STEVE INSKEEP, host:

So that's the debate about children's health. Let's talk next about your health. The flu season is approaching and you may be thinking about getting a flu shot.

Unidentified Man #1: This will feel like a little pinch.

Unidentified Woman: That's easy.

Unidentified Man #1: That's it.

Unidentified Woman: Great. Thank you.

Unidentified Man #1: Have a good afternoon.

Unidentified Woman: Thanks. You too.

INSKEEP: Some people may be cringing just hearing that.

Now, you do not need to see a doctor or a nurse anymore to get a flu shot. In many parts of the country pharmacists are giving vaccinations.

NPR's Patty Neighmond reports.

PATTY NEIGHMOND: People like Anne Collier(ph) actually seemed to enjoy getting their shots from pharmacist Ed Danoff, who owns the Medicine Chest pharmacy in McLean, Virginia.

Ms. ANNE COLLIER (Resident, Virginia): In fact, I got my shot here last June. It's just for convenience. And because they're so nice that it makes you feel that you are having a good time when you come to get a shot.

NEIGHMOND: The Medicine Chest pharmacy is a little white house with green shingles, a family-owned business.

Today, people are literally lining up for vaccines, everything from flu, pneumonia and tetanus to hepatitis A, B, HPV and shingles.

Ms. PATTY VELIOTES (Resident, Virginia): Actually, it was all of the testimonials of people my age that have had shingles that have had really, really bad reactions. And I thought, well, gee, I didn't have that, so maybe I better go and get the shingles shot.

NEIGHMOND: Patty Veliotes is 76 years old with flowing white hair and striking turquoise jewelry. Today she's being vaccinated against flu and shingles.

Mr. ED DANOFF (Owner, Medicine Chest Pharmacy, McLean, Virginia): One more. This one probably - the needle hurts less, but it burns a little bit.

Ms. VELIOTES: Okay, which one was that?

Mr. DANOFF: That was shingles.

Ms. VELIOTES: Oh, that was shingles. Okay.

NEIGHMOND: The American Association of Pharmacists reports the number states allowing pharmacists like Danoff to provide vaccines has more than tripled in just 10 years. Today most states - 46 - allow it. States differ when it comes to rules about exactly which vaccines pharmacists can provide, what kind of training they need, and whether they need the supervision of a doctor.

In Danoff's case, it was no problem getting a physician to agree to be available for consultation if needed.

Mr. DANOFF: Actually, this all started at the request of a local doctor, who wasn't getting reimbursed enough for giving flu shots.

NEIGHMOND: It's a typical complaint from doctors about many vaccines, especially the newer costlier ones. Insurance reimbursement is often inadequate. But pharmacies can buy in bulk and store vaccines more easily than doctors, and they can also take a bigger financial risk because they can make profit off other merchandise as well.

Ed Danoff took the 20-hour vaccine training course offered by the American Association of Pharmacists. He learned how vaccines are made, how to give them, and how to screen patients who should not get them. For example, since most vaccines are grown in eggs, Danoff says anyone with an egg allergy must consult a doctor before getting vaccinated.

Mr. DANOFF: I did actually - had one patient who didn't know he was allergic to eggs. He was tentative filling out his form and I happened to notice that. And I requestioned him, just to go over the important questions, and he mentioned that he didn't know if he was allergic to eggs, but his mother never gave him eggs and he wasn't sure why. It turns out he was allergic to eggs. I asked him to go to an allergist and get tested for it.

NEIGHMOND: Danoff says among the nearly 10,000 vaccinations he's given at the Medicine Chest over the last eight years, he's never had a patient have an allergic reaction, and if they did, he's trained in CPR and has medication to treat it.

Dr. Kenneth Schmader is chief of geriatrics at Duke University Medical School and at the Durham VA. Schmader says most of the vaccines pharmacists give are low-risk.

Dr. KENNETH SCHMADER (Durham VA Medical Center): I think it's a good idea from a public health perspective. We try to remove as many barriers as we can to vaccination, and having as many providers as possible, because vaccine is a good thing, and that includes pharmacists.

NEIGHMOND: Officials with the Pharmacists Association say they've trained nearly double the number of pharmacists this year to provide vaccines than they did last year. Like Ed Danoff, many pharmacists report it's not only a service to customers; it's a boon for business.

Mr. DANOFF: But I thought it'd be a nice way to get more prescription patients. It was just a way to get some new, fresh faces in the pharmacy. And so far that has worked.

NEIGHMOND: Which is a big deal for small pharmacies like the Medicine Chest that have to compete with huge national discount drug chains.

Patty Neighmond, NPR News.

INSKEEP: That's Your Health for this morning, and you can find the latest updates on health on everything from cough medicine to drug-resistant bacteria by going to npr.org/yourhealth.

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