JACKSONVILLE — Health officials on Tuesday said few students are taking the free swine flu vaccines offered at schools this week.

Across Calhoun County and the state, about 20 percent of students younger than age 10 have signed up to receive the H1N1 nasal spray. Officials had hoped for at least 50 percent.

"The point is to vaccinate as many people as we can," said Lori Bell, a state nurse who helped administer the vaccine to students at Kitty Stone Elementary here Tuesday. "… I'm hoping the numbers will pick up."

The Alabama Department of Public Health on Monday launched its campaign to protect students from the H1N1 virus. The vaccine is optional.

The first group, students younger than 10, is receiving nasal sprays. The state will begin another campaign in January for older students who will receive shots.

Officials said Kitty Stone, Piedmont Elementary and three elementary schools in Anniston each had about 20 percent of its students take the nasal spray. Clinics will begin today in Calhoun County and on Thursday in Oxford.

But Dr. Jim McVay, director of the health promotion and chronic disease for the state, said the percentage does not accurately reflect the number of students who have received the H1N1 vaccine. He said some students received shots at the health departments or doctor's office.

Still, he'd hoped for more.

"It's lower than we would have anticipated," he said.

The nasal spray, although equally effective as the shot, has caused some parents to bristle, officials said. It's a live virus in a weakened form, and parents don't know how it would react in their children.

The spray is also not recommended for children with asthma or compromised immune systems, or for people who are severely allergic to eggs.

Melvina Echols, a parent at Kitty Stone, said her daughter wasn't going home without taking the vaccine.

"The benefits way outweigh the risks," said Echols, a nurse. By not getting the spray, she said, "not only do you risk that child, but you risk everyone that that child comes in contact with."

20-second procedure

At Kitty Stone Tuesday, an assistant principal's office was transformed into a clinic, with three nurses filling out paperwork and squirting the mist up the kids' noses.

"If it runs out your nose, dab it, don't sneeze or sniff," nurse Robbie Stubbs told one student.

The procedure takes less than 20 seconds — one spray up both nostrils — and is much simpler than shots, the nurses said.

And much easier.

Students here would rather take a spray up the nose than a needle in the arm any day.

"It feels like you've got water up your nose but you don't have to sneeze," one girl said.

(The nurses cited health privacy laws and asked that the students not be identified.)

Mark Hearn, who has kids at Kitty Stone and the high school, said his biases are always toward getting the vaccine. But they feared the needle.

"They pretty much would rather have been sick than getting the shot," Hearn said. "But we were pushing them regardless."

When they learned it was the spray, they obliged.

Delay in spray

The spray comes in response to a disease that first gained headlines in April, when it was identified.

Since then, swine flu has been linked to up to 34 million cases and up to 6,000 deaths, according to the Center for Disease Control estimates.

In August, school systems in the state saw dramatic rates of absenteeism because of swine flu.

State officials made several efforts to reduce the number of empty school desks, such as urging schools to stock the hallways and rooms with hand sanitizer.

They also vowed to launch a massive free clinic vaccination at public schools in October, but the national shortage of the vaccine snarled those plans.

The cases of H1N1 have apparently peaked in Alabama. Health officials, however, said another round of the virus could hit next spring.

The school clinics are part of the U.S. Department of Health and Human Services' plan to spend billions to provide swine flu vaccines for all states.