Hawai'i is the first state in the nation to offer free flu vaccinations to all elementary and intermediate school students in an effort to slice the number of people who come down with the illness each year.

The $2.5 million program will kick off this fall and will be voluntary, with parents having to complete and sign consent forms before students can be inoculated. Either flu shots or nasal flu mist will be administered.

"It's such an opportunity to keep children healthy," said state schools superintendent Pat Hamamoto at a news conference.

The state last year ran a pilot program at three Mililani-area schools and is expanding it this year to all students — including most private school students — ages 5 to 13, with funding coming primarily from the Centers for Disease Control and Prevention.

Last year there were 15 outbreaks of flu illness reported at Hawai'i's public schools. The state said that in some flu seasons, more than 10 percent of schoolchildren came down with the illness, which can be marked by high fever, muscle aches, nausea and days in bed.

"Few illnesses have as great an impact on our state's health and economy as seasonal flu," said Lt. Gov. James "Duke" Aiona Jr., who characterized the program as making vaccinations of children fast and easy for families.

"Countless school and work absences, hospitalizations and even deaths, especially in our kupuna, could be prevented with a quick injection in the arm or nasal spray vaccine."

Nationally, influenza is responsible for more than 200,000 hospitalizations annually and about 30,000 deaths. A total of 152 children in the U.S. died in the 2003-04 flu season, many of whom were healthy and not in a high-risk group.

PRIVATE SCHOOLS, TOO

Besides the statewide public school system, the program also will be offered in most private schools, including those who are part of the Hawai'i Catholic Schools system or the Hawai'i Association of Independent Schools. School administrators and teachers also will be offered the free vaccinations, and the state is checking into ways the vaccinations may be offered to children who are homeschooled.

The promotions for the program will kick off in August, with more information and consent forms being sent home as the start of the flu season nears. Dr. Sarah Park, deputy chief of the Health Department's Disease Outbreak Control Division, said vaccinations will start in October and continue through January.

Park said Hawai'i is the first state to undertake a statewide school vaccination program, though similar programs are being considered elsewhere. Last year a number of school systems in Maryland vaccinated 114,000 students, with no severe allergic reactions or other serious adverse events.

SIDE EFFECTS MINOR

The state expects a similar experience here since flu vaccination side effects are typically minor, said state Health Director Chiyome Fukino. She said the state will be monitoring how effective the program is so it can turn over the data to the CDC.

"Flu vaccination really does matter," said Fukino, who added that the procedure is an inexpensive yet effective means of controlling influenza.

She said the school program could have a broader affect on health if it stops the spread of flu in schools since children won't be taking the infectious illness home and possibly giving it to their family.

"School-age children are more likely to get influenza than almost any other group, and when they do, they spread it around to their parents, grandparents, siblings and friends," Fukino said.

"Vaccinating a child against flu not only protects the child, but also their community."

The state also said vaccinated children have fewer illness episodes and fewer absences.

State figures show there were 142,564 children between the ages of 5 and 13 in the state last year, about 113,000 of whom attended public schools.

The state is purchasing about 120,000 doses of the vaccine because it doesn't expect 100 percent of children will opt for the program. Others are expected to continue getting vaccination from family doctors.

Last year's pilot at the Mililani schools had adoption rates as high as one-third of students, but officials said a higher participation rate could occur with the broader program as it starts the information campaign and vaccinations earlier.

It said some of the Mililani children already had received vaccinations from family physicians by the time the pilot project was rolled out.

"Last year's pilot project was extremely successful, making it natural to expand the vaccination project to more schools," Hamamoto said.

She said she is recommending each of her principals schedule a vaccination clinic.

"Providing free and easy access to flu vaccines for our students will mean fewer sick days and more quality time for classroom learning," she said.