Manitoba Health Changes to the Use of the AstraZeneca / COVIDSHIELD COVID-19 Vaccine
On March 29, 2021, Manitoba public health officials advised health care providers to pause the use of the AstraZeneca/ COVISHIELD COVID-19 vaccine in people aged < 55 years, following recommendations from Health Canada, the Public Health Agency of Canada (PHAC), and the National Advisory Committee on Immunization (NACI). The notice from Manitoba Health can be found here.
The updated AstraZeneca/COVISHIELD vaccine eligibility can be found in the updated Manitoba COVID-19 Vaccine: Clinical Practice Guidelines for Immunizers and Health Care Providers and information for the public can be found here.
Pharmacists are encouraged to continue checking Manitoba’s COVID-19 immunization program pages at https://www.gov.mb.ca/covid19/vaccine/healthcare-professionals.html and https://www.gov.mb.ca/covid19/vaccine/partners/index.html for up-to-date guidance.
Reporting of Adverse Events Following Immunization
During vaccination campaigns, pharmacists must be aware of their obligations to report adverse events following immunization (AEFI).
The College Complaints Committee has received complaint matters involving AEFIs. Pharmacists and pharmacy managers are reminded of their responsibilities when a patient informs them of an AEFI.
In accordance with the Administration of Drugs including Vaccines Practice Direction, the pharmacist must provide relevant information to other regulated health professionals and provincial health agencies as appropriate when informed or have become aware of an AEFI.
All healthcare providers, including pharmacists, are required to report AEFIs in accordance with The Public Health Act within seven days of becoming aware of the incident. For serious events, the report should be completed within one day, with the written report being completed within 72 hours. Reporting is not required in cases where the reaction is only mild and local and not overly concerning to the vaccine recipient. AEFI reports are submitted to Manitoba Health, Seniors and Active Living – Surveillance Unit.
Full details of what constitutes an AEFI, the reporting requirements, process, and reporting forms can be found here.
IMPORTANT Compounding Update
All four phases of the NAPRA Model Standards for Pharmacy Compounding of Non-sterile Preparations are now in effect as of today (April 1, 2021).
This means that pharmacies planning to engage in this level of compounding must be compliant with Section 9 (Requirements for hazardous preparations) and Section 8.3 (Level C requirements) of the NAPRA Model Standards for Pharmacy Compounding of Non-sterile Preparations.
The requirements for non-sterile compounding are based on the complexity and risks associated with preparing the compound and handling the substances used to make the compound. Level C compounds include:
- Hazardous drugs classified by NIOSH as Group 1 drugs
- Hazardous materials classified by WHMIS as representing a health hazard, such as those that are very irritating to the respiratory tract, skin or mucous membranes
- NIOSH Group 2 and 3 drugs for which large quantities of APIs are used routinely
Level C requirements include:
- Separate room
- Well-ventilated room with appropriate air exchange and negative pressure
- Appropriate containment device (i.e., Containment Primary Engineering Control [CPEC]) for materials being compounded
Please note that Hazardous products must be stored in a room with appropriate ventilation. The NAPRA Guidance Document for Pharmacy Compounding of Non-sterile Preparations provides additional clarification that hazardous products should be grouped and stored in a properly ventilated room with all air exhausted to the exterior. The storage area should have negative pressure relative to the adjacent rooms and should have at least 12 air exchanges per hour. The storage area should be identified with appropriate signage to indicate the presence of hazardous products.
For more information on compounding, please visit the College Pharmacy Compounding Standards page.
Pharmacy Technician — Final Check of Logged Prescriptions
For a pharmacy technician to complete the final check of a prescription, the pharmacy must submit a Pharmacy Technician Final Check Application to the College and receive approval. More information on the application process can be found in the Pharmacy Technician Final Check Information Sheet.
Each pharmacy determines what prescriptions a technician will review (new, refill and/or logged prescriptions) and the processes in place when doing the final check. The College has received questions from pharmacy technicians regarding completion of the final check when logging a prescription or putting it on file and either filling or transferring the logged prescription.
A pharmacy technician can complete the final check of a prescription when another pharmacy staff member prepared the prescription. A technician cannot check their own work. All prescriptions — new, refills and/or logs — require both a technical and therapeutic check. When a prescription is being logged or placed on file, both the technical and therapeutic check must be done. A technician can perform the data check to ensure all the information has been entered correctly. However, the pharmacist must still review the prescription from a therapeutic perspective before being logged. In this case, both the technician and pharmacist must document their checks either in a written or electronic format.
When a logged prescription is filled and dispensed, a technical and therapeutic check must be conducted again. The technician who performed the initial technical check when it was logged or put on file cannot perform the technical check before releasing the medication to the patient. The technical check should be done by either another trained pharmacy technician or a pharmacist. If there is no process to determine or verify who did the technical check on the prescription when logged, then a pharmacist must complete both the technical and therapeutic checks of all processed logged prescriptions.
Independent double checks in pharmacy practice are an effective process to reduce the risk of a medication error.
Health Canada’s Updated Guidance on Post-Consumer Returns Containing Controlled Substances
Health Canada’s Office of Controlled Substances (OCS) has issued an updated bulletin providing pharmacy professionals with information on temporary exceptional measures for post-consumer returns containing controlled substances during the COVID-19 pandemic.
The OCS bulletin contains several recommendations to reduce contact between consumers and pharmacists when returning products that may contain controlled substances to a pharmacy.
Pharmacists are still required to protect post-consumer returns containing controlled substances from theft and diversion by securing them in the narcotic safe until they are denatured. It is recommended to keep them separate from the pharmacy’s unserviceable stock for ease of tracking. Please see Health Canada’s Guidance Document on Handling and destruction of post-consumer returns containing controlled substance and the College Narcotic and Controlled Drugs Accountability Guidelines for more information.
If you have any questions, please contact Health Canada’s Office of Controlled Substances at hc.compliance-conformite.sc@canada.ca.
Upcoming Events: AGM and Awards Presentations
Annual General Meeting
The College of Pharmacists of Manitoba (College) will hold its 2021 Annual General Meeting (AGM) on Saturday, May 8, 2021, via webinar. For more information and a link to register, please click here.
2021 College of Pharmacists of Manitoba Awards Presentations
Each year, the College takes great pride in recognizing excellence and leadership in pharmacy practice and initiatives to improve patient safety in our province.
Please plan to join us in celebrating the deserving award recipients announced in the upcoming Spring Newsletter. The 2021 awards recipients will be acknowledged immediately following the AGM.
CPhM Hours of Operation
The College of Pharmacist of Manitoba wishes everyone a happy spring season!
Please be advised that the College office will be closed:
- Friday, April 2, 2021
- Monday, April 5, 2021
Regular office hours resume on Tuesday, April 6, 8:30 a.m. to 4:30 p.m.
Please be reminded that the College Office remains closed to visitors and continues to operate as a virtual office due to the COVID-19 pandemic. All services continue, however, adjustments in service delivery and delays may occur.
Documents may be left in the black deposit box to the left of the main office entrance.
Email is the most efficient means by which to contact staff.
Professional Development Opportunities
CAPT National Professional Development Virtual Conference 2021
May 29 & 30, 2021
Register, here.
Manitoba ACS Network Heart Attack Day 2021
April 9, 2021
8:00 am – 4:00 pm
To purchase event tickets, click here.
Opioid Agonist Therapy 101 Introduction to Clinical Practice
April 29-30, 2021
8:30 am – 4:30 pm
To purchase event tickets, click here.
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All PD opportunities are listed on the College website under
Upcoming Professional Development Opportunities