WAILUKU, Maui - Swine flu vaccine is still arriving on Maui in a trickle, but a wave of children will get the shot when public and private schools start up immunization clinics later this month.
Medical providers and state health officials said they've been inundated by inquiries and requests for the vaccine and asked for understanding as high-risk groups continued to receive priority for the limited number of doses coming into the county.

"We've got to ask the public to be patient," said Marc Nishimoto, public health emergency prepardeness planner at the Maui District Health Office. He said he receives numerous calls from the public and doctors every day asking about the status of the vaccine for swine flu, or H1N1.

While they wait, people shouldn't forget to practice the first preventive measures against the illness, which include hand washing, covering one's mouth and nose when sneezing, and staying home when one is sick, said Maui District Health Officer Dr. Lorrin Pang.

He said those practices can also help prevent many other diseases.

So far, both officials estimate that Maui County providers have received around 10,000 doses of the H1N1 vaccine in injectable or nasal spray form. Of that number, they estimate around 5,000 people have received it. Some of the remaining doses are being held for school vaccinations, and the Health Department is working to redistribute vaccines from providers who may have an oversupply.

Maui Medical Group President Dr. Bill Mitchell said the physicians in his group had quickly used up the supply they received last month.

Maui Medical Group allocated the vaccines it received to physicians with special attention to pediatrics and obstetrics, he said, and used up its supply of about 2,000 doses in about two weeks, he said.

"Needless to say, there's a huge demand for it," he said.

Doctors at the clinic are definitely seeing cases of H1N1, Mitchell added.

"It's here," he said. "What we're seeing is young adults, in their 40s or less, who come in with sudden onset, high fever, and they feel terrible. Fortunately it's usually self-limited, it goes away in a few days."

During the Department of Health's weekly H1N1 media update Thursday morning, epidemiologist Dr. Sarah Park said the department just got word that the CDC has allocated 181,400 does of the vaccine for the state.

Of that amount, the state has set aside 80,000 doses for H1N1 clinics at public and private schools.

Unlike states on the Mainland that have run out of vaccines, Park said she is confident that won't be the case here.

"We will not be in that situation here in Hawaii," she said.

On Maui, the first H1N1 school clinics, which are separate from seasonal flu clinics, will be held Nov. 23 at Lokelani Intermediate School and Montessori School of Maui.

School H1N1 flu vaccine forms have already been sent out and collected, said DOH spokeswoman Janice Okubo.

She said no late forms will be accepted.

Although the returned consent forms are still being tallied, Okubo said 150,000 forms were sent out to parents of public and private school children statewide.

There is no fee for the vaccine, which is available in nasal spray or injectable form, Okubo added.

The clinics are only being offered for students in kindergarden through 8th grade, as those schools already have seasonal flu clinics in place, making the logistics of H1N1 clinics easier, Okubo said.

(Children younger than 10 years old will need to receive two doses of the H1N1 vaccine to achieve full immunization. The school-based clinics will administer one of those doses. Parents of children who participate should consult their primary-care physician to schedule the second dose.)

Okubo said that in the past a pilot high school flu clinic drew less interest and attendance, so focus was put on the elementary and intermediate grades. High school and college students can receive the vaccine from their medical providers.

Maui Community College previously reported that it had received an initial batch of the vaccine. Last month, officials said they would be administering the vaccine to students in the priority groups first.

Pang said his Maui office is focused on making sure the priority group gets immunized.

According to the Centers for Disease Control and Prevention, the priority group consists of: pregnant women; people who live with or provide care for infants younger than 6 months; health care and emergency medical services personnel; people 6 months through 24 years old (especially those with a higher risk for influenza-related complications) and people ages 25 to 64 who have certain medical conditions that put them at higher risk for influenza-related complications.

Mitchell said most patients who don't meet those criteria have been understanding about having to wait for their turn to be immunized.

"They actually do read the newspaper, and they understand they may not be in a high-risk pool," he said. "Rarely do I have people who say, 'I want it anyway, no matter what.' They're appropriately concerned - not panicked."

Other than individual doctors, Nishimoto said Safeway stores in Kahului and Kihei, Walgreens' Lahaina store and one of its pharmacies in Wailuku, and the Paia Pharmacy all ordered .

But people should call first before heading to these locations. People under 18 years old will not be able to be vaccinated at most pharmacies.

Nishimoto said priority groups will be served first and that only state residents - not visitors - will be served.

Nishimoto added that Safeway now can also vaccinate children ages 5 to 18 if a referral is given from the child's physician.

For more information on H1N1, see: www.flu.hawaii.gov or the Centers for Disease Control and Prevention: www.cdc.gov/H1N1FLU.