This guidance document outlines the College’s expectations for Designated Managers, registrants and community pharmacies opting to provide COVID-19 services such as vaccine administration and testing to the public. It is intended to be used alongside, and not in place of, the guidance documents provided by the Ministry of Health (MOH), which oversees the province’s response to COVID-19.
Pharmacies provide essential healthcare services, and the choice to offer COVID-19 services must not impede or limit the public’s accessibility to, or the safe delivery of, other pharmacy services at all times. Therefore, it is paramount that participating community pharmacies have processes in place to ensure the protection of their patients, personnel and visitors—especially those who may be part of a vulnerable population, such as the elderly or those with chronic illnesses.
COVID-19 services should only be offered when the pharmacy has the capacity (i.e., staff resources) and appropriate environment to do so in accordance with this Guidance.
The practice environment must support quality patient-centered care and enable the safe provision of all pharmacy services at all times
- The College expects pharmacy professionals involved in COVID-19 vaccine administration and testing to follow the relevant legislation, the Standards of Practice, and the Code of Ethics.
- Community pharmacies must comply with the requirements set out in the Ministry of Health (MOH) and Public Health Ontario (PHO) guidance relevant to the type of service performed.
- Pharmacy owners, directors and Designated Managers (DM) are accountable for continuing to meet the Standards of Operation for the pharmacy.
Before offering COVID-19 services, the DM and owner must assess whether the pharmacy is suitable for this purpose and develop written policies and procedures to ensure that the expectations outlined in this guidance are met. Quality assurance mechanisms should be implemented to monitor the ongoing effectiveness of, and compliance with, policies and procedures.
The pharmacy’s physical space, facilities and premises as a whole (including the building and areas surrounding the pharmacy) must be adequate to safeguard the health and safety of patients, personnel and the public.
- Public health physical distancing guidelines to prevent the spread of COVID-19 are continuously maintained
- There must be separate, dedicated space(s) appropriate for the purpose of providing COVID-19 services, segregated from the rest of the premises to protect the comfort, privacy and dignity of patients and, if applicable, their caregivers
- Patient contact surfaces must be suitable for proper disinfection between patients/services
- Depending on site for administration, this may require a flat stable surface that is of sufficient size to accommodate positioning the patient.
- There is appropriate equipment for storage and handling of vaccines as required by MOH and PHO guidelines
- There are separate, secure and temperature appropriate storage facilities for storing only specimens collected for COVID-19 testing
- Hand-washing facilities with soap and water, and/or an adequate supply of alcohol-based hand rub, are easily accessible and available for proper hand hygiene
Infection Prevention and Control
Pharmacies should review Public Health Ontario’s (PHO) Infection Control Guidance on a regular basis as information is evolving.
Stringent infection prevention and control (IPAC) measures are implemented including:
- Passive and active screening of all patients; those who screen positive are triaged and managed appropriately
- Active screening of personnel
- Universal masking/face coverings for all personnel on the premises
- Recommended routine environmental cleaning and disinfection is completed
- Patient contact surfaces are cleaned and disinfected in between patients
- Proper hand hygiene is performed in between patients as well as before putting on and taking off PPE
Pharmacies providing COVID-19 testing must also follow IPAC measures shared by Ontario’s Chief Medical Officer of Health (DDD Notice No.21158) and guidance provided by PHO’s Infection Prevention and Control Practice Considerations for Pharmacies Conducting Symptomatic Testing
Providing patient care
The pharmacy must have an adequate number of staff available who are provided with the appropriate level of supervision and training to adhere to all policies and procedures and ensure safe, effective patient care. It is strongly recommended that all pharmacy staff are vaccinated against COVID-19.
- Workflow should be optimized to minimize the number of patient-personnel interactions and movement to other areas of the pharmacy
- Appointments for vaccine administration and testing on the premises are booked in advance whenever possible
- Pharmacy staff providing COVID-19 services should be adequately supported to provide these services within an appropriate physical environment to ensure patient comfort and safety
- Appropriate use of Personal Protective Equipment (PPE) for pharmacy professionals providing COVID-19 services
Registrants are advised to access the additional references to support the implementation of policies and procedures that comply with Ministry requirements at the end of this document.
COVID-19 Vaccine Administration
If providing COVID-19 vaccine administration to infants/ young children (specialized practice area), pharmacy professionals are expected to have sufficient knowledge, skill and judgment to safely and effectively administer the vaccine to patients in this age group. The administration of the vaccines must occur in a private area that is comfortable and appropriate for both the patient and caregiver.
COVID-19 Testing and Screening
If providing COVID-19 testing services, it is to be conducted in accordance with the regulations under the Laboratory and Specimen Collection Centre Licensing Act (LSCCLA), Executive Officer (EO) Notices and guidance documents provided by the Ministry of Health (MOH).
Laboratory-based PCR Testing
- Pharmacies are exempt from requiring a licence to collect specimens for a COVID-19 test
- Pharmacists can order a polymerase chain reaction (PCR) laboratory COVID-19 test
- Pharmacists can collect specimens for any COVID-19 test
- Only pharmacists have the authority to collect specimens for PCR testing under the regulations; pharmacy technicians, registered pharmacy students and interns do not.
- Pharmacists cannot collect specimens using nasopharyngeal (NP) swabbing
- The registrant explains how the patient can obtain (or will be notified of) the test result and how follow-up will be communicated
- Refer to COVID-19 Provincial Testing Guidance (MOH)
Antigen Point-of-Care Testing (POCT)
- Any person can collect specimens for COVID-19 point-of-care testing (POCT)
- Pharmacy professionals must do so in accordance with the Standards of Practice and Code of Ethics, working within the limits of their competence and ensuring they have the appropriate knowledge and skill to do so safely
- Rapid antigen POCT are for screening purposes only
- Refer to COVID-19 Provincial Testing Guidance (MOH)
POCT for serology (antibody or Ig testing) is not permitted, nor can pharmacists perform specimen collection for, or requisition, lab-based serology tests.
For publicly-funded testing for patients who meet the eligibility criteria of the Provincial Testing Guidance, refer to the Ministry of Health Executive Officer Notices.
For non-publicly funded testing, refer to Considerations for Privately-Initiated Testing.
- Ontario Regulation 45/22 GENERAL (under the Laboratory and Specimen Collection Centre Licensing Act)
- Ontario Regulation 107/96 – Controlled Acts (under the Regulated Health Professions Act)
- Ministry of Health
- Ontario Health:
- Public Health Ontario
- Canadian Pharmacists Association
- Ontario Pharmacists Association
- Health Canada
- Ontario College of Pharmacists:
Published: July 21, 2022
College Contact: Practice Department
|September 29, 2020
|New Guidance established: COVID-19 Testing of Asymptomatic Persons in Community Pharmacies
|November 20, 2020
|Updated to include MOH information –
COVID-19 Guidance: Testing of Asymptomatic Persons in Pharmacies.
|November 18, 2021
|Updated to include symptomatic testing. Renamed COVID-19 Testing in Community Pharmacies
|January 21, 2022
|Updated to include PHO information – Infection Prevention and Control Practice Considerations for Pharmacies Conducting Symptomatic Testing
|July 1, 2022
|Clean up and update of links. Incorporated new MOH documents
|July 21, 2022
|Updated to include vaccination alongside testing. Renamed from COVID-19 Testing in Community Pharmacies