Kyle Green The Roanoke Times

Kristen Leigh Vest gets an H1N1 vaccine shot Thursday at the Roanoke City Health Department. Health officials say demand for the shots has been high.

Kyle Green The Roanoke Times

Ethan Geronimo, 4, gets an H1N1 vaccine shot Thursday at the Roanoke City Health Department.

The tears disappeared as quickly as they had come and then Ethan Geronimo, 4, proudly wore the sticker that proclaimed, "I'm a Junior Flu Fighter."

It was Thursday afternoon and Geronimo had just received a shot at the Roanoke City Health Department as a vaccination against 2009 H1N1 flu, commonly known as swine flu. Because of Geronimo's age, he will need a second shot in about four weeks to develop adequate protection.

It wasn't clear whether Geronimo knew that Thursday.

He was one of an anticipated 1,500 children to receive free H1N1 vaccinations Thursday during appointment-only clinics at four health department offices, including the Roanoke facility. Another was Kirsten Vest, 7, whose eyes filled but did not spill. She also will need a second H1N1 vaccination, which is true for children 9 years old and younger.

Meanwhile, the New River Health District anticipates it will have dispensed by Saturday, via on-site vaccination clinics at several schools, all of its currently available supply of 4,000 doses of H1N1 vaccine.

The Alleghany/Roanoke City Health Districts opted to proceed with Thursday's clinics as a stopgap strategy until enough H1N1 vaccine is available to hold additional clinics or take the vaccines to all the districts' many schools or other public sites. The national supply of H1N1 vaccine, as well as seasonal flu vaccine, has been limited by production delays among vaccine manufacturers.

And that reality is frustrating for state and local health officials during the midst of what HCA Virginia Health System described Thursday as "one of the worst flu seasons in recent history."

Robert Parker, a regional spokesman for the Virginia Department of Health, said the goal Thursday was to reach as many children as soon as possible, reasoning that every child vaccinated was one more child protected -- or on their way toward protection -- and one less threat to other higher-risk groups.

Children fall within one such group, from age 6 months through 24 years old.

Separately, VDH reported Thursday that it had received notice of a child's death attributed to H1N1 that had occurred in the Piedmont Health District, which centers roughly upon Farmville. The news was especially sobering because the department reported that "the child had no known underlying high-risk medical condition." The girl's death was the 10th in Virginia attributed to H1N1 flu complications but the first in an otherwise healthy person.

Earlier this week, when Dr. Stephanie Harper, director of the Alleghany/Roanoke City Health Districts, announced the first-come, first-served clinics held Thursday, callers initially overwhelmed a phone number set up to schedule vaccination slots for health department offices in Roanoke, Salem and Botetourt County. A separate number was used for Covington/Alleghany County.

And by Thursday morning, all slots had been filled.

Harper said the Alleghany/Roanoke City Health Districts will alert communities when additional supplies of H1N1 vaccine arrive. The districts include the cities of Roanoke, Salem and Covington and the counties of Alleghany, Botetourt and Craig. She did not speculate Thursday about a specific date when resupply might occur but anticipates additional stocks will arrive within two weeks.

The New River Health District is low on vaccine, too, but has held eight on-site school clinics so far this week for younger students and plans additional school clinics today and Saturday. But an earlier plan for the coming week has been revised.

"Our clinics are proceeding as scheduled this week," said Dr. Jody Hershey, director of the New River Health District, in an e-mail Thursday evening. "However, further school-based vaccination activities in the New River Health District are 'on hold' until additional vaccine is received -- hopefully in the next week or two."

Hershey said these initial school clinics Wednesday and Thursday vaccinated a total of 1,925 students and faculty at a number of elementary and middle schools in the district.

Although children are the initial target group for vaccinations in both the New River Health District and Alleghany/Roanoke City Health Districts, Harper and the Centers for Disease Control and Prevention continue to promise that everyone, young and old, who wants an H1N1 vaccination will eventually be able to get one.

H1N1 flu is highly contagious because it is a novel flu strain against which few people have immunity.

On Thursday, HCA Virginia Health System -- with hospital facilities that include Lewis-Gale Medical Center, Alleghany Regional, Montgomery Regional and Pulaski Community -- announced tightened visitation restrictions will begin Monday and remain in place throughout the flu season.

The new visitation policy restricts anyone younger than 18 from "all areas of the hospital unless being treated as a patient." In inpatient units, adult visitors will be limited to two people at a time.

Among several additional restrictions, visits to the maternity unit will be limited to immediate adult family members, including grandparents.

Carilion Clinic tightened its hospital visitation policies in early October.