The push to get children vaccinated against the flu will soon begin in earnest, but for the second year in a row the kids will have to endure a shot instead of the painless nasal spray most prefer.
The spray, FluMist, was deemed so ineffective by the U.S. Centers for Disease Control and Prevention that authorities recommended against using it last year.
That prompted some school systems, including those in Harford and Anne Arundel counties, to cancel or scale back vaccination clinics rather than subject students to arm pricks out of sight of their parents.
The move concerned health advocates, who point out that thousands of people, including healthy children, die every year from the influenza virus during flu season, which generally runs from October through May.
The CDC still recommends that everyone over age 6 months get vaccinated. The agency released a study this year showing that 358 children died of lab-confirmed flu between 2010 and 2014, and that vaccination reduced the risk by 65 percent.
FluMist makers at AstraZeneca say the scientific investigation into the vaccine's ineffectiveness continues and the goal is approval and renewed recommendation this season. But schools already say they will offer shots.
And with more lead time, more school systems are adding back clinics. Tiffany Tate, executive director of the Maryland Partnership for Prevention, a nonprofit that works on school immunization programs, said schools in Maryland are likely to vaccinate about 70,000 students this year, up significantly from last year, but still not as many as when the nasal mist was available.
Schools vaccinated about 100,000 children, a quarter of the elementary students, in years past. (Others are vaccinated by their doctors, by local health departments or at pharmacies.)
The partnership is working to vaccinate 40,000 students in Howard, Carroll, St. Mary's and Anne Arundel schools beginning the last week of September. Harford won't vaccinate in schools this year, but others, including Baltimore, plan to offer shots to every student.
Flu vaccinations are not required by Maryland schools, and each jurisdiction's program looks a bit different. Most focus on elementary-age kids, but some target only low-income families.
Following the death this year of a healthy Baltimore County student from flu, Tate said, some school districts, including Carroll County, plan to expand to older grades.
Seventeen-year-old Lansdowne High School senior Kayla Linton died in January.
Tate said a big takeaway from last year: The fuss over shots was overblown.
"Children as young as 3 years old tolerated the vaccine amazingly well," she said. "All the fears were unfounded."