Continued: How to get flu vaccine to children en masse

With a federal panel now urging annual flu shots for all school-aged children, Minnesota health officials are looking for new and creative ways to offer the vaccine en masse.

In the fall, flu-shot clinics may start popping up in new places, such as schools, as officials try to efficiently deliver the vaccine to more people. If everyone the federal panel recommended was vaccinated, as many as 30 million more Americans would seek flu shots next year.

But so far, no one is predicting a run on the vaccine, said Kris Ehresmann, who heads the vaccine program at the Minnesota Department of Health. "The thought that the public would all of a sudden come in one mad rush to pursue vaccine is a very, very unlikely scenario," she said. Mainly health officials are studying ways to make it convenient so more people will try to get kids vaccinated.

Even yet this flu season, the push is on. March is past the peak of flu season in Minnesota and far beyond when most people consider getting a flu shot. But renewed interest in the vaccine surged last week with the state's first death of a child this season to flu.

Jasmine Levy, 12, whose step-grandmother said the girl had not had a flu shot, died during the night before her mother even realized she was sick with flu and an accompanying staph infection. Levy had an underlying health condition -- asthma.

A few days later, the vaccine advisory committee to the Centers for Disease Control and Prevention (CDC) voted to recommend flu shots for virtually all children ages 6 months to 18 years.

Until now, healthy children ages 5 to 18 were generally considered a low priority. But officials are looking anew at school-aged children as the population that initially gets the flu and then spreads it to the very young and very old -- for whom the flu can be far more dangerous. In the wake of Levy's death and the CDC recommendation, the Minnesota Visiting Nurse Agency organized late-season flu shot clinics that were held Friday and Saturday.

Turning to schools

Next flu season, the new federal recommendation could mean extra walk-in clinics at pediatricians' offices, Ehresmann said, or a bigger role for "non traditional" sites such as MinuteClinic and Target clinics.

But the most appealing sites, some say, are where children naturally gather.

"I do think schools are a natural setting," said Patricia Stinchfield, director of infectious disease at Children's Hospitals and Clinics of Minnesota, and a member of the federal vaccine advisory panel. She and others say there are logistical issues to be addressed, such as getting parental permission without overburdening the schools.

Last fall, a group of Minneapolis charter schools experimented with providing flu shots with the help of the Minnesota Visiting Nurse Agency. About 250 students and adults got flu shots at schools, said Peck Tierney, the agency's school health coordinator.

Now the organization, which provides flu shots to many nursing homes and businesses, is talking with the Minneapolis public schools about a similar project this fall.

Mary Heiman, nursing manager for the school district, said schools are wary of taking on the burden alone. "We have not been in the business of giving immunizations for a very long time," she said. "I could see ... why the schools would seem like a natural place for that, but we would need some very strong collaborative partners." She said no decision has been made yet for next fall.

The key to curbing flu?

Typically, only a fraction of school-age children get flu shots: just under 13 percent of kids with no special risk factors, according to a 2005 government survey.

Even high-risk kids are often no-shows: only about a third of those with underlying problems such as asthma got flu shots, the survey found.

Yet experts say vaccinating kids could be the key to curbing influenza.

"In any community, the bulk of the disease is actually in school-age kids, and then they spread it to the rest of the community," said Dr. Peter Dehnel, a pediatrician in Eden Prairie and medical director of the physician network at Children's Hospitals and Clinics. If kids get flu shots, he said, they're less likely to infect their baby brothers and sisters or grandparents.

Stinchfield, who voted for the recommendation, said she's not worried it will cause an unmanageable stampede of parents seeking shots for their kids next fall. "I think it's going to be slow in uptake, and we have to set realistic goals," she said.

Realistically, they couldn't handle all the kids at once anyway, Ehresmann said. "We don't have enough vaccine to meet the current recommendations." If everyone who is supposed to get the vaccine actually did, she said, "there would definitely be a problem in terms of shortages."

But that's unlikely, she said, and they plan a gradual approach with school children.

"We can't eat the elephant in one bite," she said, but "we're going to continue to move forward to make this happen."

Maura Lerner • 612-673-7384