frequently. The College continues to collaborate with the Ministry of Health, public health officials and other health system partners and professional associations to inform and support pharmacy professionals.

For the College’s latest email updates, please visit the e-Connect page of our website.

If you are a patient, please visit the COVID-19 Information for Patients webpage.

On January 13, 2021, the provincial government amended Ontario Regulation 107/96 under the Regulated Health Professions Act (RHPA), exempting a part A pharmacist, intern, registered pharmacy student or pharmacy technician from subsection 27 (1) of the Act for the purpose of administering a coronavirus (COVID-19) vaccine by injection.

Community pharmacies offering this service must follow expectations outlined in the Guidance for Providing COVID-19 Services in Community Pharmacies.

The exemption permitting pharmacy professionals to administer the COVID-19 vaccines applies to all age groups, including infants and children six months to five years of age.

The College has developed a guidance document titled Administration of COVID-19 Vaccine by Pharmacy Professionals which outlines expectations and resources for pharmacy professionals administering COVID-19 vaccines and serves as a supplement to the Executive Officer Notices and other COVID-19 vaccine-relevant guidance from the Ministry of Health, below:

Ministry of Health COVID-19 Vaccine-Relevant Information and Planning Resources
Ministry of Health COVID-19 Vaccine Guidance – updated December, 2022
Ministry of Health Executive Officer Notices Regarding Vaccine Administration in Pharmacies (updated regularly):
- Administration of Publicly Funded COVID-19 Vaccine in Ontario Pharmacies – Eligibility
- Administration of Publicly Funded COVID-19 Vaccine in Ontario Pharmacies – Billing
- Questions and Answers for Administration of Publicly Funded COVID-19 Vaccine in Ontario Pharmacies

Helpful Resources

Resources for Healthcare Professionals

Canadian Pharmacists Association
- Pharmacy Top Tips: Childhood Vaccinations. Setting your pharmacy up for success
- Preparing for a child’s vaccine appointment
Canadian Vaccination Evidence Resource and Exchange Centre (Canadian Public Health Association)
Centre for Effective Practice – COVID-19: Vaccines
Children’s Healthcare Canada
- Immunizing Children with Confidence
Government of Canada
- Health Care Provider Vaccines Tool Kit
Immunize Canada has a number of resources for healthcare professionals, including information on the CARD system
- Pain Management During Immunizations for Children
- CARD System
  - Improving the vaccination experience: Comfort positions
  - Webinar: Needle fear, pain and vaccines: Introduction to the CARD system as a framework for vaccination delivery
ISMP Canada Safety Bulletins
National Collaborating Centre for Infectious Diseases
- Supporting Vaccine Confidence in Indigenous Peoples
National Advisory Committee on Immunization (NACI) Webcasts (includes Public Health Agency of Canada webcasts)
University of Waterloo School of Pharmacy
- Infographic: Timing of COVID-19 vaccines for young children
- Infographic: What are the reasons to vaccinate my young child against COVID-19?

GUIDANCE AND REPORTING

Guidance on Pharmacy Professionals Wearing Masks

The College expects pharmacy professionals to follow current public health recommendations.

The following is a list of selected resources:

Universal Mask Use in Health Care (Public Health Ontario)
Focus on Universal Mask Use in Healthcare Settings and Retirement Homes (Public Health Ontario)
COVID-19 medical masks and respirators: Information for health professionals (Public Health Agency of Canada)

The College strongly encourages the continued use of masks in all pharmacies to further protect patients and staff, particularly when interacting with patients and providing professional services.

Provincial Guidance for Pharmacies

The Ministry of Health webpage for healthcare providers provides important updates and resources.
COVID-19 Health Care Resources from Public Health Ontario, including infection prevention and control guidance.
Management of Cases and Contacts of COVID-19 in Ontario
For the latest case numbers in Ontario, visit the Status of Cases in Ontario webpage.

Patients and members of the public should be directed to the Ministry’s COVID-19 self-assessment.

Public Health Reporting Requirements

As outlined in the Ministry of Health’s COVID-19 Provincial Testing Guidance, positive rapid antigen test results do not require confirmatory testing in most settings, or reporting to the public health unit, unless otherwise recommended by the public health unit or sector specific guidance.

Other than rapid antigen tests and self-test kits, positive COVID-19 tests performed using a Health Canada approved test or an assay validated by the laboratory must be reported to the local public health unit as per the LSCCLA’s Reg 682 and/or under the Health Protection and Promotion Act. You can find the contact information for your local public health unit using the Ministry’s Public Health Unit Locator.

Hospital pharmacists and technicians should be familiar with the hospital’s policy and procedures, including the expectation of pharmacists, if any, for reporting suspected cases of COVID-19 among inpatients and outpatients.

Resources from Associations

A number of pharmacy associations have made their COVID-19 resources available to all pharmacy professionals, including:

PATIENT CARE

Paxlovid™ – Prescribing & Dispensing

May 2023 update: Ontario Health is advising that Paxlovid™ can cause severe interactions with some transplant medications and solid organ transplant recipients should not take Paxlovid™ without first speaking to their transplant care team. Solid organ transplant recipients who test positive for COVID-19 should be directed to contact their transplant care team to receive the appropriate COVID-19 therapeutics and follow-up care.

As announced by the Ontario government, as of December 12, 2022, O. Reg.107/96 – Controlled Acts, under the Regulated Health Professions Act (RHPA), was amended to authorize a Part A pharmacist to prescribe Paxlovid™ (nirmatrelvir/ritonavir) antiviral treatment for COVID-19 in accordance with section 16 of the regulation and the eligibility criteria set out by the Ministry of Health.

Pharmacists must possess the required clinical knowledge, skills and competency to prescribe and/or dispense Paxlovid™ for eligible individuals. A comprehensive patient assessment is required to identify and manage potential drug therapy problems (such as drug interactions, contraindications, the need for dosage adjustments, etc.) or to determine whether a referral to a primary care provider is necessary. Pharmacists offering this service must follow expectations outlined in the Initiating, Adapting and Renewing Prescriptions Guideline.

Additional resources to support pharmacists with clinical decision-making and links to the Ministry of Health Executive Officer notices can be found below. Resources related to screening protocols and IPAC measures can be found under Pharmacy Operations – Infection Prevention and Control Measures.

No other registrant (i.e., Part B pharmacist, registered pharmacy student, intern, pharmacy technician, pharmacist (emergency assignment), or pharmacy technician (emergency assignment)) is authorized to prescribe Paxlovid™.

For more information, please reference the resources below:

Ontario COVID-19 Science Advisory Table
- COVID-19 Drug Interactions Checker
University of Waterloo School of Pharmacy / University of Toronto Leslie Dan Faculty of Pharmacy
- Nirmatrelvir/Ritonavir (Paxlovid): What Prescribers and Pharmacists Need to Know
- Paxlovid for a Patient on a DOAC
Canadian Pharmacists Association
- Treatment of COVID-19 with Paxlovid™

Centre for Effective Practice (CEP)
- COVID-19: Clinical Guidance for Primary Care Providers
Government of Canada
- COVID-19 vaccines and treatments portal

Renal function (eGFR) calculators (examples):

Controlled Drugs and Substances Act (CDSA) Exemption

Health Canada’s section 56 (1) exemption from the Controlled Drugs and Substances Act has been extended to September 30, 2026 authorizing pharmacists to:

Accept a verbal order from a prescriber for a controlled substance.
Transfer a prescription for a narcotic or controlled drug to another pharmacist in Canada. If it has already been transferred, it may be transferred to another pharmacist.
Transfer a prescription for a benzodiazepine or other targeted substance to another pharmacist. If it has already been transferred, it may be transferred to another pharmacist.
Refill a prescription for a benzodiazepine or other targeted substance if more than one year has elapsed since the date it was written
Renew a prescription for a controlled substance.
Adapt a prescription for a controlled substance, including part-filling or de-prescribing.

To align with this extension, amendments to O. Reg. 202/94 (General) made under the Pharmacy Act, 1991 have been approved by the Ontario government. These changes continue to temporarily allow pharmacists to renew and adapt prescriptions for controlled drugs and substances until September 30, 2026.

Health Canada has also issued:

Please contact Health Canada for questions concerning the exemption at HC.compliance-conformite.SC@canada.ca.

CDSA Exemption – OCP Resources for Pharmacy Professionals

To support the profession in adapting to these temporary CDSA changes, the College has updated a number of resources for pharmacy professionals to reflect these interim measures:

COVID-19 Testing and Screening in Community Pharmacies

See the Ministry of Health COVID-19 Guidance for the Health Sector – Symptoms, Screening and Testing Resources

COVID-19 Testing (Laboratory Based PCR Testing)

The College has created GUIDANCE – Providing COVID-19 Services in Community Pharmacies outlining the College’s expectations for Designated Managers, registrants and community pharmacies opting to provide COVID-19 testing (including the specimen collection required to perform a test) to the public.

For information on publicly-funded laboratory-based PCR testing in pharmacies, refer to the Ministry of Health Executive Officer Notices.

COVID-19 Screening (Antigen Point-of-Care Testing (POCT))

On March 3, 2021, section 10 of Reg. 683 under the Laboratory and Specimen Collection Centre Licensing Act was amended and, as a result of the exemptions enacted, any person may collect specimens for COVID-19 point-of-care testing. When performed by pharmacy professionals, the Standards of Practice and Code of Ethics expect registrants to recognize and work within the limits of their competence and to only practice when they have the appropriate knowledge and skill to do so safely. Training materials for conducting antigen POCTs are available from Ontario Health.

For these and any other COVID-19 testing and screening initiatives, please refer to Ministry of Health COVID-19 Guidance for the Health Sector – Symptoms, Screening and Testing Resources. For further inquiries, please send an email to: PublicDrugPrgrms.moh@ontario.ca.

Managing Opioid Agonist Treatment (OAT)

CRISM Guidance

The Canadian Research Initiative in Substance Misuse (CRISM) has developed six national guidance documents to address the urgent needs of people who use substances, service providers and decision makers in relation to the COVID-19 pandemic.

Access the six guidance documents.

CAMH Guidance

The Centre for Addiction and Mental Health (CAMH) has provided new guidance to pharmacists and prescribers for dispensing and prescribing of OAT that will assist in the provision of collaborative patient care during COVID-19 pandemic.

Providing Influenza Immunization Services

Suggested Best Practices for Community Pharmacies Providing Influenza Immunizations During the COVID-19 Pandemic (Canadian Pharmacists Association)

Treatment Advisories

Advisories on Hydroxychloroquine, Chloroquine and Ivermectin

Virtual Care

The Virtual Care Policy (June 17, 2021) describes the College’s expectations of pharmacy professionals when providing virtual care. The Information and Privacy Commissioner’s Guideline – Privacy and Security Considerations for Virtual Healthcare Visits provides additional considerations.

PHARMACY PROFESSIONAL TRAINING, HEALTH AND SAFETY

Emergency Assignment Registration

The College has initiated emergency assignment registration to address the workforce need for additional pharmacists and pharmacy technicians that has arisen due to the COVID-19 pandemic.

The government of Ontario is also recruiting experienced healthcare professionals. Please visit the COVID-19 Health Care Provider Recruitment webpage.

Illness and Return to Work

The Canadian Pharmacists Association has developed a list of key considerations for pharmacy managers/owners to help them prepare for next steps if a pharmacy staff member is exposed to or infected with COVID-19.

Please refer to the Management of Cases and Contacts of COVID-19 in Ontario for recommendations related to healthcare workers return to work.

Mental Health Support

A variety of mental health resources and services are available to healthcare workers during the pandemic, including:

Personal Protective Equipment (PPE) Supply

The College supports pharmacy professionals having access to Personal Protective Equipment (PPE) during the COVID-19 pandemic, not only to protect their own health and safety, but those of their patients.

PHARMACY OPERATIONS

Infection Prevention and Control Resources

Please see the following resources related to implementing and maintaining infection prevention and control activities:

IPAC Measures Memo from Ontario’s Chief Medical Officer of Health (December 30, 2021)
Best Practices for Environmental Cleaning for Prevention and Control of Infections in All Care Settings (Public Health Ontario)
IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19
(Public Health Ontario)
Patient Safety and Infection Prevention and Control (Winter 2020 Pharmacy Connection article)
A Pharmacist’s Guide to Pandemic Preparedness, see Environmental Cleaning section (Ontario Pharmacists Association)
PPE: Suggested Best Practices for Pharmacies During the COVID-19 Pandemic (Canadian Pharmacists Association)
Interim COVID-19 infection prevention and control in the health care setting when COVID-19 is suspected or confirmed (Government of Canada)
Optimizing the Supply of PPE During the COVID-19 Pandemic (Ontario Health)

Sterile Compounding and Personal Protective Equipment Shortages

The College is providing guidance and information to support pharmacists and pharmacy technicians who are performing sterile compounding where there is a documented shortage of personal protective equipment (PPE).

As always, the priority must be both a sterile, quality compounded preparation and the protection of the personnel involved in compounding.

Review the Guidance on Shortages of Personal Protective Equipment (PPE) for Sterile Compounding During Coronavirus Pandemic.

Helpful Links

Public Health Agency of Canada

World Health Organization

Centre for Effective Practice - COVID-19: Clinical and Practical Guidance for Primary Care Providers

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