Vaccinations: the last season at your own expense

In June the Federal Department of Home Affairs decided to include the administration of vaccinations in pharmacies for people aged sixteen and over in the catalogue of services of the compulsory health insurance. This implements a request from parliament arising from the second cost containment package. The regulation enters into force on 1 January 2027. The tariff framework still has to be worked out with the insurers.

For the coming vaccination period this changes nothing in legal terms. In practice it changes everything. Anyone who sets up processes, appointment windows, documentation and demand data cleanly in the autumn of 2026 will enter, with robust figures, a year in which it will be decided how this service is remunerated in future. Anyone who lets the season run alongside everything else as usual will negotiate in 2027 without arguments.

The calendar

September belongs to preparation. Ordering vaccines, checking cantonal authorisations and certificates of competence, setting up the appointment grid, briefing the team. The recommended flu vaccination period begins in mid-October and lasts until the start of the flu wave; for the Covid-19 vaccination, the FOPH and the Federal Commission for Vaccination Issues (FCVI) name the window from mid-October to December as ideal.

The fixed point of the season is National Vaccination Week from Monday 2 to Saturday 7 November 2026. It takes place for the second time, having replaced in 2025 the National Flu Vaccination Day that had existed since 2004, and covers influenza, Covid-19 and RSV. It is run by the College of Primary Care Medicine together with the FOPH, the FMH and pharmaSuisse. Participating vaccinating pharmacies can be found via the impfapotheke.ch directory.

Two things are regularly underestimated here. First, the week is a demand accelerator, not a demand generator: anyone who only communicates in October mainly picks up customers who would have come anyway. Second, the season is not over on 7 November. As long as the flu wave has not begun, the vaccination remains sensible, and December uptake frequently reaches precisely those people who were still hesitating in October.

Influenza

The vaccination is recommended for people at increased risk of complications, that is people aged 65 and over, pregnant women at any stage, premature infants up to the age of two and people with chronic illnesses. Added to these are close contacts of these groups, explicitly including healthcare professionals and carers of infants, as well as people with regular contact with poultry or wild birds.

For vaccine choice there is a differentiation that often gets lost in the consultation. For all people aged 75 and over, as well as for 65- to 74-year-olds with an additional risk factor, the high-dose vaccine is to be preferred. In severe egg protein allergy the cell-based vaccine comes into consideration. In the 2025 season the nasally administered attenuated live vaccine was not available in Switzerland; for children that is relevant, because the alternative is an injection from six months of age.

On effectiveness, honesty at the counter pays off. Depending on the season and the population group it lies between twenty and eighty per cent, and lower in older and immunosuppressed people. The argument is therefore not the prevention of every infection, but the attenuation of the course and the avoidance of complications. Influenza usually causes 112,000 to 275,000 medical consultations per season in Switzerland, plus several thousand hospitalisations and several hundred deaths.

A note on currency: at the time this overview was compiled in mid-August, the recommendation for the 2025 season was still published on the FOPH page. The structure of the recommendation has been stable for years, but the specific list of available vaccines changes annually. The updated version must be consulted before ordering.

Covid-19

A single dose in autumn or winter is recommended for particularly at-risk people aged sixteen and over, that is people aged 65 and over, people with relevant pre-existing conditions including pregnant women with pre-existing conditions, as well as people with trisomy 21. For pregnant women without risk factors the vaccination is recommended only on individual medical indication. For everyone else it is not recommended.

Commercially the situation has been settled since 1 July 2024 and is nonetheless frequently presented incorrectly in consultations. For people with a vaccination recommendation, the basic insurance covers the costs, subject to deductible and co-payment. People without a recommendation bear the costs themselves. The sentence “the Covid vaccination is free” has not been true since then and creates avoidable annoyance at the till.

The flu vaccination can be given at the same time as, before or after the Covid-19 vaccination. That is the season’s strongest organisational lever, because it puts two indications into one appointment.

RSV in adults

Here lies the commercially most interesting and, in counselling terms, most delicate item. Since 1 September 2025 there has been a vaccination recommendation for adults aged 75 and over, as well as for at-risk people aged 60 and over. It was explicitly not included in the Swiss vaccination schedule, because the costs are not covered by the basic insurance.

That means: recommended, but paid for out of pocket. The vaccination is not an annual booster but a single dose, which distinguishes the repeat-business economics markedly from the flu vaccination. Whether administration in the pharmacy is permitted depends on the canton; the regulations differ more strongly here than for influenza and Covid-19.

In the consultation, the price and the reimbursement status belong at the beginning of the conversation, not at the end. A recommended but non-reimbursed vaccination requires explanation, and the explanation is more unpleasant when it comes only at the point of payment.

For infants a different logic applies. For newborns and infants in the first year of life, maternal vaccination during pregnancy and passive immunisation with long-acting monoclonal antibodies are available as equivalent options, supplemented by a recommendation for young children at increased risk. For the pharmacy this is above all a counselling topic with pregnant women and young parents, with a direct link to flu vaccination in pregnancy.

The second basket

The flu appointment is the best screening moment of the year, because a vaccination-ready person at increased risk is standing in front of you and time has been set aside. Four items are worth checking.

Vaccination against herpes zoster with the adjuvanted subunit vaccine is recommended for everyone aged 65 and over with no upper age limit, and additionally for people with immunodeficiency from age 50, or from age 18 in severe immunodeficiency. Two doses at least two months apart are required, and the costs are covered by the basic insurance. Anyone giving the first dose in October has the second in December or January, that is within the same season.

For pneumococci, the FCVI updated its position on the differently valent conjugate vaccines on 23 February 2026; for the age groups concerned, a single dose of the 21-valent conjugate vaccine is envisaged. The current status per age group is published by the FCVI and should be checked before the consultation, because this dossier has moved several times in recent years.

Added to this are two classics: booster status for diphtheria, tetanus and pertussis, in particular pertussis vaccination in pregnancy, as well as catch-up vaccination against measles and varicella in adults under forty. Both come to light during a flu vaccination without additional effort if the vaccination record is looked at systematically.

Who pays what today

The division is simple and is nonetheless rarely communicated clearly. If a recommended vaccination is given in the pharmacy on medical prescription, the vaccine is reimbursed through the basic insurance. The administration itself is charged to the vaccinated person. The pharmacy sets the price for this service.

It is precisely from this that the season’s task arises. The amount for the administration is visible, it appears on the receipt, and the spring’s experience with the individually itemised positions of the new performance-based remuneration shows how quickly a visible item becomes a point of contention. Anyone who names the vaccination price in advance, displays it in the window and on the website and justifies it with the service – that is, history-taking, checking of indications and contraindications, information, administration, post-vaccination observation and documentation – is not selling more expensively but more comprehensibly.

The formal requirements

Vaccinating in the pharmacy is today possible in all cantons, and actually offered in over two thirds of pharmacies. The authorisation is granted by the cantons, and the catalogues differ considerably. Some cantons permit inactivated vaccines only, others all vaccinations according to the vaccination schedule, still others only follow-up vaccinations after an initial medical vaccination. Yellow fever vaccination remains reserved for authorised medical centres; rabies vaccination is possible in the pharmacy pre-exposure, but not post-exposure. pharmaSuisse maintains an overview of the permitted vaccinations broken down by canton; the current version is dated 3 July 2026.

In terms of personnel, the FPH certificate of competence for vaccination and blood sampling is required, although pharmacists with a federal diploma from 2022 onwards do not need this certificate separately, since the training is contained in the basic degree course. In every case the cantonal authorisation, a valid recognised BLS-AED certificate and liability insurance covering the risk are required. Added to this are the operational requirements: a suitable consultation room, a seat that can be brought into a reclining position, a hazardous waste container, a triage questionnaire and documentation of the vaccination, preferably electronic. In several cantons vaccinations outside the pharmacy premises are prohibited.

What needs to be done now

Three things decide this season. First, the order: schedule influenza, Covid-19 and RSV vaccines as well as, where applicable, monoclonal antibodies in good time and in realistic quantities, with an eye to the high-dose variant for the oldest cohorts. Second, the calendar: open appointment windows before and during the week of 2 to 7 November, allow walk-in vaccinations but avoid waiting times. Third, the data: vaccinations administered, vaccinations declined and the reasons for that are not administrative burden but the material with which the profession will negotiate a tariff in the coming year.

The pharmacy’s vaccination service will become part of the regular catalogue of services for the first time in 2027. What it is then worth will be measured on a data basis created this autumn.