Parents who opt to vaccinate their school-age child against the seasonal flu this year may also be able to get the swine flu vaccination.

The state Department of Health has sent letters to schools participating in the "Stop Flu at School" program, asking if they would like to also safeguard their students against the swine flu.

Clinics will likely be held at those schools wishing to participate, but discussions between the DOH, the Department of Education and health care providers are still preliminary, DOH spokeswoman Janice Okubo said.

Public health nurses will first administer vaccines against the common flu. Last year about 40 percent of students were vaccinated in the in-school program.

Any swine flu vaccination program would follow at least 30 days later, health officials say, and the logistics are complicated by the fact that the swine flu will likely require two shots.

It's not yet clear whether public health nurses would hold two series of swine flu clinics or whether some sort of program will be created in which they will administer only the first swine flu shot, with students getting their follow-up shots from private health care providers. Okubo stressed that such concepts are preliminary.

Parents must fill out a consent form for the seasonal flu, and a second consent form would be required for the series of swine flu vaccines.

"We're in discussions with the DOE and community vaccinators, but a lot of work needs to be done," Okubo said.

The unknowns: the number of swine flu vaccines being made and how many Hawai'i will get, how furloughs of state employees may affect the numbers of days that DOH employees will be able to administer vaccines, and what information parents and students will have to provide on the additional consent form.

School-age children have been among those recommended to be the first to receive the vaccine, Okubo has said.

The other unknown is the swine flu vaccine itself, which is undergoing clinical trials and is not expected to be available until at least September.

The private sector is beginning to receive vaccines, however. People can probably get a seasonal flu shot now through their doctor.

Physicians have received some flu vaccines and the balance is expected to arrive next week, according to a local distributor, Okubo said.

"People can check with their physicians to see if the vaccine is available," Okubo said.

The DOH would like to see more people getting flu shots this year in hopes of reducing all strains because of the potential for the strains to combine and mutate into deadlier forms.

"If multiple strains are circulating, our workers could be overrun with illnesses, and businesses and schools could be affected," Okubo said.

More than 43,000 cases of swine flu were reported nationwide between April 15 and July 24, when counting was halted. During that time, 5,011 people were hospitalized and 302 died.

Hawai'i has had six swine flu deaths.