The role of the pharmacist in public health has been transforming and expanding in recent years.

For
example, in many states, including Massachusetts, pharmacists can become certified to provide
injections such vaccinations and long-acting antipsychotics without the appointment and trip to the
doctor’s office. In 2012, the number of vaccines administered by pharmacists was expanded from just
the flu shot, to include a total of 10 adult vaccines for prevention of illnesses such as shingles, hepatitis
A and B, meningitis, and more.4 In many cases, vaccines are available through prescription insurance
without a copay or the cost of an office visit. In many states, pharmacists have the authority to
recommend and prescribe routine medications such as smoking cessation agents and oral
contraceptives, as well as interpret common diagnostic tools such as for influenza and strep throat. 5,6
The trend continues to expand in many other states as the need for accessible and affordable healthcare
continues to grow and an untapped resource of providers is being recognized.7,8

As the healthcare industry shifts from a reimbursement structure based on volume towards a reimbursement structure based on

value, the unsung role of the pharmacist as an integral healthcare team member will come to realization. As practitioners trained

to assess the whole-patient picture, pharmacists connect the dots between prescribers and impact the clinical and economic

effects of drug therapy in an ever-changing healthcare system. Professional medical and pharmacy organizations remain

instrumental in advocating for the underutilized resource of pharmacists in any healthcare setting.

Approximately 2/3 of children and 1/4 of adults are afraid of needles.4 This is usually due to negative
past experiences with needles. Fear of needles can lead to future traumatic experiences with
immunization and in about 10% of children, non-compliance with immunizations altogether.4 Needle
fears persist into adulthood and contribute to non-compliant behaviors including refusal of
immunization and other health care interventions involving needles (e.g. blood tests, dental
appointments).5 This can result in resurgence of vaccine-preventable diseases and poor health
outcomes.5

In addition to this, pharmacists felt that vaccinating patients helped to increase their patients' trust in
them as well as allow for more time for clinical interactions. Pharmacists also noted that administering
the influenza vaccine allowed them to serve patients they may not have had the opportunity to
otherwise (Table 
The policy is intended to provide a more convenient and cost-effective way for consumers to get shots,

“This doesn’t require an office visit to a primary care provider, and it lowers the work burden on physicians,’’ Cranston said.
The rules, finalized last month, require that pharmacists have appropriate training that meets state standards for administering
vaccines. As with flu vaccines, consumers will not need a prescription to get a shot.

said the new state policy especially helps consumers who face transportation and time constraints. He said many drugstores have
ramped up services and vaccines.
An increase in health demands, with a complex range of chronic medicines and poor adherence to prescribed medicines, has

forced pharmacists to take a patient-centered approach [5]. The paradigm shift for pharmacy practice took turn in 1990, when

Hepler and Strand introduced the term "pharmaceutical care" [6]. Over the last few decades, pharmacy organizations and

academic training programmes around the world have promoted pharmaceutical care as a philosophy and standard of provision

of care for patients [7]. In essence, the pharmaceutical care concept has transformed the pharmacy profession to be more

accountable in patient care, especially to ensure that a patient achieves positive outcomes from drug therapy [8].

In many parts of the world, pharmacists have played a significant role in provision of pharmaceutical
care services. In addition, it is also widely believed that pharmacists can make a great contribution to
the provision of the primary health care, especially in developing countries [9, 10]. Their role varies in
different parts of the world: some deal with the preparation and supply of medicines, while some focus
on sharing pharmaceutical expertise with doctors, nurses and patients [11].
WHO has contributed effectively towards encouraging and defending the role of pharmacists worldwide [9]. Although all health

care providers and the public are rationally involved in using drugs, WHO has recommended a special role for pharmacists,

particularly in quality assurance and the safe and effective administration of drugs[12]. The International Pharmaceutical

Federation (FIP) and WHO developed the concept of "The seven star pharmacist", which stated that a well-rounded pharmacist

should be a compassionate care giver, decision maker, active communicator, lifelong learner and good manager; and should

possess good leadership qualities and the ability to be a teacher and researcher [13]. According to WHO, future pharmacists must

possess specific knowledge, attitudes, skills and behaviors in support of their roles [14, 15].

Due to the increasing demand for pharmacists in public health, WHO recommends a ratio of one
pharmacist per 2000 population in order for optimal health care to be delivered. Besides their pivotal
role in public health, pharmacists can also act as advisors to physicians and nurses and contribute to
policy decisions [16].
Clinical activities in pharmacies involve pharmacists providing patient care to optimize medication therapy and to promote
health, wellness, and disease prevention [1]. Among such activities are the identification, prevention, and resolution of drug-
related problems (DRPs) [2,3]. A DRP is defined as an event Pharmacists reported that their new role allowed them to offer an
additional service to patients and provided pharmacists with increased knowledge and skills regarding vaccinations. Some
pharmacists reported that it expanded their pharmacy business and attracted new patients (Table 3). They reported an increase in
their overall professional satisfaction. Participant 3 explained, “It's a very… good experience, very fulfilling

an increase in knowledge, skills and interactions with patients. Foxman S. Giving it their best shot. Pharmacy Connection. Vol
20. Winter 2013 ed. >Ontario: Ontario College of Pharmacists; 2013:15–21. [Google Scholar]
Centers for Disease Control and Prevention. Get to Know Your Pharmacist [webpage on the internet].
Centers for Disease Control and Prevention. 2018 Oct 18 [cited 2019 Feb 20]. Available from:
https://www.cdc.gov/features/pharmacist-month/index.html
2Werble C. Pharmacy Benefit Managers. Health Affairs Health Policy Brief. 2017 Sep 14 [cited 2019
Mar 4]. DOI: 10.1377/hpb20171409.000178
3Carroll AE. TheUnsung Role of the Pharmacist in Patient Health [webpage on the internet]. The New
York Times. 2019 Jan 28 [cited 2019 Feb 20]. Available from:
https://www.nytimes.com/2019/01/28/upshot/pharmacists-drugs-health-unsun...
4Lazar K. State allows pharmacies to offer more vaccines [webpage on the internet]. The Boston
Globe. 2012 May 21 [cited 2019 Feb 20]. Available from:
https://www.bostonglobe.com/metro/2012/05/20/massachusetts-pharmacies-po...
5Macdonald-Evoy J. House panel approve bill to let pharmacists write prescriptions, over doctors’
objections [webpage on the internet]. AZ Mirror. 2019 Feb 07 [cited 2019 Feb 20].
https://www.azmirror.com/2019/02/07/house-panel-approve-bill-to-let-phar...
6Lu S, Rafie S, Hamper J, Strauss R, Kroon L. Characterizing pharmacist-prescribed hormonal
contraception services and users in California and Oregon pharmacies. Contraception. 2018 Dec 16.
pii: S0010-7824(18)30525-0. doi: 10.1016/j.contraception.2018.12.002. [Epub ahead of print]
7Davis A. Bills aim to allow Arkansas pharmacists to dispense birth-control pills, administer some
vaccines [press release on the internet]. Arkansas Democrat Gazette. 2019 Mar 1 [cited 2019 Mar 4].
Available from: https://www.arkansasonline.com/news/2019/mar/01/bills-aim-to-add-to-drug....
8Cummings C. Gov. Reynolds proposal would increase access to birth control in Iowa [press release on
the internet]. KHQA. 2019 Feb 13 [cited 2019 Mar 4]. https://khqa.com/news/local/gov-reynolds-
proposal-would-increase-access-...
9Giberson S, Yoder S, Lee MP. Improving Patient and Health System Outcomes through Advanced
Pharmacy Practice. A Report to the U.S. Surgeon General. Office of the Chief Pharmacist. U.S. Public
Health Service. Dec 2011.

• Mohamed Izham Mohamed Ibrahim,

• Maqsood Ahmad,
• Imran Masood &
• Asrul Akmal Shafie 
Human Resources for Health volume 7, Article number: 54 (2009)