Almost half of Hawai'i's elementary and intermediate school students will get flu shots under a new program that will help keep the children healthy and help prevent the disease from spreading to others, state officials said.

"We think that is a major success," said Dr. Paul Effler, state epidemiologist with the Department of Health.

Yesterday was the first day vaccines were given. About 66,000 of the 142,564 eligible public and private school students in elementary and intermediate grades signed up to get the shots. That's about 46 percent of those eligible.

"When you look at the consent form that went out, which was quite long and detailed, almost one in every two parents made it through that process and got their kids signed up. That's fantastic," Effler said.

Hawai'i is the first in the nation to offer such a program. An additional 8,900 teachers and school staff — about 40 percent of those eligible — also will receive a flu vaccine during the program.

Asked why more parents didn't register their children for shots, health officials said some students may already have received a vaccination from their doctor, may plan on getting a flu shot elsewhere or may plan on not getting a flu shot at all.

"It's hard to know what the reasons are," said Health Department spokeswoman Janice Okubo.

Kaiser Permanente and Hawaii Medical Services Association were unable to say yesterday how many children have already received flu vaccines this year at clinics and doctors' offices.

SHOT CONTROVERSY

Some parents were concerned about a preservative in the vaccine that contains mercury, saying it is toxic and possibly causes autism. Parents whose children will get the shots, however, can choose between the injected vaccine and a spray mist that does not contain the preservative. Health officials said numerous studies have shown no link between the preservative in the vaccinations and autism.

The Health Department will likely conduct an evaluation at the end of the program that will look into the reasons why some students did not participate.

The school vaccinations are beginning just a month after the Health Department confirmed a small outbreak of influenza in a private school on O'ahu. The name of the school was not released.

Tests by the state found that a kindergartner and a first-grader came down with influenza A at the private school in late August, spurring talk that flu season in Hawai'i was starting early.

Asked if the vaccinations in the schools would come too late for some children, health officials said vaccinations are generally offered all the way through February and are considered ample protection during flu season.

Effler said because of Hawai'i's central location in the Pacific, it is possible for flu to break out sporadically at any time in the year. However, influenza season in Hawai'i is typically from December to March, he said.

"There is a low level of flu activity going on right now, but it will escalate as we get more into the winter months," he said.

Lanakila Elementary School was one of the first schools to host a flu vaccine clinic yesterday. About 166 students came through the school library throughout the day, receiving either a flu shot or a nasal spray.

Kindergartner Alexander Linmark was the first student in Juliet Kin's class to receive a shot.

He was visibly frightened just before getting his shot, but he proudly displayed his Daffy Duck Band-Aid afterward.

"I almost cried," he said, sitting at a library table with several other students who also received their shots. "I thought it was going to hurt. It was more like a poke."

Effler said the vaccination of schoolchildren against influenza is being urged because children tend to have very high rates of flu.

Studies have shown that students who get immunized for flu tend to miss fewer days of school and make fewer visits to the doctor, he said.

Last year, there were 15 outbreaks of flu reported at Hawai'i public schools. The state said that in some flu seasons, more than 10 percent of schoolchildren contracted the virus.

Nationally, influenza is responsible for more than 200,000 hospitalizations annually and about 30,000 deaths. A total of 152 children in the United States died in the 2003-04 flu season, many of whom were healthy and not in a high-risk group.

MORE CONCERN NOW

Hawai'i has had relatively mild flu seasons over the past few years. However, health officials have said they are more concerned this year. That's because Australia — which typically experiences its flu season during the Australian winter, which ended in September — has seen more than three times as many cases as normal, including the deaths of six children.

The state has about 115,000 flu shots or nasal spray vaccines, more than are needed, Health Department officials said.

Some 66,000 children are signed up to receive more than 88,200 doses of flu vaccine this fall through the program. Many children under the age of 9 need more than one dose of the vaccine, Effler said.

With the number of teachers and school staff expected to receive a flu vaccine, the total number of administered doses will rise to more than 97,000, health officials said.

Reach Loren Moreno at lmoreno@honoluluadvertiser.com.