BETHESDA, Md. (McClatchy-Tribune Information Services) -- Federal public health authorities hope to have 100 million doses of swine flu vaccine ready by October, as long as clinical trials scheduled for next month go well.

The goal emerged Thursday at a swine flu summit called by the White House and attended by 500 public health and education officials at the National Institutes of Health.

States should prepare for a fall wave of swine flu as if it were a resurgence of the notorious 1918 pandemic that killed 600,000 in the United States and 100 million worldwide, Secretary of Health and Human Services Kathleen Sebelius told a summit audience.

State, local and federal officials, preparing for the twin threats of swine and seasonal flu in the fall, brainstormed on everything from school closures to mass vaccination strategies.

"The virus has not gone away," Sebelius said. "We're doing everything possible to monitor the virus and protect the American people."

She also urged every American to develop a swine flu "personal pandemic plan." Families should consider now who might stay home with a sick child, and workers may want to discuss whether absenteeism for tending a sick relative will jeopardize their jobs.

She announced a $350-million flu preparedness package, $260 million of it earmarked for state health departments and $90 million targeted for hospitals to cope with a surge in patients.

Throughout the daylong summit, experts continually pointed to New York -- the state hardest hit by swine flu -- as a leading model of preparedness. But even though the state has already coped with more cases and deaths than any other, said Dr. Guthrie Birkhead, New York State's deputy commissioner for public health, it will prepare even more for the fall. "New York, like the other states, is going full-bore," he said.

The plans include making certain the state has an adequate supply of antiviral drugs to treat flu patients.

Schools were a special focus of the summit, because they are incubators of flu, which can spread rapidly among students before fanning out to the wider community, said Dr. Marcelle Layton, assistant commissioner of the New York City Department of Health. She said her department is studying the spate of closures that gripped New York City in the spring as a basis for developing policies to be implanted in the fall.

A key problem discovered in her research, Layton said, was that high school students who were out of school as a result of the flu turned up at part-time jobs, serving as possible flu vectors in the workplace.

The swine flu is now circulating in the Southern Hemisphere, where the flu season is just under way and where it has caused waves of illness and a growing number of deaths. The World Health Organization declared it a pandemic last month and now estimates the disease is circulating in 111 countries.

Five pharmaceutical companies in the United States are working on a vaccine against the flu, which seems to more severely affect people between the ages of 5 and 24. Experts Thursday estimated that as many as 1 million people nationwide may already have been exposed and believe that people who've already had the flu may have some passive protection against it.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said a candidate vaccine against swine flu could be tested as early as next month. A government committee called the Advisory Committee on Immunization Practices is deciding what groups of people should get the vaccine.

So far, it appears panelists are proposing that all children and teens receive the shots, as well as adults with medical conditions that can make flu infection lethal. Panelists are also proposing that health care workers, emergency first responders, pregnant women and families with young children be among the first to receive the vaccine.

"The elderly don't seem at high risk," said Dr. Jay C. Butler, director of the H1N1 Vaccine Task Force at the Centers for Disease Control and Prevention, and therefore are not considered a priority group for swine flu vaccination, Butler said.

President Barack Obama, who briefly joined the conference through a satellite link from L'Aquila, Italy, said the potential impact on schools makes preparation an urgent need. "We want to make sure we aren't promoting panic," Obama said. "But we are promoting vigilance and preparation."

Copyright (C) 2009, Newsday, Melville, N.Y.