A U.S. government media event to promote H1N1 school vaccinations on Friday included VIPs, cute kids and a phalanx of television cameras -- but only one in five children at the school had proper parental consent to get immunized.
"This school was ready to go," Health and Human Services Secretary Kathleen Sebelius declared after touring a makeshift vaccination clinic in the cafeteria at Dodge Park Elementary School, near Washington.
But 80 percent of the student body were ineligible for vaccinations due to missing paperwork during the day-long swine flu clinic.
Federal officials did not want to discuss the turnout. It underscored the challenge facing the U.S. government's $6.4 billion immunization effort which involves the widespread use of schools as vaccine clinics for the first time in a generation.
H1N1 poses a greater danger of severe illness and death for children and young people than seasonal flu, which is particularly dangerous for the elderly.
Only about 20 percent of U.S. children get vaccinated against seasonal flu in a typical year. Some parents, including many at Dodge Park Elementary, are holding back on H1N1 vaccination because of worries about the newness of the vaccine -- concerns that health officials say are unfounded.
The U.S. Centers for Disease Control and Prevention said on Friday that 76 U.S. children have died from H1N1 since April, with widespread swine flu in 37 states.
Most victims had underlying disease but 20 to 30 percent were healthy before they contracted swine flu.
This death toll compares with 46 to 88 pediatric deaths for entire flu seasons over the past three years, the CDC said.
250 MILLION DOSES
Dodge Park is among the first schools in the United States to serve as a clinic for student vaccinations as the government rolls out up to 250 million doses of vaccine by year end.
There will be some 90,000 vaccination sites nationwide including doctors' offices, clinics, hospitals and stores.
Federal officials have cautioned that the early weeks of the immunization program could be bumpy as state and local health departments cope with the strain.
One problem at Dodge Park was bureaucratic. Dozens of children could not get immunized because their parents submitted incomplete consent forms, officials said.
Another was that the only vaccine on offer was AstraZeneca (AZN.L) unit MedImmune's nasal spray, which is unsuitable for children with underlying conditions such as asthma. Injectable vaccine is due to become available next week.
But school officials said the main barrier was the safety concern.
"Many parents are not comfortable with it. They'd like to see more testing," school nurse Irene Campbell explained after helping to immunize 107 students out of a student body of 510.
Popular safety concerns are frustrating for public health officials, who say clinical trials show the new vaccine to be as safe and effective as seasonal flu vaccinations.
"It's very safe. Although the virus is new, the vaccine is not new. It's made exactly the way seasonal flu is made year in and year out," Sebelius said.