Now that students in elementary and middle schools are getting the swine flu shots, the first shipments of the vaccine are arriving at University of Hawaii clinics, the state Department of Health said.

Dr. Andrew Nichols, interim director of University Health Services, said the initial doses arrived Friday and were administered to health clinic workers.

As more vaccine arrives, nursing students, medical school students and students with pre-existing medical conditions will be vaccinated.

Nichols said UH-Manoa has ordered “;several thousand”; doses of H1N1 influenza vaccine, but he is not sure when the bulk of the supply will arrive.

Once there are enough doses, health services hopes to hold a mass vaccination clinic and will make the shots and nasal spray more widely available.

But most college students are in a high-risk group and don't have to wait until the vaccine is widely available on campus, said Dr. Sarah Park, state epidemiologist.

Adults under 24 years of age are in a priority group for the vaccine and should call their local pharmacies and doctors to see if they can get the nasal spray or shot, Park said.

Initial reports from vaccine providers show that adults between 19 and 24 are lagging in getting the vaccine, she said.

It may be because young people “;think they're invincible,”; she said. “;Unless it happens to them or close friends, they really don't believe it can happen to them.”;

The focus has been on getting pregnant women and young children inoculated, but young adults are vulnerable too, Park said.

If they are healthy, she said, students and other young adults can get the nasal spray, which is in greater supply than the shots.

Of particular concern are college dorms, where young people live in close quarters.

There were outbreaks of H1N1 flu at the UH-Manoa dorms in May and at Chaminade University in the summer.

The outbreak at UH-Manoa, just before graduation, led the school to make the traditional handshake optional when graduates received their diplomas.

Brigham Young University Hawaii ordered 600 doses for its health clinic, said Michael Johanson, director of communications at BYU-Hawaii. There are 2,500 students and two-thirds live in university housing, he said.

Hawaii Pacific University and Chaminade do not operate university health centers. But the schools are encouraging students to get vaccinated and to take steps to prevent the spread of both H1N1 and seasonal flu.

Most campuses have put up posters and flyers around campus and have posted information on their Web sites about preventing the flu and where to get vaccinated.

“;It's an active campaign,”; said Rick Stepien, HPU vice president for administration.

The colleges are also working on pandemic plans, outlining how to isolate students in an outbreak and even conducting classes online if students aren't able to go to the campus.

“;These things could really be devastating to operations and academic programs,”; Stepien said.