Hawai'i is among the nation's leaders in swine flu vaccinations and health officials here credit an aggressive educational program for much of the success.

But officials also caution that the H1N1 virus threat isn't over and that residents who have not been vaccinated are encouraged to do so.

A report released yesterday by the U.S. Centers for Disease Control and Prevention said that 34.6 percent of Hawai'i residents have received the H1N1 vaccine since October 2009. That placed Hawai'i sixth among the 50 states and U.S. territories .

Nationally, about 24 percent of Americans had been vaccinated, the CDC said.

Rhode Island led the nation at 38.8 percent, followed by Massachusetts (37 percent), Maine (36.7 percent), Vermont (34.2 percent), and South Dakota (36.9 percent). The CDC said one reason the New England states had a high rate of vaccination is that they had aggressive, statewide efforts to hold clinics, particularly at schools.

The Hawai'i Department of Health also held swine flu clinics in schools that helped the state achieve a 55.4 percent vaccination rate among children 6 months to 17 years old, according to the CDC report. Rhode Island reported 84.7 percent of its children were vaccinated, the CDC said.

Dr. Sarah Park, state epidemiologist, credited the school program as well as pediatricians and other providers with aggressively targeting children for vaccination. She said getting these programs up and running was challenging because of difficulties in getting federal funding and early problems obtaining the vaccine because of supply limitations.

"We all pulled together and in the end it was a success," Park said.

But she reminded parents that children under 10 who received a first dose should be sure their children get a second dose. Park said an estimated 30 percent of children in this category got the second dose.

"Thirty percent is not 100 percent, but it's better than no percent," she said.

ADULTS LAGGING

While the rate of vaccination for children is high here, the same cannot be said for adults. The CDC reported that 23.4 percent of people over 18 had been vaccinated.

Park said residents may be complacent because swine flu hasn't been in the news lately.

"People are well-intentioned, well-meaning and they do want to do it, but it's human nature," she said. "You're not hearing the news about deaths or severe illness and you probably don't have anyone close to you who's had very severe illness, so it becomes this once-removed event that could be bad and you know it's bad, but you kind of prioritize things that are more real to you."

Hawai'i has recorded 13 deaths connected to the virus, compared with about 12,000 nationally. Ten of the deaths here occurred last July and August.

SECOND WAVE

The first confirmed case of the swine flu in Hawai'i was reported in early May and the number of cases peaked in July. A second wave of disease activity hit the Mainland, but that second round didn't reach the Islands.

But there has been an uptick in the South and Park cautioned that Hawai'i isn't immune from a possible increase in cases.

"We get a lot of visitors from the Southeast, so even if you're not traveling, you could be exposed to someone who did travel, directly or indirectly," Park said. "Getting vaccinated is pretty easy. It's better to get vaccinated than to get sick."

Hawai'i received about 570,000 doses of the vaccine and Park said there is an ample supply for anyone who wants to be vaccinated.

"In general, we've been very lucky," she said. "We still need to put up our guard and make sure we stay lucky."

The CDC report also found:

• 37 percent of children nationally were vaccinated.

• 33 percent of people in priority groups, including children, young adults, health care workers and pregnant women, were vaccinated.

• 37 percent of health care workers were vaccinated, while 62 percent received seasonal flu vaccinations.