OBJECTIVES: In the fall of 2009, two Canadian provinces, BC and Alberta, allowed pharmacists to deliver immunizations (policy provinces), while other provinces across the country either did not change their legislation or implemented this policy after 2010 (non-policy provinces). The purpose of this study was to investigate the impact of pharmacist delivered immunizations on influenza immunization rates. We also evaluated perceptions of individuals around the need for immunization in those provinces that changed policy in 2009 compared to those that did not. METHODS: The Canadian Community Health Survey (CCHS) is a nationally representative survey that reports results every two years. With respect to influenza immunization, respondents were asked whether or not they received an immunization in the past year and if not, they were asked if they believe immunization was unnecessary. Hierarchical logistic regression was employed, clustering respondents by province of residence, to examine trends in these two outcomes from 2007/08 (prior to policy implementation) to 2009/10 (after policy implementation). RESULTS: Between 2007/08 and 2009/10, the adjusted odds of getting an influenza immunization decreased by 22% (p<0.01) in non-policy provinces, but increased by 4% (p=0.06) in policy-provinces. The adjusted odds of ‘thinking an immunization is unnecessary’ increased across Canada, but at a slower rate in provinces that received the policy.  The odds of ‘thinking an immunization is unnecessary’ increased by 27% (p<0.01) in non-policy provinces compared to a 6% (p<0.05) increase in policy-provinces. CONCLUSIONS: Our findings suggest that the pharmacist immunization policy has not yet remarkably improved immunization rates, but may have prevented a more severe decline that was experienced by non-policy provinces. It may have contributed to a smaller increase in perception that immunization is unnecessary relative to non-policy provinces.  Further research is needed to ensure that pharmacist delivered immunization improves population level immunization rates.