The state House took the first steps Thursday to paving the way for Arizonans to get vaccinated against some diseases - including the flu - without having to go see a doctor.
Without dissent, lawmakers gave preliminary approval to legislation that would allow pharmacists to administer certain immunizations and vaccinations without a prescription. A roll-call vote will send the measure to the Senate.
Final action is unlikely to come before the swine flu runs its course. And, in fact, there is currently no vaccine on the market that works against this particular strain of the H1N1 virus.
But Rep. Nancy Barto, R-Phoenix, said the change in law will make it easier for people to get the shots they need when the next strain of influenza hits.
HB 2164 actually is a compromise of sorts between the pharmacists who want to be able to administer vaccinations without prescription and doctors who expressed concern about whether patient safety might be compromised.
As approved Thursday, the only shots pharmacists could prescribe would be those on one of two specific lists of vaccinations and immunizations approved by the Centers for Disease Control.
One includes vaccines required for international travel, with what is on that list depending on the destination. The other is the agency's adult immunization schedule. And that includes measles, mumps, pneumonia, human papilloma virus, hepatitis types A and B - and influenza.
"Part of the reason for the bill is to increase access to vaccines like the flu vaccine,'' she said.
Barto said the legislation is set up to be flexible, so that when new vaccines are approved - as she presumes one eventually will be for the swine flu - they can be added to the list of those which can be administered without a prescription.
She said there is a good reason to let people bypass having to go to a doctor first.
"About a third of the people don't even have a primary care physician," Barto said.
She said there are other safeguards built into the legislation, including a requirement for a pharmacist to inform the patient's doctor - assuming he or she has one - within 48 hours.
"It helps the record-keeping for the patient," Barto said.
Bob England, Maricopa County's health director, praised the legislation because it will result in more people getting inoculated. And that, he said, benefits everyone.
He said there needs to be a certain percentage of people getting vaccinated to build up a "herd effect."
"If you can get enough people vaccinated in the community, and get enough immunity in the community, then the germs don't have any place to bounce around (and) you never get exposed," England said. That means even those who are not vaccinated - or whose immunizations didn't take - are protected.
As to the current swine flu outbreak, England said it could take three or four months to develop an effective vaccine. But he said developing one still is significant, saying many of these infections come in waves.
He pointed to the flu pandemic of 1918 when the first wave "went largely unnoticed" because people did not get terribly ill. That first wave, like this swine flu outbreak, came in the spring.
"In September the second wave started and it hit the world like a ton of bricks," England said. Somewhere between 20 million and 40 million people died worldwide.