Florida's surgeon general says the state is preparing for massive swine flu immunizations, starting with schoolchildren, as the Obama administration urges states to prepare for the likelihood that the virus might worsen in the fall.

"We may end up averting a crisis. That's our hope," said President Barack Obama, who took time away from the G-8 summit in Italy to telephone another summit back home — the 500 state and local health officials meeting to prepare for swine flu's fall threat.

"We want to make sure we aren't promoting panic, but we are promoting vigilance and preparation," Obama said.

Kathleen Sebelius, secretary of Health and Human Services, told the swine flu summit some H1N1 vaccine should be ready by mid-October.

"Scientists and public health experts forecast that the impact of H1N1 may well worsen in the fall, when the regular flu season hits or even earlier, when schools start to open, which is only five or six weeks away," she said.

Florida already is planning for such vaccinations, said Dr. Ana M. Viamonte Ros, Florida surgeon general, as she emerged from the summit.

"We're already meeting with local schools and day-care centers on how we would do this," she said. "By mid-October we won't have doses for everyone. The vaccines will have to be directed toward individuals at high risk. It's important to determine who really is at risk. With swine flu, more of the younger ages are affected. That puts more stress on schools."

Complicating the issue is the need to vaccinate against regular seasonal flu and the swine flu with different vaccines at the same time, Viamonte Ros said. Priorities would have to be different, because regular flu hits older people harder while swine flu is most widespread among the young.

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