Published Online: July 10, 2009

Swine Flu Shots at School: Bracing for Fall Return

U.S. swine flu vaccinations could begin in October with children among the first in line — at their local schools — the Obama administration said Thursday as the president and his Cabinet urged states to figure out now how they'll tackle the virus' all-but-certain resurgence.

"We may end up averting a crisis. That's our hope," said President Barack Obama, who took time away from the G-8 summit in Italy to telephone another summit back home — the 500 state and local health officials meeting to prepare for swine flu's fall threat.

No final decision has been made on whether to vaccinate Americans, Health and Human Services Secretary Kathleen Sebelius stressed. That depends largely on studies with experimental batches that are set to start the first week of August — to see if they're safe and seem to work and to learn whether they require one or two doses.

See Also
View the federal government's Flu Web site for more information on the flu, its impact, and how to prepare for a possible outbreak.

But if all goes well, the federal government will buy vaccine from manufacturers and share it for free among the states, which must then "try and get this in the arms of the targeted population as soon as possible," Sebelius said.

First in line probably will be school-age children, young adults with risky conditions such as asthma, pregnant women and health workers, she said. Unlike regular winter flu, the swine flu seems more dangerous to these groups than to older people.

"Schools are natural places" to offer those vaccines, Education Secretary Arne Duncan said.

Go home and get schools, mayors and other community leaders to spread that message, Sebelius said.

"The last thing we want is millions of parents to be surprised" the day the get-your-kid-vaccinated-at-school note comes home, she said.

Schools do occasionally team up with local health officials for special flu vaccination clinics, but it's not common. More than 140 schools around the country scheduled flu vaccination days last fall, some providing free vaccine. Some vaccinated only students bearing parent consent forms; others opened their doors to entire families.

It will be a confusing fall, Sebelius acknowledged. Doctors' offices, clinics and even grocery stores will be in the midst of dispensing 100 million-plus doses of regular winter flu vaccine — and the swine flu vaccine, which will roll out slowly, will require at least one completely separate inoculation.

"We know a mass vaccination program of even modest scale will involve extraordinary effort on your part," Sebelius told state health workers.

She also announced $350 million in grants to help states prepare, money to be used partly to brace hospitals for a surge of demand from the truly sick and the well-but-worried.

"We want to make sure we are not promoting panic but we are promoting vigilance and preparation," Obama told the gathering.

See Also
The Department of Health and Human Services is launching a Public Service Announcement contest to encourage more Americans to get involved in flu preparedness. Learn more.

State officials welcomed the funds but had more practical questions for the feds, starting with what they learned from the chaos when swine flu first burst on the scene last spring and schools around the country closed because of sick students.

Since then, the virus has infected an estimated 1 million Americans and still is spreading, remarkable considering influenza usually can't tolerate summer's heat and humidity.

"What I need from all of you is an idea of when it is best to close, when it is necessary to close and when it's not," said Belinda Pustka, superintendent of Texas' Schertz-Cibolo-Universal City Independent School District.

"Closing school is a last resort not a first resort," Duncan stressed, but he said schools need to plan how they'll keep students learning if they do have to close for extended periods.

Pustka's schools posted assignments online. But Sue Todey of Wisconsin's Department of Public Education said that between rural geography and poverty, many students don't have the necessary Internet access and she's exploring using public television or old-fashioned sending home of paper assignments.

An even bigger problem: When schools close and working parents need to stay home — or any worker gets sick — too often, they don't get paid, said Paul Jarris of the Association of State and Territorial Health Officials. So they come to work, spreading infection.

"How are we going to assist people who don't have benefits?" he asked.

Homeland Security Secretary Janet Napolitano said she was working with the Labor Department to address that question, and she urged employers to allow telecommuting and make other provisions should swine flu hit their workplaces this fall.

Swine flu outbreaks in the fall are all but certain given its continued spread here — 50 outbreaks in children's summer camps so far — and abroad, with major problems in parts of the Southern Hemisphere.

What doctors can't predict is how bad it will be during the U.S. flu season, but Obama's team of heavy-hitters spent Thursday warning against complacency.

Even if swine flu proves no more deadly than regular winter flu, that kills 36,000 Americans a year — and with swine flu, teenagers and young adults are being disproportionately hit, said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention. And both types could very well spread at the same time this fall.

"If it doesn't happen, we'll be fortunate," Sebelius added.

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