Kotloff, who is treating children hospitalized with the H1N1 flu at the University of Maryland Hospital for Children, said the emergency room and outpatient clinic are flooded with children sickened from the virus. Given that children are at higher risk for complications from this flu - some 40 percent of children who have died have had no underlying medical conditions - even one vaccination is important.
"We have lots of kids here who have really bad infections," she said. "The number of children who have died in the last month is higher than the number of children who have died in a complete flu season. Most people will have mild illness - we're not trying to scare the public - but we think this is important."
The CDC reports that there have been many millions of cases of pandemic H1N1 flu since the first wave of illnesses in April. And children have been disproportionately affected. Half of the 20,000 hospitalizations and a quarter of the 1,000 deaths have been children.
In a news conference Friday, Dr. Thomas R. Frieden, director of the CDC, called the swine flu "a young person's disease." He said a recent phone survey revealed that one in five children nationwide had flulike symptoms early this month - though they didn't all have swine flu.
"The survey showed that kids get a lot of infections," he said. "That's why it's important to teach them to cover their mouths when they cough and wash their hands."
And it's important to get vaccinated against the H1N1 flu.
Frieden said more than 16 million doses of vaccine have been produced and more than 11 million doses have been ordered by states. He called the vaccine manufacturing technology "antiquated, but tried and true," meaning that the vaccine could be trusted to work, but production was slow and unpredictable.
If children wait more than three or four weeks for a booster, it's not dangerous, officials said. And that's for the nasal spray or the shot. A second vaccination in less time wouldn't offer more protection and getting a second mist so soon is not advised because it's a live virus.
In Baltimore, there has been huge demand for vaccines at the few clinics scheduled for priority groups, said Dr. Anne Bailowitz, the city's acting chief medical officer. Officials are trying to get everyone one vaccination but expect to be able to offer a booster shot in another month to kids.
