Update on joint proposal from Pharmac and Te Whatu Ora to enable many childhood vaccinations to be given in pharmacies - further feedback required

Medicines Consultation Closed

Update on the Xpharm consultation 

Te Whatu Ora is looking to enable pharmacists to give certain childhood vaccinations. To support this change, Pharmac is proposing to remove the Xpharm restriction from some childhood vaccines in the Pharmaceutical Schedule. We shared a joint proposal about this on 15 January 2024. The decision on this proposal will now be delayed.

Joint proposal from Pharmac and Te Whatu Ora to enable many childhood vaccinations to be given in pharmacies

The consultation closed on Monday 29 January 2024. We received a lot of responses from the primary health sector and consumers. Pharmac and Te Whatu Ora are carefully reviewing all the responses. This will take some more time, so the earliest the Xpharm restriction could be removed would be 1 April 2024, if the proposal is approved.

We’d like to thank everyone who took the time to provide feedback and reassure the public that no decision has been made at this time.

Further feedback required

In response to the Xpharm consultation we received feedback that, if the proposal was approved, it would be important for pharmacists to be able to provide paracetamol oral liquid for infants under two when giving the meningococcal B (branded as Bexsero) vaccine.

Paracetamol is recommended for children under 2 years of age receiving Bexsero vaccine as they can experience fever and some pain at the injection site as part of their normal immune response to Bexsero. Paracetamol is used to reduce the likelihood of fever or injection site pain occurring. More details are available from the Immunisation Advisory Centre website(external link).

Currently it’s not possible for pharmacists to give funded paracetamol directly to children who are receiving vaccines. A change to the Pharmaceutical Schedule rules would be needed to enable this.

We would now like further feedback about a proposal to amend the listing for paracetamol oral liquid to enable Direct Provision by pharmacists. This change would be considered alongside the proposal to remove the ‘Xpharm’ restriction from certain childhood vaccines, including meningococcal B vaccine.

The consultation closes at 9.00am, Monday 19 February 2024. Feedback can be emailed to Pharmac at vaccines@pharmac.govt.nz

We acknowledge this is a short timeframe. We consider it important to seek feedback on any changes to the listing of paracetamol oral liquid, ahead of any decision on the wider proposal to remove the Xpharm restriction from some vaccines.

What would the effect be?

Pharmacists would be able to claim reimbursement for paracetamol oral liquid provided for infants under two years of age receiving meningococcal B (Bexsero) vaccine at the time of administration, under Pharmaceutical Schedule Rule 1.3.7 Direct Provision.

Who we think will be interested

  • Pharmacists
  • Healthcare professionals working in primary care and outreach vaccination settings
  • Pharmaceutical suppliers and wholesalers
  • Wellchild Tamariki Ora providers
  • Hauora Māori providers
  • Pacific Health providers
  • Midwifery services
  • Social services
  • Organisations and people with an interest in immunisation

Why we’re seeking feedback on this

Consultation feedback from the proposal to remove the Xpharm restriction from some childhood vaccines noted that pharmacists would need to be able to provide and claim reimbursement for paracetamol for children under two years of age being vaccinated with meningococcal B vaccine (Bexsero).

This proposal would enable a mechanism for pharmacists to provide and claim for paracetamol oral liquid in these specific circumstances.

Other vaccinators are already permitted to obtain paracetamol oral liquid on a Bulk Supply Order (BSO) for this purpose. A BSO is a form that certain organisations and some vaccinators can use to obtain funded supply of some medicines.

Details about the proposed changes

To amend the listing of Paracetamol oral liq 120 mg per 5 ml and 250 mg per 5 ml as follows (additions in bold):

    a) Maximum of 600 ml per prescription; can be waived by endorsement

    b) Up to 200 ml available on a PSO

    c) Not in combination


    1)  Maximum of 200 ml per dispensing for non-endorsed patients. If quantities prescribed exceed 200 ml (for non-endorsed patients), then dispense in repeat dispensing not exceeding 200 ml per dispensing.

    2) Subsidy by endorsement for higher quantities is available for patients with long term conditions who require regular daily dosing for one month or greater and the prescription is endorsed or annotated accordingly. Pharmacists may annotate the prescription as endorsed where dispensing history supports a long-term condition.

    3) Note: 200 ml presentations of paracetamol oral liquid may be supplied on BSO to a Vaccinator (other than a Pharmacist) under the provisions in Part I of Section A

    4) Note: Direct Provision by a pharmacist of up to 200 ml permitted under the provisions in Part I of Section A in conjunction with immunisation of a child under 2 years of age with meningococcal B multicomponent vaccine

    Any changes to paracetamol oral liquid would happen at the same time as the Xpharm restriction is removed, should this be approved. We have not made a decision on the removal of the Xpharm restriction at this time.

    To provide feedback

    Send us your feedback by 9.00am Monday 19 February 2024, to vaccines@pharmac.govt.nz

    All feedback received before the closing date will be considered by Pharmac’s Board (or its delegate) prior to making a decision on this proposal.

    Your feedback may be shared

    Feedback we receive is subject to the Official Information Act 1982 (OIA). Please be aware that we may need to share your feedback, including your identity, in response to an OIA request. This applies to anyone providing feedback, whether they are providing feedback themselves or for an organisation, in a personal or professional capacity.

    We can only keep feedback confidential as allowed under the OIA and other related laws. If you want any part of your feedback treated as confidential, you need to tell us. Please let us know if you want to keep part of your feedback confidential, and why. Is it commercially sensitive, confidential or proprietary, or personal information? Clearly state this and tell us which parts of your feedback you want to keep confidential for these reasons. We will consider your request under our OIA requirements.