Low uptake of immunization services remains a major public health issue. Pharmacists serve as key facilitators and, more frequently, as vaccinators themselves. However, strong evidence regarding their effect on patient health outcomes and vaccination coverage remains limited.To assess the effect of pharmacist-led interventions on population-level vaccination rates.A systematic search was conducted in SCOPUS, PubMed, and Web of Science from database inception to April 2023 to identify both randomized controlled trials (RCTs) and non-randomized controlled trials. Studies lacking a comparator group for pharmacist involvement were excluded. Two reviewers performed data extraction and risk-of-bias evaluations, and meta-analyses were conducted using random-effects models.The review included 4 RCTs and 15 non-RCTs covering influenza, pneumococcal, herpes zoster, and tetanus-diphtheria-pertussis vaccines delivered in varied settings, including community pharmacies. Pooled analyses showed that pharmacist involvement, in any capacity, increased overall immunization uptake by up to 51% compared with usual care [RR 1.51 (1.28, 1.77)]. When pharmacists specifically functioned as advocates, immunization frequency more than doubled [RR 2.09 (1.42, 3.07)].Evidence concerning pharmacists acting directly as immunizers was inconsistent; nevertheless, their overall participation in immunization programs significantly raised public vaccination rates. Pharmacists demonstrated leadership and played essential advocacy roles in both community and hospital environments. Future studies should examine the intensity of pharmacist engagement and its impact on immunization coverage.
