MOULTRIE — While the initial wave of swine flu seems to have passed, health officials warn that it will return and that people need to continue taking precautions.

Among the most important is getting an H1N1 flu vaccine when they become available. In the interim the officials recommend following previous hygiene recommendations and staying home when ill.

So far the spray vaccine, made from a live influenza virus, has not been exactly flying off the shelves, at least for local health departments.

As of Friday Colquitt County Health Department was the leader for the Southwest Public Health District’s 14 counties with 35 vaccinations. Grady County was next at 26.

That leaves 765 doses of vaccine in Colquitt County, said Carolyn Maschke, public information office for the district. The office initially received 300 doses in early October and has since gotten 500 more.

Officials are not sure why the interest is not greater in the spray vaccine, which initially was available only for 2-, 3- and 4-year-olds but has since been opened up for anyone ages 2-24 who is healthy.

Maschke said that is a concern because H1N1 already has accounted for 86 deaths in children, about double the number who die of seasonal flu over an entire flu season. About half of those were ages 12-17.

“That trend is scary because there are going to be some more kids that get really ill and more kids who are going to die, and here we have a vaccine available and people aren’t taking it,” she said.

Some of the possible reaons people may not be rushing out to get available vaccine is a loss of interest because of the drop-off in the number of cases in recent weeks.

The national flu season is typically September-April, but it normally begins later in southern states.

Some people also may have concerns about the safety of the vaccine, although all indications are it is safe, Maschke said. All vaccinations carry risks, but the risks for the H1N1 vaccine should be the same as those for seasanol flu vaccines.

“The thing they don’t understand is the H1N1 and the seasonal flu vaccines they get are (made by) the same people using the same process in the same places every year,” she said. “When I look at children dying — some of these children were completely healthy beforehand — when you see them not getting the vaccine, it’s a concern.”

The public health office predicts that a second wave of H1N1 influlenza will hit in Southwest Georgia some time between late October and Nov. 10.

An injectable vaccine, manufactured using a dead flu virus, will be available later, but it is not known when it will arrive, Maschke said. H1N1 appeared after the time officials had selected which influenza strains to include in the seasonal shot, thus making it necessary to produce a second vaccine.

As the vaccines are shipped they will be made available to the public, with high-priority groups receiving the first shot at the shots, Maschke said.

One additional concern with H1N1 is that 15 to 20 percent of people requiring hospitilization are going to the intensive care unit, Maschke said.

“The people who do get sick from it do get really sick, more sick than they do from the seasonal flu,” she said.

The last case of flu treated at Colquitt Regional Medical Center was about three weeks ago, said Gary Boley, hospital marketing director. However, doctors are concerned that there could be another “spike” when seasonal flu season begins.

Seasonal flu season normally hits in the area around the winter holidays, he said.