By Peggy O'Farrell
The Cincinnati Enquirer

Imagine being hit by a Hummer, and lying there, helpless, as it rolls back and forth over your still-conscious self three or four times.

Throw in a week or so of fever and chills, plus the potential for pneumonia, and you've got influenza.

"People don't understand how awful it can be," says Dr. Mary Jo Wakeman, employee health physician for the Health Alliance and a flu survivor herself. "You just lie there and wish for death."

This season could be worse than past years thanks to a potent new flu strain dubbed A-H3N2, which has made the rounds through Australia and New Zealand, according to the Centers for Disease Control and Prevention. The CDC bases its projections on flu cases reported in the southern hemisphere.

Health officials are urging everyone, whether they're in a high-risk group or not, to be vaccinated against the flu this year. And, for the first time, the needle-phobic can opt for a nasal spray instead of the traditional injection to fight the flu.

"From a practical standpoint, certainly it's less painful to use," says Dr. Steve Bartz, a family medicine specialist with the University of Cincinnati. "A large percentage of people don't get their flu shots just because they don't want to face the needle."

FluMist, manufactured and marketed by MedImmune Inc. and Wyeth Vaccines, was approved earlier this year by the Food and Drug Administration.

But it's expensive - $40 to $50 a dose or more - and insurance plans might not cover it, or might charge a higher co-payment "so someone has to be pretty motivated to get it," Bartz says.

FluMist, which uses a live virus, also isn't approved for those most at-risk for influenza and its complications: Adults 50 and older, children under 5, the chronically ill and people with compromised immune systems. Pregnant women shouldn't use it either. The spray is approved for healthy people ages 5 to 49.

Flu vaccine is plentiful this year through doctor's offices, public health clinics, pharmacies and other providers.

Hamilton County General Health District will first distribute flu shots to seniors and high-risk patients, and then make the remainder available to the general public. The health district is also offering FluMist for $50. The flu shot is free for Medicare patients, and $5 for everyone else.

FluMist will only be available by appointment at the health district's main office, says Mary Sacco, director of nursing. The vaccine has to be kept frozen and is too hard to transport.

The Cincinnati and Northern Kentucky health departments are reserving their flu shots for senior citizens and high-risk adults. Neither department offers FluMist.

The emphasis on getting children vaccinated continues this year, says Carol Westermeyer, director of nursing for the Cincinnati Health Department.

Children as young as 6 months and up to 8 years old should be vaccinated against the flu, according to CDC guidelines. Young children are at risk for pneumonia and other complications, and often bring the virus home from day care or school and infect the rest of the family.

Flu shots can't cause the flu, though some people might have a reaction that includes a mild fever and achy feeling. And flu shots can't prevent other viral infections that mimic influenza symptoms or SARS.

But the flu itself is reason enough to get the shot or nasal spray, says Evie VanHerpe, epidemiology administrator for the Northern Kentucky Health Department.

"Nobody should get the flu. Who wants to be sick for two weeks and infect other people and worry about all those work days lost?" she says.

Drive through shots

You say you don't even have time to get out of your car for your annual flu shot?

That's no excuse this year: The Greater Cincinnati Flu Collaborative is holding a drive-up flu clinic for the time-challenged in Norwood.

From 10 a.m.-2 p.m. Oct. 30, Cincinnatians who want to save time and avoid influenza can pull up to the deposit windows at the old Fidelity Bank building at Montgomery and Sherman, roll up their sleeves and get their vaccinations, says Mary Sacco, director of nursing for the Hamilton County General Health District. The flu collaborative is made up of local health departments, providers and other businesses.

Health departments in other parts of the country have reported success with drive-up clinics, Sacco says, so local health officials expect success here.

"You'll be able to stick your arm out the window and get your vaccination," she says. "It's the first time we've ever done it, so we'll see how it works."

Information: 946-7882.

Finding flu shots

Flu vaccine should be in plentiful supply this year, and health officials are advising everyone to be vaccinated, since this year's strain is expected to be especially nasty.

Contact your physician for an appointment, or get your shot at one of the many locations set up for the purpose throughout the Tristate.

Resources for getting immunized:

•  In Greater Cincinnati, call 931-SHOT (931-7468), or visit www.the-collaborative.org and click on the "flu shots" link for locations, including grocery stores and pharmacies that offer shots.

The Cincinnati Health Department's senior flu program schedule:

9 a.m.-noon Oct. 28, Oakley Senior and Community Center, 321-9407

9-11 a.m. Oct. 29, Gamble-Nippert YMCA, 661-1105

9:30-11 a.m. Oct. 29, Over-the-Rhine Senior Center, 381-3007

9:30-11 a.m. Oct. 30, Senior Chateau on the Hill, 471-9555

9:30-11:30 a.m. Nov. 4, Pinecrest Senior Center, 921-8922

9 a.m.-noon Nov. 5, Clifton Senior Center, 861-6934

9:30-11 a.m. Nov. 6, Dunham Seniors, 471-9844

10-11 a.m. Nov. 6, Pleasant Ridge Community Center, 731-7894

10 a.m.-noon Nov. 12, Butterfield Recreation Center, 421-2803

9:30-11:30 a.m. Nov. 13, Bush Community Center, 281-1286

9-11 a.m. Nov. 13, Carthage Community Center, 821-2954

9:30 a.m.-noon Nov. 18, Hyde Park Senior Center, 321-6816

9-11 a.m. Nov. 19, Hartwell Community Center, 821-5194

9:30-11 a.m. Nov. 20, McKie Community Center, 681-6952

9:30-11 a.m. Nov. 25, South Fairmount Senior Center, 921-4315

9-10:30 a.m. Nov. 25, St. Paul Village, 272-1118 or 527-2394

In Hamilton County, call 946-7882 for information.

The Greater Cincinnati Flu Collaborativewill hold a "drive-up" immunization clinic 10 a.m.-2 p.m. Oct. 30 at the old Fidelity Bank building at the corner of Sherman Avenue and Montgomery Road, Norwood.

The Northern Kentucky Health Department is also offering flu shots for seniors and other high-risk people. For schedules, call:

Boone County Health Center, Florence (859) 363-2060

Campbell County Health Center, Newport, (859) 431-1704

Grant County Health Center, Williamstown, (859) 824-5074

Kenton County Health Center, Covington, (859) 431-3345

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E-mail pofarrell@enquirer.com