The Estonian Dispensing Pharmacists' Association (EPAL) proposed Monday that the government could include pharmacies in the vaccination process, as they have the necessary facilities and experience with vaccine injections.

EPAL manager Ly Rootslane noted that tens of thousands of people have been vaccinated against, for instance, tick-borne encephalitis and influenza at the EPAL member pharmacies, which also see use for different shots ahead of trips to various locations worldwide.

The Ministry of Social Affairs however would not rush to approve the proposal as the facilities needed for vaccinations are just one part of the equation. Another, more important part is the necessity having trained vaccinators, who also have medical educations. Pharmacy personnel lack the latter, as pharmacies have previously also ordered vaccinations as a nursing service.

"Vaccinators must be doctors, nurses or midwives who have passed the respective training. There is actually no lack of vaccination facilities in Estonia. We have some 400 family physician centers, we have hospitals, we have conducted vaccinations in care homes and elsewhere, meaning there is no need to open new centers in the coming weeks. It could be discussed in the longer picture, if we are talking of creating vaccination centers, but it must be considered for all those that vaccinators need to be healthcare workers," health minister Tanel Kiik told ERR on Tuesday.

In addition, the vaccinated people need to be monitored at the location in order to react to any possible side effects. "It is also a reason why hospitals and physician centers are largely more suitable as a location where people are vaccinated. In the current phase, there is no need to open additional centers," the minister said.

Vaccinations in Estonia have taken time to get going. Kiik admits that the preparatory process took long, but the tempo has gone up and will continue to do so.

"Last week, we conducted more than 15,000 vaccinations, this week we are certainly aiming for more than 20,000. The question was not only the number of vaccinators or the capacity, but rather certain organizatory questions, such as the creation of lists, arranging logistics for a new vaccine that has differences in its intended use. Therefore, vaccinating frontline workers with the AstraZeneca vaccine has taken some time, getting the system running," Kiik said. "The numbers coming now will be much better. There has never been a question of us not having enough centers to conduct vaccinations."

This week, the vaccination of rescue officers begun, to be followed by the rest of the frontline workforce next week, estimated at around 75,000 total people. "The goal is for a majority of the rescue officers to be done in February-March," the health minister noted.

Vaccinating the general population is set to begin in May. By then, Estonia's vaccination capacity could increase to 100,000 a week. "100,000 could be our limit capacity. But we do not have enough vaccines today to even theoretically achieve these numbers," Kiik said.

"Certainly, Estonia's ceiling is not 20,000 or even 30,000, the ceiling is significantly higher, depending on how many vaccinating centers and private sector partners we include and that we will decide based on how much vaccine arrives in Estonia, meaning how much manpower we need in addition to the regular physician centers and hospitals," the minister added.

The plan is for tents and other supplemental vaccination centers to be opened by May at the latest. For this, the state will announce a procurement through the Estonian Health Insurance Fund (Töötukassa) to find a capable partner.

"We are preparing a procurement for the opening of vaccination centers. There are questions in two parts here. One is where vaccinations will be conducted physically and another is who will conduct vaccinations," Kiik said.

But even then, involving pharmacies is problematic as provisors lack the training needed to conduct vaccinations, the minister noted.

"For pharmacies, the prerequisite is that vaccinations are done by a healthcare worker on location, meaning it cannot be a pharmacy employee, the respective service must be ordered from a partner," Kiik explained.

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