“The vaccine over time will be available to every child,” Education Secretary Arne Duncan said. “And I personally think the best place for them to have access would be at their local school or at a school in their neighborhood.”

The school setting is attractive for many reasons, said Dr. Anne Schuchat of the Centers for Disease Control and Prevention.

Swine flu seems to strike the young most often, and it’s particularly easy to spread from child to child. Moreover, school-age children “don’t see doctors very often,” Schuchat said, after they’ve accumulated the list of vaccinations required for school entry.

She added that it should be relatively easy for schools to offer flu-shot clinics because the federal government would be buying swine flu vaccine and sending it free to states.

“You won’t have to screen for insurance. That’s been a big challenge in school-associated regular flu-shot clinics,” Schuchat said. “That slows down the process.”

There is plenty of experience with vaccinating school kids for regular flu, and there is plenty of evidence it works.

For the fourth year running, Knox County, Tenn., vaccinated 30,000 children for free in schools and daycare centers last year. The county often closed schools because of winter flu outbreaks in the past, but it hasn’t since vaccinations began.

And in the last flu pandemic, in 1968, Tecumseh, Mich., vaccinated 85 percent of its school-age children, resulting in two-thirds less illness there than in a neighboring community.

There is an important difference with this year’s swine-flu inoculations: Health officials think two separate doses, about three weeks apart, will be needed. Studies are under way now to confirm that. If so, it means any school that offers the first shot must set up for each recipient to get the second dose.

Vaccination Plans

Different school districts handle vaccinations differently. Some will offer only vaccine against the regular winter flu–also important, as both types are expected to hit this year. In Florida’s Pinellas County, which includes St. Petersburg, the health department won an economic stimulus grant to vaccinate every student at all 78 elementary schools against seasonal flu, said Rita Becchetti, supervisor of school health services.

That could be confusing for parents trying to remember which vaccine their child is getting.

Chicago, on the other hand, probably will have swine-flu shot clinics at select high schools, not elementary schools, saying it simply doesn’t have the workers to send teams to more than 600 schools.

Berkeley County, W.Va., is considering drive-thru vaccinations at its three high schools, said district official George Michael.

In New York City, swine flu exploded in the spring at Saint Francis Preparatory School, which sent home 102 sick kids in one day. Today, City Health Commissioner Dr. Thomas Farley’s first choice is for kids to get vaccinated by their own family doctors, but he’s looking into clinics at schools or other locations.

“There’s an awful lot of children who need to be vaccinated,” Farley said.

Once the decision is made to offer flu shots at school, there are still issues to be worked out.

Not only must a parent sign a permission form, but someone needs to make sure it’s filled out correctly and matches up with the kid. And there is staffing: Health professionals will need to administer shots and also check kids for reaction to the vaccine.

Schools will also need to decide whether parents should be present, said Brenda Greene, director of school health programs for the National School Boards Association.

“Are you going to do it at a time when the parents can be present, if they want?” Greene said. “I’ve heard the kids are more panicky when their parents are around than when they’re not.”

Knox County, Tenn., has always used FluMist, the nasal spray flu vaccine, to eliminate that concern, and will again this year in school vaccinations against regular flu. But most of the swine flu vaccine supply will be in shot form, and program director Jennifer Johnson hasn’t decided whether to offer that in schools, too. She said one possibility is to inoculate kids at elementary schools after-hours, so parents could hold scared youngsters and then be vaccinated themselves.

The nasal spray is popular. Last year, FluMist maker MedImmune said it sent about 450,000 doses of the nasal spray vaccine to 140 school vaccination programs. The company expects FluMist vaccinations against regular winter flu to nearly double in schools this year.

In St. Paul, Minn., vaccinations are on the back burner until school gets under way after Labor Day, said Ann Hoxie, assistant director of student health and wellness.

“It’s not going to be the first thing on everybody’s mind. Reading and writing remain at the top of the list,” Hoxie said.