Photo by Bill Green Second-grader Cody Spencer gets his H1N1 nasal mist vaccine Friday from nurse Debbie Wareham in the cafeteria at Monocacy Elementary School. About 280 students were among those to get the vaccine at the school, which was the second school in the county to receive the vaccine.

About240 of Spring Ridge's 501 students got the vaccine, offered free through the Frederick County Health Department. On Friday afternoon, about 280 of about 700 students at Monocacy Elementary School got the H1N1 intranasal mist. Participation was voluntary and required parental consent.

All of the county's eligible elementary school students in public and private schools are slated for H1N1 flu clinics as vaccine becomes available. Certain existing health conditions, such as asthma, preclude getting the vaccine in mist form. The school order was randomly selected.

By the end of next week, clinics should be scheduled for Woodsboro and New Life Christian elementary school students. Packets of information that include a parental consent form and H1N1 flu and vaccine information sheets were to go home with students Friday.A flu clinic for students at Rock Creek School is set for Oct. 29. Students will receive the injectable vaccine.

"Most of the students there are not eligible to receive the mist," said Dr. Barbara Brookmyer, Frederick County health officer.

Lura Hanks, assistant principal at Spring Ridge, said parents were grateful for the opportunity to get the H1N1 vaccine for their children.

"It's been very positive," said Hanks, who referred parents' questions about the vaccine to the health department.

At Monocacy Elementary, assistant principal Sue Gullo said the health room staff did field some parent queries about the vaccine.

Once vaccine is received at the health department, information packets are sent home with students and consent forms are returned to the school, said Teri O'Gwin-Harris, director of school health for the Frederick County Health Department. The school nurse reviews the forms to make sure students are eligible for the intranasal mist vaccine. The school nurse and principal then schedule the two-hour clinic.

The first few clinics have taken about five days to schedule, but "the process will start speeding up now that we have the packets ready to go," O'Gwin-Harris said.

At the clinics, health department RNs administer the vaccine. Health technicians and the school nurse keep the flow of students moving. At Spring Ridge, almost half the students were vaccinated within the first 30 minutes of the clinic.

"It's a fast way to get a lot of vaccine out in a short time and to the right population," said Christa Williams, health specialist for Frederick County Public Schools.

Students 9 and younger will need two doses a minimum of 28 days apart for full effectiveness. They will get just the first dose through the school program, said O'Gwin-Harris. By then she expects the vaccine will be more readily available and parents can take their child to a flu clinic or to their health care provider for the second dose.

Children who turn 10 between doses will still need the second dose for full effectiveness, said Brookmyer. "We're not planning to (offer the second dose) at this time because we're not sure what version of the vaccine we will have at that time." There are no plans to offer the injectable vaccine to elementary students.

Brookmyer said people are becoming more comfortable with getting the H1N1 vaccine in part because of a better understanding of how it's being produced.

"It's the same as for seasonal flu, by the same manufacturers and the same procedures," she said. "The FDA views (H1N1) as a strain change, just as occurs to a degree every year with seasonal flu. That's why it didn't require any additional testing. (H1N1) wasn't recognized soon enough in the production process, which begins in spring; otherwise it would have been part of the seasonal flu vaccine. It may be next year."

She also said seeing more people sick with the flu and missing school or work has changed some public opinion on getting vaccinated for H1N1 and seasonal flu. Reports of pneumonia in association with H1N1 in healthy people have also swayed public opinion.

Vaccinating elementary-age children against influenza has proved effective in reducing the spread of the virus, Brookmyer said. A recent study in Carroll County schools, in which elementary students received the seasonal flu vaccine, showed that the absentee rate not only dropped in that age group but in middle and high school students as well, according to Brookmyer.

The health department is still awaiting more seasonal flu vaccine.

"It was ordered back in February and the amount was based on the number of the previous year's interest," Brookmyer said. "And every years fewer people have been coming to the health department for seasonal flu vaccines."