(AP) -- The nation's largest school district said Tuesday it will offer free swine flu vaccinations to its 1 million-plus schoolchildren as New York City takes bold steps to avoid becoming the country's flu epicenter again in the fall.
Hundreds of school districts nationwide have agreed to allow vaccinations in school buildings, once the vaccine becomes available in mid- to late October as the nation prepares for a spike in swine flu cases in the coming months.
New York officials said the vaccine - also available to private school children - would mostly be given to children through a "mist" in the nose rather than by injection.
Last spring, the virus rapidly spread among high school students, beginning with a private high school in Queens. Officials estimate as many as 1 million people were sickened in the city, and more than 50 people died. Nationwide, swine flu has killed about 500 people.
President Barack Obama said Tuesday that while swine flu vaccine will be voluntary, the government will "strongly recommend" that people get it.
"I don't want anybody to be alarmed, but I do want everyone to be prepared," the president said of the second, more serious wave of the virus expected this fall.
A White House report suggests up to half the U.S. population could be infected.
"We know New Yorkers are concerned, very understandably, about the risks that they might face," New York City Mayor Michael Bloomberg said. "Our job is to plan in case it is a big deal."
The vaccine is still being tested and analyzed. Once it is deemed safe and effective, the government - which has bought 195 million doses - will ship the vaccine to state health departments in portions, starting with about 45 million doses in October.
Brenda Greene, director of school health programs for the National School Boards Association, said the city could wind up being "a great role model" for school districts across the country, but she was also surprised by the announcement, given questions about the availability of the vaccine.
"I don't know how New York City is making this commitment, because I don't think anybody knows how much vaccine they are going to get," Greene said.
New York City Health Commissioner Thomas Farley said the city expects to receive 1.2 million doses of the vaccine in October, and half a million doses for every week after that.
Bloomberg and officials from his health, schools and emergency departments announced the vaccine plan as part of the city's multi-pronged strategy Tuesday to manage the next wave of swine flu.
The city also plans to post data online about influenza-like symptoms at hospital emergency rooms, and post daily updates on public school absences and other schools reporting five or more cases of flulike illness.
The administration plans to send out hundreds of volunteers known as "flu fighters" to visit senior centers, houses of worship, schools and other gathering places to educate New Yorkers about the flu.
Certain groups have shown to be more vulnerable to swine flu, including children and young adults.
City officials say if a school sees five or more cases of flulike illness in one day, the school will send a letter to parents stressing the need to keep sick children home.
Schools that experience "excessive" flu activity - 4 percent of the student body on a single day - will get a visit by a doctor or supervising nurse to further assess the situation.
Officials said they do not expect swine flu to cause widespread severe illness, but warned that hospital emergency rooms could be overburdened with worried people again this season, similar to what happened last spring.
To prepare for that, the city is identifying other venues to treat flu patients; under this part of the plan, some of the city's health clinics could be designated as flu centers for people to get vaccinations and outpatient care.
And in an emergency, the city said it could treat large numbers of people by deploying volunteers through its Medical Reserve Corps, a network of 8,700 doctors, pharmacists, nurses and other health professionals.
On the Net: http://www.nyc.gov.flu/
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