CHARLESTON, W.Va. -- Lewis, a first-grader at Kenna Elementary, began to cry as Alison Corbin swabbed his arm with alcohol.
He was sitting on school nurse Lisa Hartney's lap in a plastic chair in the school's library. Hartney gently wrapped her arms around Lewis, who had started to squirm.
Corbin, a nurse with the Kanawha-Charleston Health Department, continued about her business, removing a flu vaccine from its packaging. Lewis saw the needle and began to squirm even more.
"No!" he hollered.
Some of his classmates peeked around a corner. Teachers were sending students into the library two at a time to avoid undue freak-outs. Poor Lewis' yelps did little to help morale.
Hartney wrapped her arms a little more tightly around the little boy, and Corbin plunged the needle into his arm. His tears instantly subsided.
"Is that the only one I get?" he asked.
Corbin and fellow nurse Sherry Graves doled out 90 flu vaccines at Kenna Elementary on Monday morning, all in about two hours. Children moved through the library with assembly line precision: the ones carrying white permission forms received shots, while those holding a yellow paper got an intranasal spray vaccine.
This year's school clinics began three weeks ago and will continue into early December. Health department nurses will visit each Kanawha County school, including the private ones, to administer 7,000 to 8,000 shots.
Health department and school officials say the program is a great success.
Since they began during 2009's H1N1 "swine flu" outbreaks," the flu clinics have greatly reduced student absences, which results in fewer missed days of work for Mom and Dad and also has cut the number of flu cases in older adults. Young children are among the leading causes of flu in grandparents.
But there's another side effect of the flu clinics, a decidedly non-medical one, that is catching the attention of health officials nationwide.
While many school systems across the country provide students with flu vaccines, Kanawha-Charleston Health Department's yearly clinics are rare because they are completely self-sustaining.
On each year's flu shot permission form, the health department asks parents to voluntarily provide their health insurance information.
More than 90 percent of parents include the information, health department Executive Director Rahul Gupta said, and the health department bills those insurance companies for the flu shots.
The department then uses that money to cover "the cost of going out there and doing it," Gupta said, along with the cost of vaccines for the 9 percent of children whose parents did not provide health insurance information.