It’s not fear about the H1N1 vaccine that School Nurse Coordinator Kim McPherson hears from parents these days, but questions about when the shot will be in schools.

“Most of the interaction has been positive,” says McPherson of parents’ calls. “They just want to know when.”

But the “when” and “where” of the shot is out of McPherson’s control.

“It will really depend on the response from the parents and the availability of the vaccine,” she says.

For now, there is just not enough vaccine for everyone who wants it.

The Center for Disease Control reports 186,400 H1N1 vaccine doses shipped to South Carolina at the end of the month, whose population is roughly 4,479,800, according to 2008 U.S. Census Bureau data.

As far as the number of vaccines a school will get, there are no set doses-per-school, says County Health Supervisor DHEC region 3 Beth Bozard, but she thinks allocations per county is based on population.

But the district sent backpack mail home this week with a shot permission slip to get ready.

And students will only receive the vaccine if their consent form is signed.

The district will probably begin in-school immunization at the end of next week, starting with elementary schools and moving class by class through middle then high schools if vaccinations are available, says McPherson.

Children under age nine need two H1N1 vaccines. The CDC recommends that the two doses of 2009 H1N1 vaccine be separated by four weeks, but says if the second dose is separated from the first dose by at least 21 days, the second dose is valid.

Both shots will be available at school, says McPherson.

Nurses from DHEC, some hired part-time just to help give H1N1 shots, will work with Newberry school nurses to help students transition easily from class to get the shot and back to class again without much interruption.

The first elementary school to host an immunization depends on the number of parents at a school who return the permission slip and, again, the number of vaccines available, says McPherson.

“We plan to vaccinate all children whose parents sign the consent. We had originally planned to do all the schools in one week, but due to the amount of vaccine and the supply chain, we may have to do fewer schools each week until we get them all done,” says Bozard.

If enough vaccine was here, McPherson estimates the district could give the shot to every student who wanted it within six or seven days.

TAKING SOME

STING OUT

Hearing the CDC say the shot is safe and made in similar fashion to the regular seasonal flu shot may take some of the sting of parental concern, but McPherson blankets on more ease:

“There will be nurses with them through the entire process,” she says.

And shot sites will have “comfort stations” perhaps with cookies to reassure students that all is well. Nurses will use the comfort station time to observe the students to make sure they’re OK.

And the district will only give shots before 12:30 p.m. so students are in school long enough for adequate monitoring, says McPherson.

The shot is also “100 percent free” says McPherson because the federal government is paying for the vaccine.

Parents who want to stand with their child during vaccination will not be refused, says McPherson, but may have to be there all morning since the district can’t promise a certain time slot.

“Because of the scheduling, not knowing how long its going to take, if they did, they may have to wait a long time,” says McPherson.

Another comfort is the in-school system set up for the H1N1 shot.

The nurse regularly stationed at a school will not give the vaccine there, so students don’t get “white coat syndrome,” automatically connecting their nurse with a shot.

“We don’t want to do anything to impeach the relationship that students already have with their building nurse,” says McPherson. “The building nurse will probably be the one in the comfort area, or the one getting them out of class.”

WHO SHOULD GET IT

The CDC still honors its list of who should be first to get the H1N1 shot:

-Pregnant women

-Persons who live with or provide care for infants less than 6 months old

-Health care and emergency medical services personnel

-Persons aged 6 months to 24 years

-Persons aged 25 to 64 years who have medical conditions that put them at higher risk for influenza-related complications.

Highlighting one group in the list, Dr. David Merz of J. Kess Derrick Medical Center points to youth. A local physician, Merz is very knowledgeable in virology.

So far in this country, young people less than age 24 make up roughly 80 percent of cases of the novel H1N1 influenza, Merz said.

“Students are encouraged to get vaccinated,” he said.

But the infection is slowing a bit in our state, and the shot may not be as beneficial as in other areas, he says.

South Carolina is, after all, one of only two U.S. states shown in gold on CDC recent map to have “regional” activity compared to most of the rest of the country’s “widespread” H1N1 activity.

“It’s ebbing somewhat. I would say three weeks ago it was very active,” Merz says

“If the infection is diminishing, I’m not sure how helpful the novel H1N1 vaccination will be for right now. Whereas, if you had it to give in, let’s say in Chicago or something—it seems they’ve got tons of activity in that area—then there it might make a dent in how many people get infected,” Merz says.

But it won’t be bad to get the shot, he says, calling information against the vaccine “really, really sad.”

However, those who already had the bug and a “confirmed culture” proving H1N1 infection “may not need the vaccine,” says McPherson.

But those who were sick and had only a rapid flu test showing a positive case of type A influenza should get the shot, she says.

Probably it was H1N1, but it’s a possibility it may not be.

“You’re not 100 percent sure on that rapid test what it was,” says McPherson. “So to ensure that you child has the protection, the CDC is recommending to get the vaccine.”

From her days working in the health department, McPherson says it’s better to over-immunize than under-immunize.

“And I think that’s sort of the message here too,” she says.

The novel H1N1 flu (swine flu) spreads the same way that regular seasonal flu viruses spread, mainly through the coughs and sneezes of people who are sick with the flu.

It can also spread when a person touches an object or surface that harbors flu germs, then touches their eyes, nose or mouth.

The best way to prevent the flu is by getting your flu shot each year, says the Department of Health and Environmental Control.

Slow the spread of flu by:

• Talk with your child about hand washing. Frequent hand washing with soap and warm water helps remove germs and viruses. Children should wash their hands for about 20 seconds or as long as it takes to sing the "Happy Birthday" song twice.

• Teach your child to cover his or her mouth and nose with a tissue when coughing or sneezing and then to throw the tissue away. Your child can cough or sneeze into his or her upper sleeve if no tissue is handy. Wash hands afterward.

• Encourage your child to eat healthy foods, exercise, and get plenty of rest.

• Keep your child home if he or she has a fever of 100oF or higher and a cough or sore throat for which there is no known cause. Call your child’s school and tell them your child’s symptoms. In most cases, your child can return to school after he or she has been fever free for at least 24 hours without taking fever-reducing medications.

• Make sure the school has a way to reach you during the school day. Students who become ill at school with flu-like symptoms must be sent home.

—info from DHEC