Background: Immunization rates among the adult population in Saudi Arabia fall below desired targets, urging the need to expand this service in the community. Community pharmacists are recognized as highly accessible healthcare professionals, and community pharmacies-because of the convenient location and extended working hours-offer a unique place to provide a vaccination service. The aims of this study were to assess community pharmacists' readiness and willingness to provide an immunization service and to identify the factors that may support the implementation of such service in Riyadh region, Saudi Arabia. Methods: This study was a cross-sectional paper-based survey conducted in the community pharmacy setting in Riyadh region between February and April 2016. A questionnaire was developed to determine the pharmacists' readiness and willingness to provide immunization services. A convenience sample of community pharmacists from five different parts of Riyadh was reached and invited to participate. Results: Of the 179 invited community pharmacists, 139 completed the survey (response rate was 77.7%). Of the 139 respondents, 76 (55%) expressed their willingness to administer vaccines and establish an immunization service. Among the participants that had shown willingness, many explained their reasons in accepting this role, including their accessibility in the community (56/57, 98.3%) and the possibility of expansion in the rate of immunization coverage in certain age group, such as the elderly (47/51, 92.2%). The remaining 63 (45%) respondents who were not willing and ready to provide immunization services mainly agreed that a lack of training (46/61, 75.4%) and concerns in maintaining patient safety (31/46, 67.4%) were considered as barriers to deliver immunization services. Most importantly, continuous professional education and training workshop on immunization and pharmacist's interest were the main drivers of immunization service implementation. Conclusion: Community pharmacists working in Saudi Arabia are willing to provide immunization services. However, overcoming the barriers identified in this study is a key to success in any future planning for implementing immunization services in the community pharmacy setting. Future larger studies are also needed to explore patients' willingness and acceptability to use this service from community pharmacists.

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