As the number of residents showing up at public flu-vaccine clinics across greater Sacramento dropped over the past few years, some health officials worried. Were people getting complacent about the flu?

It turns out that people are still getting their shots. They're just getting them somewhere else.

Supermarkets and retail drugstores such as Walgreens and CVS are increasingly getting into the vaccine business. The share of seasonal flu shots given at stores jumped from 7 percent in the 2006-07 season to more than 18 percent last fall and winter, the Centers for Disease Control and Prevention reports.

A doctor's office is still the most common place to go – 40 percent of people who got immunized last season did so in that setting – but stores came in second.

Among seniors age 65 and over receiving the vaccine, 24 percent got it at a store.

The turning point for retail pharmacies came in 2009, when the H1N1 virus, or swine flu, was circulating the globe. The U.S. government that fall urged every possible provider – including retail pharmacies – to offer inoculations.

The pandemic prompted record numbers of people to get immunized against the regular flu, too. Manufacturers distributed about 111 million vaccine doses that season – the first time the number topped 100 million – and 140 million in the following one, the CDC estimates.

Yet even after swine flu went away, the new vaccine infrastructure kept chugging.

"It was really a watershed year," said Chrissy Kopple, spokesperson for the National Association of Chain Drug Stores. "More and more people were becoming aware that in their neighborhood they could go down the street and get their flu shot."

In the past dozen years, the number of states allowing pharmacists to give seasonal flu shots has jumped from 22 to 50. More children also are receiving vaccines at schools, said CDC spokesman Tom Skinner.

Offering vaccines may be good business for pharmacies, but health officials say it's also good for the overall health of the community. Many stores provide shots daily and without the need for an appointment. They typically charge about $30 per shot, though many insurance plans cover the full cost.

If that convenience prompts more people to get immunized, the health officials say, so much the better.

"To us, the most important thing is that people get vaccinated," said Lynnan Svensson, supervising public health nurse for El Dorado County, which has seen attendance numbers drop at its public vaccine clinics.

Attendance has similarly plunged at public flu-vaccine clinics across the Sacramento region this year. The Yolo County clinic in Winters last flu season vaccinated 700 people; this year, 280 people came. Placer County reduced the number of clinics it offers from nine to four since last flu season because of lower demand the past few years, said county spokesman Mike Fitch.

It's hard to say exactly how much money the flu shots are worth to pharmacies. CVS and Walgreens, for instance, haven't reported vaccine revenue separately from other income. But Matthew Coffina, a stock analyst with Morningstar, said the value probably doesn't come in dollars.

"It's something they want to do to get people coming into their stores, to build those customer relationships," he said.

Even if CVS made a couple hundred million dollars on flu vaccines, Coffina added, it would be "just a drop in the bucket" of the chain's $60 billion in projected retail sales this year.

"It's one of the many ways in which we are expanding the role of the community pharmacist," said Walgreens spokesman Jim Cohn.

In the past two years, the number of Walgreens pharmacists licensed to give flu vaccines has jumped from 7,000 to 26,000 nationwide. The stores also provide various immunizations, blood pressure checks, tests of blood sugar and cholesterol, and other services.

Cohn predicted that when the new federal health care law brings new patients onto insurance rolls in 2014, pharmacists will be "a key part of the solution" to help the health care industry serve them.

Locally, county health departments say they still play an important role in giving inoculations.

"We're out to serve the people that have no other access, or the people that just like to come to us," Svensson said. "Beyond that, we're just glad the rates (of vaccination) are going up."

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Call The Bee's Grace Rubenstein, (916) 321-1270. Bee researcher Pete Basofin contributed to this report.

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