Information for Pharmacists and Pharmacies COVID-19

This page was updated on: 28 April 2023

The pharmacy workforce plays an important public health role and is a vital asset in combatting the spread of COVID-19. Pharmacies are a frontline point of contact for the public and a place in which people can expect to receive accurate and responsible information about the management of their healthcare, virus prevention and treatment. Pharmacies also have to manage and assess how best to provide continued care to their patients with the demands on their services and staff. The PSI recognises the challenges faced by pharmacists and the contributions being made by them and the wider pharmacy staff at a time when there is high demand on healthcare services and for the supply of medicines and advice.

The following information from the PSI, Health Protection Surveillance Centre (HPSC), HSE and other sources is available to support pharmacists, pharmacy owners and pharmacy staff in their continued care for the public.

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COVID-19 Vaccines- Information and Resources

National roll-out and sources of information
The national COVID-19 vaccination strategy and implementation plan outlines Ireland’s high-level plan for safe, effective and efficient vaccination of the population, while safeguarding continued provision of health and social care services.

As part of the roll out of the national COVID vaccination programme, the Department of Health issued the Medicinal Products (Prescription and Control of Supply) (Amendment) (No. 7) Regulations 2020 (SI 698 of 2020) on 24 December 2020. The purpose of these Regulations is to allow for COVID-19 vaccinations, listed in the Eighth and Twelfth Schedules, to be administered by pharmacists, nurses and midwives, advanced paramedics, paramedics, emergency medical technicians and physiotherapists, as per Regulation 4F as part of the national COVID vaccination programme.

Pharmacists as a trusted key information source
The public places a high degree of trust in their pharmacists, and pharmacists are an important source of accurate and reliable information for patients and the public, including for information about the COVID-19 vaccines. People will have questions as to how the various vaccines will work, both for individuals and as regards controlling the spread of COVID-19 in our communities. Pharmacists are in an ideal, and very influential, position to respond to questions and to provide up-to-date and evidence-based information relating to the safety and efficacy of the COVID-19 vaccines. We recommend that pharmacists get information on the vaccine and the illness it prevents from the following trusted sources:

HSE
HSE COVID-19 vaccine information for health professionals, general information about COVID-19 vaccines and COVID 19 vaccine materials

Government
Latest updates on the COVID-19 vaccine in Ireland

HPRA
The HPRA has a dedicated section on their website.

World Health Organisation (WHO)
WHO has a dedicated section on their website.

European Medicines Agency (EMA)
The EMA has a dedicated section on their website.
COVID-19 Vaccination Programme - Community Pharmacies
Community pharmacies are providing COVID-19 vaccines as part of the HSE national vaccination programme. A list of pharmacies providing the COVID-19 vaccine and boosters is available on the HSE website.

The HSE has issued guidance documents to support pharmacists in providing COVID-19 vaccines as part of the National Programme
- HSE COVID-19 Vaccine Information for Health Professionals
- HSE Operational Guidance for Vaccination in Community Pharmacy, which sets out the detailed requirements for the COVID-19 vaccination. This has been updated to add the details for administration of the Moderna vaccine that has been distributed to pharmacies (Dec. 2021). The key messages with the Moderna vaccine are:
  - the vaccine is contained in a multidose clear vial and no dilution is required
  - the booster dose is 0.25mls and therefore each vial will contain 20 doses
  - the vial should be punctured no more than 20 times and must be used within 19 hours of first opening
  - Spikevax® Moderna is not to be used for persons under 30 years of age
The PSI is keen to ensure that relevant and proportionate regulation plays an appropriate role in ensuring public trust and participation in the national vaccination programme. Since early 2021, we have been working collaboratively with the HSE and the Irish Pharmacy Union to facilitate and support the roll-out of COVID-19 vaccination services in pharmacies. We continue to prioritise matters relating to COVID-19 vaccination services and, in particular, ensuring that pharmacist vaccinators are trained and authorised to provide these services safely within community settings. For those considering involvement in the vaccination programme, you can find information in the Education section of this website about the PSI approved training that all pharmacists must complete to be authorised to supply and administer vaccines.

In June and July 2021 the Registrar wrote to all superintendent pharmacists in pharmacies providing the vaccination service in order to provide support and guidance on the regulatory framework, which governs the operation of the COVID-19 vaccination service in community pharmacies.
Information for Pharmacists on COVID-19 Vaccination Training
In order to participate in the COVID-19 vaccination services, pharmacist vaccinators must be up to date with all of the required training. Information for pharmacists on COVID-19 vaccination training is available on this website.

The PSI has approved the HSE National Immunisation Office (NIO) COVID-19 vaccination training for the Comirnaty (Pfizer/BioNTech), Moderna, Aztra Zeneca and Janssen and Comirnaty for Children Aged 5-11 Years COVID-19 vaccines. These are the vaccines which are currently approved for use in the national COVID-19 Vaccination Programme. The NIO training is available through HSELanD- the Health Service Executive's online learning and development portal.
Advice on reducing Infection Transmission in Pharmacies
COVID-19 Operational Standards

In response to the COVID-19 pandemic, the PSI developed COVID-19 Operational Standards to apply across all pharmacies. The Standards aim to provide concise, outcomes focused statements to guide those people involved in the governance and leadership of pharmacies in providing safe, patient centred care and in delivering quality pharmacy services during this challenging period. The Standards are also intended to inform patients and the wider public as to what they can expect from their pharmacies and to provide assurance that pharmacies are a safe and supportive healthcare environment despite the ongoing risks arising from COVID-19. More information is available on our COVID-19 Operational Standards webpage.
Pharmacy Contingency Planning
COVID-19 Rapid Antigen Detection Tests (RADTs) and Community Pharmacies
Patients and the public trust pharmacies, and pharmacists, to provide accurate and evidence-based healthcare advice in the community. This is particularly important during the pandemic when pharmacies are playing such an important and frontline role, including acting as sources of reliable information to the public on COVID-19. It is highly important to the public that this trust is protected and that pharmacies continue to be a source of correct, scientifically valid and reliable information that is in line with the current public health advice.

The Chief Medical Officer and the HSE have issued statements on the appropriate use of Rapid Antigen Detection Tests (RADTs) as part of the national COVID-19 response:
As trusted health professionals, every pharmacist providing or supervising COVID-19 testing services and/or the supply of testing kits, must ensure they are following the most up to date and reliable scientific and public health advice in what can be a rapidly changing public health situation. In particular, pharmacists should be able to advise on the correct use and limitations of these tests in line with the public health advice.

Given the evolving nature, and ongoing challenges, of COVID-19, the PSI expects that Superintendent Pharmacists, as the key professionals responsible for governance and leadership in community pharmacies, will inform themselves fully of the most up-to-date scientific and public health advice in relation to COVID-19 RADTs before supplying these testing kits or providing testing services. This includes carrying out a thorough risk assessment to ensure that any proposed COVID-19 testing service is appropriate to, and safe to be provided at, any particular pharmacy premises.

The PSI Code of Conduct states that as a pharmacist, you are expected to always apply your knowledge, skills and evidence-based decision making to ensure that patients receives safe and effective care. Pharmacists are expected to use their professional knowledge, competence and scientific understanding of medicines, health related products and medicinal and non-medicinal therapies for the benefit of patients, and must always provide honest, relevant, and accurate information to patients regarding the nature, cost, benefits and risk of medicinal products, non-medicinal products and services.

Any testing service provided in a pharmacy, whether for COVID-19 or any other disease or condition, must be provided in line with the PSI guidance on providing testing services in pharmacies. The PSI expects that all testing services provided by pharmacists will be accurate, clinically valid and provided in line with current public health advice and good practice. Any testing service should only be offered, or performed, by pharmacists where there is an established clinical and scientific evidence base and for which the validity, accuracy and reliability of the test(s) can be assured by appropriate quality assurance. At the conclusion of a consultation for a testing service, patients should have received all the necessary information and counselling about their results, the significance of their results and any further action advised. This advice should be in line with the latest scientific guidance and public health advice on the correct use of antigen tests.

The position outlined above is based on the information currently available. As the role and use of COVID-19 RADTs may be subject to change in keeping with the public health response to the pandemic, the PSI will keep this matter under review and will update this information if circumstances evolve.
Looking after your Mental Health
A health professional can only continue to provide care and support to their patients so long as they remain well and able themselves. Just as you might advise patients not to ignore their general health concerns during the COVID-19 crisis, please also remember how important it is to follow this advice yourself.

As the current stressful and demanding situation continues, all of us will experience loss, worry, anxiety and tiredness. Please make sure to call on your peers, family or employer for support, as well as taking time to seek out your doctor, other support services or online resources as may be needed to stay physically and mentally well as you provide continued care for the public. These are some helpful resources and supports to help maintain good health during this challenging time.
- There is information on mental health resources on the IIOP COVID hub.
- The HSE website offers information about minding your mental health during the coronavirus outbreak, general mental health tips and resources, and a series of stress control classes.
- The Practitioner Health Programme offers its services as an empathetic ear for health professionals during the current pandemic. The programme is available for pharmacists, doctors and dentists who may have mental health issues such as stress, anxiety or burnout or who may have a substance misuse problem.
- The Irish Hospice Foundation provides a range of materials to support people in times of personal grief, to aid those who support others during bereavement, and a new section specific to the challenges of dealing with death and bereavement during the COVID-19 pandemic.
Prescription Regulation Amendments and Guidance
Changes have been made to facilitate how prescription-only medicines, including controlled drugs, can be supplied to patients by pharmacists during the COVID-19 pandemic to ensure continued care and treatment for patients.

The changes amend the Medicinal Products (Prescription and Control of Supply) Regulations 2003 (as amended) and the Misuse of Drugs Regulations 2017 (as amended).

The purpose of these changes is to ensure continuity of care and access to treatment for patients during the COVID-19 pandemic and to reduce some of the burden on prescribers and the broader healthcare system.

Joint Guidance
To assist pharmacists and prescribers, the PSI, Medical Council and HSE have published joint guidance setting out the amendments to the legislation for supply of prescription-only medicines during the COVID-19 pandemic.

You can access the updated regulations using the links below:
- S.I. No. 98/2020 - Medicinal Products (Prescription and Control of Supply) (Amendment) Regulations 2020
- S.I. No. 99/2020 - Misuse of Drugs (Amendment) Regulations 2020
Professional judgement and collaboration
Changes in the legislation enable pharmacists to make additional supplies of prescription-only medicines to patients without obtaining a new prescription from the prescriber, where in the pharmacist’s professional judgement it is safe and appropriate to do so.

Pharmacists should discuss the patient’s treatment with them to ensure that it is appropriate and necessary for their continued care for further supplies to be made. This places significant emphasis on a pharmacist’s professional decision making, and the Code of Conduct can be used as a supportive framework within which pharmacists feel able to exercise their professional judgement, including in emergency or exceptional situations, motivated only by the core concern to provide safe and appropriate patient care.

Collaboration between prescriber and pharmacist remains vital, and the pharmacist should contact the prescriber to discuss the patient’s care if in doubt as to whether it is the intention of the prescriber for a continued supply of a medicine to be made, or the pharmacist wishes to obtain further information on whether it is safe or in the patient’s best interest to do so.

We have developed frequently asked questions and answers to assist pharmacists when supplying prescription-only medicines during the Covid-19 pandemic. The HSE has also developed frequently asked questions and answers to assist pharmacists.
Home Delivery of Medicines
The PSI and the HSE published joint guidance in 2020 to support patients, volunteers and pharmacists with the safe delivery of medicines at a time when vulnerable people in particular were not accessing healthcare, and their pharmacy, in person. Together with other guidance issued by the PSI, this guide remains a relevant resource.
- Home delivery of medicines by public servants and volunteers during the COVID-19 pandemic
Registration Applications and Pharmacist Education

COVID-19 Emergency Restoration Process
In line with the Emergency Measures in the Public Interest (COVID-19) Act 2020, a restoration route has been introduced to the Pharmacy Act, referred to as a Section 77 registration. This enables former PSI registrants, including pharmacists and pharmaceutical assistants, who either voluntarily withdrew from the register or were removed due to non-payment of registration fees, to have their registration restored for a temporary period only.

The legislation currently provides the end date for temporary registration as 30 June 2022. After this date the registration will cease. Should a pharmacist/pharmaceutical assistant wish to retain registration and continue to practise beyond 30 June 2022, they must make application to do so under the relevant provisions.

Questions about restoration and registration can be sent to registration@psi.ie

You will find further guidance on the process here.

CPD during the COVID-19 public health emergency

We appreciate that this is a challenging and unprecedented time for pharmacists and time may be more limited during the pandemic. It is still expected, and important, that pharmacists maintain their CPD and keep their knowledge and skills up-to-date, particularly in a time where pharmacists may need to quickly update their knowledge. Pharmacists are encouraged to continue to record their professional development and learning activities. All actions taken in responding to patient and public needs during the pandemic may be documented in a practitioner’s ePortfolio .
Medicines Availability
The Department of Health, with others involved in the medicines supply chain, are closely monitoring the availability of health services including medicines. There is continuous work to review the supply of medicines to Ireland so that, as far as possible, we can anticipate and respond to any potential vulnerabilities in medicines supply because of the outbreak of COVID-19.

Based on this ongoing assessment, there is no evidence to suggest that Ireland is likely to face general medicines supply issues, now or in the near future, caused by COVID-19 related issues. There are already additional stocks of medicines routinely built into the Irish medicine supply chain. If there are some supply issues for individual medicines, it is expected that other forms, strengths, brands, and generic medicines will be available to provide alternative options to ensure continuity of treatment. In those instances, pharmacists’ consultation with patients about those medicines will be vital, as is encouraging patients with any concerns about their medicine to speak with their pharmacist or GP.

While Ireland is unlikely to face general medicine supply issues, this is based on normal use of medicines. Continuity of care must be everyone’s priority, and to prevent hampering of the supply of medicines for others and disruption to existing stock levels:
- pharmacies, hospitals and other healthcare professionals should not order extra quantities of medicines,
- doctors should not issue additional prescriptions, and
- patients and the general public are also asked not to seek supplies of medicines over and above their normal requirements.
The existing HPRA Medicine Shortages Framework is in place to help prevent shortages from occurring and to reduce the impact of shortages on patients and healthcare professionals. International authorities, including the European Medicines Agency, remain vigilant to any potential risk and the Department of Health and the HPRA are also working as part of this wider EU response to COVID-19. The situation remains under review as authorities seek to facilitate continuity of care and treatment.

Work also continues to identify evidence-based treatments and vaccines for COVID-19, in Ireland and around the world.
COVID-19 and Medicines
- HSE repository for COVID-19 clinical guidance and evidence. The HSE repository provides a national easily-accessible repository of clinical guidance to equip the clinical community in Ireland with the requisite information whilst working within the current COVID-19 environment.
- National Medicines Information Centre update on COVID-19 and medicines.
- The HSE website has clear information about the treatment of COVID-19 symptoms including the use of medicines and advice on the continued use of medicines that people are already taking.
- COVID-19 and testing kits
We have received queries on the COVID-19 testing kits being offered to pharmacies. The HPRA has issued the following advice:
‘The National Public Health Emergency Team (NPHET) is coordinating the management of and response to COVID-19 in Ireland. All testing for COVID-19 in Ireland is currently conducted in the National Virus Reference Laboratory (NVRL) and in a number of regional laboratories on samples taken by healthcare professionals. Any decision to change from the current testing strategy will be directed by the NPHET. Stakeholders (manufacturers, distributors) of invitro diagnostics should contact the HPRA prior to supplying IVD test kits for COVID-19 to the Irish market at devicesafety@hpra.ie.’

This and other information is available on the HPRA’s website.

PSI COVID-19 Communications

Messages from the PSI Registrar and President

January 2022	On 27 January, the President shared this message of appreciation to pharmacists, pharmacy teams and pharmacy owners.
July 2021	On 9 July, the Registrar shared this message on the expansion of the national COVID-19 vaccination programme in community pharmacy.
June 2021	On 18 June, the Registrar shared this message on the national COVID-19 vaccination programme in community pharmacy.
November 2020	In the November issue of the PSI newsletter, the President and Registrar shared this message on meeting the challenges of COVID-19.
July 2020	In the July issue of the PSI newsletter, the President and Registrar shared this message to all those with governance roles in pharmacies.
April 2020	On 24 April, the President and Registrar shared this message with PSI registrants and all those who support the provision of pharmacy care, in acknowledgement of the professional pharmacy response in the face of the global pandemic.
March 2020	On 19 March, the Registrar shared this message on how the PSI is regulating and operating during the delay stage of the COVID-19 response.
March 2020	On 12 March, the President and Registrar highlighted some key messages for pharmacists, pharmacy owners and pharmacy staff, and acknowledges the challenges that pharmacies are facing at this time. It also provides clarity about how the PSI will carry out its role as regulator in light of the challenges presented by COVID-19 to our health service.

Communications to registrants

Particularly during the early months of the COVID-19 pandemic, the PSI provided regular email updates to registrants based on our engagement with public health authorities, and about the ongoing provision of pharmacist-led safe care during a pandemic. Those emails can be read here:

June 2021	1 June 2021
March 2021	4 March 2021
January 2021	29 January 2021
December 2020	14 December, 22 December 2020
August 2020	7 August, 26 August 2020
July 2020	July 2020
May 2020	1 May, 16 May, 22 May, 29 May 2020
April 2020	1 April, 3 April, 10 April, 22 April, 24 April 2020
March 2020	6 March, 13 March, 15 March, 16 March, 17 March, 21 March, 27 March, 28 March, 30 March, 31 March 2020