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Hundreds of schools nationwide are establishing clinics to administer vaccines against the H1N1 virus, representing what could be the most widespread school vaccination effort "since the days of polio," the Associated Press reports. According to the AP, nearly 3 million students attend schools in districts where officials intend to offer the H1N1 vaccine when federal health officials begin distributing it in mid-October, and many more school districts are likely to follow suit. A recent survey by the National Schools Boards Association found that three-quarters of school districts have decided to allow vaccinations in school buildings, and at least 700 health and school officials last week participated in the National Association of County and City Health Officials' online seminar on how to best manage school flu vaccinations. In South Carolina, there will be at least one vaccination clinic in each of the state's 85 school districts, according to the state superintendent. Meanwhile, South Dakota, which in 2007 began offering free vaccinations against the seasonal flu for children, will provide both the seasonal flu vaccine and the H1N1 vaccine in many schools. According to health officials in Chicago, the city will offer swine flu vaccinations only in select high schools because of staff constraints at elementary schools and other facilities. Although the New York City health commissioner recommends that children receive the vaccinations from their primary care physicians, he, too, is considering establishing clinics at schools or other locations throughout the city. In addition to offering vaccination clinics, many schools are taking measures to encourage parents to keep sick children at home and to prevent the H1N1 virus from spreading within schools by emphasizing hand hygiene and other precautions. Some states, such as California, Ohio and Massachusetts, will focus solely on such approaches because of uncertainty surrounding the federal government's supply and distribution of the vaccine. The Secretary of the U.S. Department of Education notes that "the vaccine over time will be available to every child," adding that she believes that local schools would be "the best place for them to have access." Meanwhile, a representative from the Centers for Disease Control and Prevention adds that schools are an ideal setting to administer the vaccinations because young children are particularly susceptible to the virus, which spreads easily. She also notes that schools will not need to screen for insurance, which has been a challenge for regular flu-shot clinics in schools (Quaid/Neergaard, AP/Yahoo News!, 8/16/09).