Seasonal flu immunization clinics are giving local health departments and school districts a look at how they might handle large-scale immunization against the H1N1 virus. Durham County has been immunizing fifth graders all week as a trial run for clinics during the school day.

"What we'll be getting out of the seasonal clinics is how quickly can we do them, how many can one nurse do in an hour, two hours," said Sue Guptill, director of Nursing and Community Health for the Durham County Health Department. "That will really help us be able to tell how efficiently we can get this done."

But counties differ on how they'll achieve that efficiency. Wake County is hoping to reach its 140,000 public school students and thousands more private and home school students through a series of after-school clinics. More than 900 seasonal flu shots were given to students in the first two clinics. Wake Community Health Director Sue Lynn Ledford said H1N1 vaccine could be offered in later clinics if enough is available.

Durham County is planning to provide H1N1 vaccine to most of its 33,000 public school students during the school day.

"The 30 minutes that a child spends out of class might save them three or four days of actually being absent," said Guptill. "In the worst case scenario, where there was huge absenteeism from any kind of flu, then the risk of having to shut down some classes or shut down schools would have a big impact on instructional time."

But offering the vaccine is only part of the solution. Health officials are finding that educating parents about which vaccine is available and why it is important is a challenge. Just 38 of more than 90 fifth graders at Bethesda Elementary, one of the district's largest elementary schools, received vaccine during a Thursday clinic.

"They squirt and then you sniff," said student Faith Henderson. "And it tingles, but it makes your eyes water. It doesn't really hurt."

Guptill said even a small group of students who are immunized - whether for seasonal flu or H1N1 or both - can have an impact on reducing absenteeism for students and for teachers. And making immunizations readily available is critical to making that happen.

"It's really a win-win situation," said Mary Hoose, Bethesda's school nurse. "For working parents, it's hard to get to the hours of a clinic, even if there are evening hours, it's hard to skip dinner and go. So it's very convenient for the families and it was free."

Durham County will hold two H1N1 vaccine clinics for elementary age children on Oct. 19 and 21, from 3 p.m. to 7 p.m. at the Durham Public Schools Staff Development Center at 2107 Hillandale Road. H1N1 vaccine also is available at the Durham County Health Department.

Guptill said there are plans to immunize middle and high school students against H1N1 during the school day. Parents of older children can expect information to come out before end of October.