To synthesize review-level evidence on pharmacy-delivered vaccination and preventive screening while distinguishing effectiveness, equity reporting, healthcare integration and continuity, methodological quality, and dependence created by overlapping primary studies. Umbrella review of systematic reviews and structured evidence syntheses concerning pharmacist- or community-pharmacy-delivered vaccination and preventive screening. Reporting followed PRISMA 2020 and overview-of-reviews principles where applicable. Searches conducted on 14 September 2026 used targeted PubMed-indexed searches supplemented by citation-chain and targeted reference searching. Sixty-three records were identified. Twelve duplicates were removed, leaving 51 unique records for title/abstract screening. Thirty-one were excluded. Twenty reports were retrieved and assessed in full text; six were excluded, leaving 14 included review-level evidence units. Seven principally addressed vaccination and seven preventive screening. Vaccination showed the clearest review-level effectiveness signal, particularly for uptake and coverage. Preventive-screening reviews supported feasibility, acceptability, case identification and referral initiation across mental-health, cancer and cardiovascular domains, but downstream clinical management, completed referral and continuity were less consistently established. Equity was more often represented through population targeting or demographic description than through stratified evidence demonstrating differential reach or reduction of disparities. Similar conclusions across reviews were interpreted cautiously because methodological quality varied and later reviews often covered overlapping intervention eras and populations. Existing reviews support an expanded preventive role for community pharmacy, with the strongest evidence for vaccination uptake. Evidence for equitable reach, completed downstream referral and sustained healthcare integration remains less mature and should not be inferred from initial service effectiveness.
