With novel H1N1 Influenza A (swine flu) established in Hawaii and regular flu season coming up from October to March, state epidemiologist Sarah Park is encouraging Islanders to get seasonal flu shots.

People should protect themselves because every flu-like case isn't being tested and they won't know if they have seasonal or H1N1 flu, she pointed out in an interview.

More than 90 percent of public and private elementary and middle schools — about 340 — are participating in the third annual “;Stop Flu at School”; program offering free vaccinations to students and staff, said Park, chief of the state Health Department's Disease Outbreak Control Division. The voluntary clinics will begin Oct. 7 and most will be in October and early November, she said.

She said the Health Department has been working with schools to try and move up some clinics to prevent infections and complete seasonal flu shots before H1N1 vaccine is available, tentatively in mid-October.

“;We have no firm date or numbers on how many doses,”; she said, adding, “;We're being told the Food and Drug Administration considers the vaccine a simple strain change from the regular formula. It will be a fully licensed vaccine.”;

Clinical trials are going on now but no more problems are anticipated with the H1N1 vaccine than with seasonal flu vaccine, she said.

Schools in the “;Stop Flu at School”; program have been offered the option of having an H1N1 vaccine clinic about a month after the seasonal flu clinic to avoid any confusion or mix-up on vaccines, she said.

Two shots likely will be needed for the H1N1 virus because “;we need a priming dose, then an immunizing dose.”;

However, public health care experts advise giving as many people as possible the first dose, “;which will probably give at least partial immunity,”; she said. “;With time, there will be enough doses coming from the five manufacturers to vaccinate everyone who wants one, as well as to get their second dose.”;

Doctors' offices, pharmacies and organizations that provide vaccinations have an ample supply of seasonal flu vaccine, she said, stressing that vaccinations “;are our most effective method of protection against infectious disease.”;

The Health Department has opened a Web site for any doctors who vaccinate patients to pre-register as H1N1 providers to facilitate getting target groups vaccinated, Park said.

Health officials also are talking to community groups, pharmacies, hospitals and other large organizations to get them involved in vaccinating the target groups, she said. They include health care and emergency medical workers, pregnant women, young people and others with chronic diseases.

Six Hawaii deaths have been reported associated with swine flu since the first confirmed cases May 5. All had underlying medical problems. The Health Department laboratory is testing only severe cases now, with surveillance efforts focused on trying to understand the characteristics of the H1N1 virus, Park said.

She expects more deaths to occur, pointing out, “;Seasonal flu kills and pandemic influenza shouldn't be expected to act any differently.”;

Testing for the pandemic swine flu and case investigations put a tremendous burden on the health system over the summer, she said.

“;Even in a pandemic, we're going to have people with diabetes, asthma and other conditions that need to be addressed on a regular basis. There is a lot of competition for health care access and delivery.”;