By Matt Leingang
Enquirer staff writer

Voters heading to the polls this November will have some big decisions to make.

Bush? Kerry? Flu shot?

Public health officials may offer the vaccine at polling locations in Southwest Ohio and Northern Kentucky in an effort to increase the flu immunization rate.

The idea sprang out of meetings this summer by the Greater Cincinnati Flu Collaborative, which is planning for the upcoming flu season. Cases of influenza can start as early as November and run through February.

Other ideas include expanded use of drive-up vaccination clinics where motorists can fill out paperwork and get a flu shot in 10 minutes without leaving their cars.

A drive-up clinic made its local debut last year at the old Fidelity Bank building in Norwood, vaccinating 250 people, a number that health officials hope to triple with multiple sites this fall.

"Anything to make getting a flu shot more convenient," said Mary Sacco, nursing director at the Hamilton County Health District and a member of the flu collaborative.

This past winter's flu season got off to an early and harsh start.

By the end of December, health departments in Greater Cincinnati, like others nationwide, had run out of the vaccine and many hospital emergency rooms - swamped with patients - went on diversion. (Diversion means that life squads are asked to take non-critical patients to other hospitals.)

The outbreak waned in January and February.

Ohio finished with 30,563 reported cases of influenza and influenza-like illness. Kentucky, which compiles data differently, had 565 confirmed cases and 2,904 probable cases.

Nationwide, about 150 children died from the flu, including seven from Ohio.

Kentucky did not report any.

This year, the U.S. Centers for Disease Control and Prevention is boosting the supply of flu vaccines.

It expects there will be 90 million to 100 million doses available - up from 87 million in 2003-04.

The CDC is also stockpiling 4 million doses to guard against another shortage.

The federal government recommends that people in these high-risk groups receive a shot:

• Children age 6 months to 23 months.

• People age 50 and older.

• People with chronic medical conditions.

• People with weakened immune systems.

But don't count on flu shots being available at Hamilton County polling locations just yet. A decision hasn't been made, said John Williams, director of the county's board of elections.

"Conceptually, I like the idea. It's a good, noble purpose," Williams said. "But we have some other issues to work out first."

Chief among them is security, Williams said.

And there's the issue of fairness, Williams said. Hamilton County has 1,013 polling locations.

"Do we make flu shots available to some and not others?" he asked.

Officials in Northern Kentucky haven't made a decision on whether to offer the vaccine at polling sites, either, said Evie Van Herpe, an epidemiologist with the Northern Kentucky Health Department.

But Butler County has been giving flu shots at selected polling locations for the past five years and plans to do so again in November. The shots cost $15 each.

"We have seven nurses, and we send them to polling sites across the county," said Butler County Health Director Patricia Burg.

E-mail mleingang@enquirer.com