The team at Pharmasave Cloverdale. From left to right: Sim Kalar (pharmacy assistant), Christine Cheng (RPh), Michael Nguyen (RPh/pharmacy manager), Shelley Sidhu (RPhT), Lyle Sunada (RPh-Vet Specialist/NAMS Certified Menopause Practitioner), Martin Leonard (General Manager) and Josephine Leonard (Marketing Manager).
Registered pharmacy technician Shelley Sidhu recalled the moment she received an email that said members of her profession would be empowered to administer COVID-19 vaccine injections in British Columbia. Her first thought was, “Finally!”
It was January 2022, when the world was still in the second year of its war against the COVID-19 pandemic. In this month, B.C.’s provincial health officer Dr. Bonnie Henry issued an order authorizing pharmacy technicians, among professionals including dentists, midwives, podiatrists and more, to administer COVID-19 vaccines. Later that year, the order was expanded to permit those same professionals to administer influenza vaccines.
Thrilled at the news, Sidhu immediately told her employer that she was eager to be trained to provide immunizations. Her employer supported the idea and even paid for the course.
“I was pretty keen. I knew it was going to be very rewarding to be contributing to pharmacy practice in a different way, while helping people in the community,” she said. “This was something I could personally do to better myself, so patients can have greater access to care.”
Over the next few years, Sidhu administered hundreds of vaccines. On some days, she would immunize a patient every 10 minutes. She was confident in performing this new scope of practice, to the point where she was soon relied on as the primary COVID and influenza vaccine provider at her workplace.
“Unless I wasn’t on duty, I was doing the bulk of them,” said Sidhu, who works at Pharmasave Cloverdale in Surrey.
But that all changed in July 2024, when pandemic restrictions and public health orders were lifted to signal the end of the COVID-19 public health emergency, effectively ending the authorization that permitted Sidhu and her registered pharmacy technician colleagues to administer injections.
“That was really disheartening,” said Sidhu. “I felt that they took away valuable registered pharmacy technician expanded scope of practice in regards to the knowledge and skillset that we were utilizing to better support our pharmacists.”
"Being a certified vaccine provider allowed me to connect with my patients on a different level of providing gratifying pharmacy patient care." — Shelley Sidhu
She began writing letters: to the Ministry of Health, to the provincial health officer, to the College of Pharmacists, and to local politicians.
“I’m trained to do it, right? If somebody is capable of doing the work independently, confidently, and they want to take on the responsibility, then why not? We keep hearing about how the health care system needs more resources, that there are too many patients and not enough health providers, but they’ve taken this away even though pharmacy technicians work alongside the pharmacist, inside the pharmacy where patients are going to for vaccines,” Sidhu said.
Pharmacy technicians as a profession first became regulated in British Columbia in 2011. These professionals are an intermediate role, with a greater scope of practice than pharmacy assistants — the most junior role in a pharmacy — and a lesser scope than pharmacists, the leaders in the dispensary. Technicians’ responsibilities include administrative tasks such as documentation, preparing medications, managing inventory, providing instructions for medical devices, checking prescriptions, compounding medications, claims adjudication and more.
In B.C., there are more than 1,800 registered pharmacy technicians. The bulk of them work in hospitals, while about 400 work in community pharmacies.
That pharmacy technicians should continue to be authorized to administer vaccines by injection is an idea that has substantial precedence.
That pharmacy technicians should continue to be authorized to administer vaccines by injection is an idea that has substantial precedence.
In four Canadian provinces, technicians are permitted to administer injections: Ontario, New Brunswick, Nova Scotia and Prince Edward Island.
In the United States, prior to the pandemic, only three states — Idaho, Rhode Island and Utah — had immunization authority for pharmacy technicians. That changed in 2020, when a federal Public Readiness and Emergency Preparedness Act declaration effectively permitted pharmacy technicians in the remaining 47 states to provide immunizations of authorized vaccines, if the immunization is ordered by a supervising pharmacist and the technician is trained to inject through an accredited course. This declaration was initially set to expire in 2024, but has since been extended to 2029.
Recognizing the significant benefits of pharmacy technicians being employed as vaccine providers, the BC Pharmacy Association (BCPhA), the Pharmacy Technician Society of BC (PTSBC), and the Canadian Association of Pharmacy Technicians (CAPT), are calling for this authority to be implemented on a permanent basis in British Columbia.
Specifically, the BCPhA is making the following recommendations to support technicians:
- Amend Health Professions Act regulations to allow pharmacy technicians to administer immunizations
- Develop a financial support program for those wanting to study to become a pharmacy technician
- Develop a loan forgiveness program tied to years of service in community pharmacy settings
Pharmacy technicians' duties may include preparing medications, inventory management, checking prescriptions, compounding medications, claims adjudication and more.
The PTSBC, an organization advocating for pharmacy technicians and assistants in B.C., issued a position statement in January 2025 to support the call for pharmacy technicians to administer injections.
In its statement, PTSBC said that pharmacy technicians possess the technical expertise to provide injections, and pointed to how enabling technicians to inject could free up already overworked pharmacists to focus on patient counselling and other responsibilities. This is especially important during times of increased demand for immunizations, such as the annual respiratory illness season, it said.
The PTSBC statement also pointed to how the landscape of health care in B.C. is quickly changing, with an emphasis on maximizing the capabilities of all health professionals. Enabling technicians to do more, it said, is a logical step.
"The Pharmacy Technician Society of British Columbia (PTSBC) firmly supports granting injection authority to pharmacy technicians, recognizing this as a critical step in enhancing patient care, optimizing health care resources, and addressing growing demands on the health care system,” said Bal Dhillon, Director of Education with PTSBC.
“With proper training, pharmacy technicians are well-equipped to safely administer injections, alleviating workload pressures on pharmacists and improving access to timely, efficient care.”
Dhillon said that expanding injection authority for pharmacy technicians improves access to care by reducing barriers to timely vaccination, particularly in rural and underserved areas. She said pharmacy technicians have specialized training in medication preparation, storage, and handling, which ensures safe and effective vaccine administration.
“Strengthening the health care workforce in this way enables more patients to receive vaccinations from qualified professionals, preventing delays or missed doses. Additionally, it allows pharmacies to take on a greater role in disease prevention, ultimately reducing hospital visits and easing the strain on the health care system,” she said. “As regulated professionals under the College of Pharmacists of BC, pharmacy technicians are held to strict practice standards and accountability measures, ensuring patient safety and quality care.”
Sheena Deane, President of CAPT, the Canadian national organization advocating for pharmacy technicians, said that she believes all pharmacy technicians across the country should be given the opportunity to become vaccine providers.
“I think it should be the same across Canada. I understand each province oversees their own health care, but for something as important as allowing injection authority, it should be legislated across the country,” said Deane, who works as Operations Manager at Kristen’s Pharmacy in Southampton, Ontario.
“We’re quite capable. We carry our own liability insurance, we are licensed, and we are just as careful as pharmacists when it comes to making sure that the process is being followed.”
Deane said there is growing acceptance of pharmacy technicians taking on a greater technical role in the dispensary, to free up pharmacists for consultative and clinical work with patients. Some pharmacies are already doing it, she said, through one of two models.
One way is the pharmacist-first model, which places pharmacists as the first point of contact for patients at a pharmacy. When a patient arrives, they are immediately consulted by a pharmacist, who can review the patient’s file, assess their medications, discuss any ongoing conditions and answer any questions the patient may have; rather than the more common model of a patient dropping off a prescription with an assistant or technician, and only seeing the pharmacist at the end when they pick up their medications.
A second way, called a technician-led dispensary model, has patients interacting initially with a pharmacy assistant or technician, who enter the prescriptions and refills. A pharmacist performs clinical reviews prior to packaging, flagging any prescriptions that require counselling, and connecting with physicians as needed. Pharmacy assistants prepare the prescription itself, while technicians check the technical aspects as the last step. A second pharmacist provides clinical services, such as minor ailment assessments, medication reviews and other appointments.
“These ideas have been proven to improve workflow and improve the pharmacists’ ability to concentrate on their tasks and work to their full scope,” Deane said. “But the only way that happens is if the pharmacist has a team of technicians in the background practicing to their full scope. It’s a total waste of time for a pharmacist to check a blister pack or do an injection when a technician can step in for those roles.”
Deane believes that her pharmacist colleagues are also increasingly accepting of technicians practicing to a greater scope. Encouraging technicians to practice to their full scope, she said, in turn creates opportunities for pharmacists, whether in allowing them time to focus on clinical work, or to explore further areas of scope expansion.
“When I started as a technician in 2010 there were a lot of pharmacists who were very leery of what we could do. But I see that this has changed, and recently two pharmacists told me that they don’t know how health care ever managed without technicians,” she said. “The shift has happened. Our coworkers now see the value of pharmacy technicians, we just need the legislation to keep up.”
Josie Quick, a North Dakota pharmacy technician, serves as Chair of the Northland Association of Pharmacy Technicians and member of the Council of Pharmacy Practice in the American Society of Health-System Pharmacists. In this role, she travels to Washington, D.C. at least once a year to advocate on behalf of her profession.
Her state had been in the process of developing regulations for pharmacy technician immunizations when the pandemic hit, and the United States federal declaration enabled her to administer vaccines by injection.
Since then, each year, she immunizes several dozen hospital staff at the Sanford South University Medical Centre where her pharmacy is located.
“I think it’s great that other countries such as Canada are advocating for pharmacy technicians to provide immunizations,” Quick said. “As a pharmacy technician, in my opinion, it’s very rewarding to be able to work to our full scope and be given more responsibilities over time.”
She said it’s important for pharmacy technicians to advocate for themselves, both in their own workplace and for the profession as a whole.
“For myself, I’m always the first one to ask the pharmacist — if you let me train on how to do this, I can take this responsibility and you can have more time for other things,” Quick said.
“Some people see being a pharmacy technician as a steppingstone, but others among us are passionate about being a pharmacy technician as a career choice. To support the people who want to make this a career, there needs to be room for the profession to grow and take on more responsibilities.”
Sidhu, the Pharmasave technician in Surrey, B.C., remains optimistic that British Columbia would consider reenabling pharmacy technicians to provide immunizations by injection. Months after the temporary authority was withdrawn, Sidhu said her colleagues, including her pharmacy manager and a staff pharmacist, expressed out loud that they wish she could inject again.
For her, the part she misses the most about providing injections is the connection that she built with patients. Sometimes, she still encounters patients whom she had immunized during the pandemic, and they remember her, too.
“They’ll say, with hope, ‘I’m here for the injection. Are you administering it?’ They are comfortable with me as their vaccine provider, but I can’t help them in this area anymore,” Sidhu said.
“Being a certified vaccine provider allowed me to connect with my patients on a different level of providing gratifying pharmacy patient care.”
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