Carolyn Callaghan has four boxes of tissues in her classroom -- one within easy reach of any sneezy, germy student out there -- and a fifth box on her desk that she doesn't let anyone else touch.
She cleans the doorknobs, washes her hands constantly and occasionally walks through her classroom handing out paper towels, squirting the students' desks with disinfectant and cheering the kids on as they rub the gook away.
Teachers such as Callaghan, whose students at the private Indian Creek School northwest of Annapolis range from second-graders to eighth-graders, had gotten used to getting the influenza vaccine every year. So they had a jolt this fall when they found out supplies were severely limited.
School administrators across the region also are bracing for the coming winter. They wonder if it will be a bad season for flu, and if so, will they have enough substitute teachers? If only they could get kids to stop sneezing on each other.
In Howard County, Doug Pindell, the purchasing officer for the school system, said he tried to argue to a vaccine provider that teachers needed the flu vaccine because they were so likely to be exposed to the virus. "Our teachers are really in a high-risk category because they're dealing with all these sick little kids," he said.
No luck. The clinics he had organized with a medical provider, which drew more than 1,000 teachers last year, had to be canceled.
As in many school systems, Howard officials launched an information campaign instead, sending teachers e-mails and fliers with prevention tips.
In St. Mary's County, administrators asked the maintenance staff to make an extra effort to keep bathrooms and water fountains clean. In Fairfax County, they explained to teachers how those who qualify for the shots, based on eligibility rules set by the federal Centers for Disease Control and Prevention, might be able to find the vaccine.
In Charles County, teachers hung posters with photographs of children washing their hands. And Indian Creek School, where Callaghan teaches, sent a letter home to parents asking them to please keep sick kids away.
Everywhere, people are reminding one another to use soap.
"I've got the phone away from my ear," said Denise Malinow, the registered nurse at Indian Creek School. "I wipe it down and the door handle. And as soon as anyone walks into my office, the first place I send them is the sink. Every little bit helps."
Some teachers were anxious when they heard about the vaccine shortage. "I've worried about it because I'm used to getting the flu shot every year," said Monica Piern, a first-grade teacher at Mary H. Matula Elementary School in La Plata. She makes sure her students use a hand sanitizer and clean their desks with disinfectant wipes. "I'm just trying to keep the germs down as much as we can, so no one will get sick."
But she, like most teachers, understood that the vaccine had to be limited this year. "I'd rather people that are older and high risk get the flu shots [rather] than me," she said. "Our school nurse talked with the staff about how to stay healthy -- taking extra vitamin C, getting good rest and eating healthy as well."
An illness coming into a school can ripple from desk to desk. "My husband used to say, 'You don't get sick -- but I think you carry it home,' " said Robin Read, a teacher in Calvert County.
Read said she doesn't worry for herself. "My immune system is hard as a rock," she said, "after being around all the kids for so many years."
Callaghan was not so lucky.
She used to get the flu all the time. It would knock her back for a week, keeping her home from her job as a Spanish teacher with a fever, a runny nose, the works.
"It was miserable," she said.
Then she started getting shots, about 10 years ago, and she stopped getting the flu.
She has been teaching for 32 years, and several years ago she developed diabetes. Last year, she had a stroke. So she worried when she heard about the vaccine shortage and that only certain groups of people, such as the elderly and those who work directly with sick patients, could get the vaccine.
Her husband tried a homeopathic remedy, hoping it would keep him well. She and other teachers talked about it at lunch one day, debating whether it would work.
But then the school nurse told Callaghan that with her health risks and at her age, 60, she probably would qualify to get a shot.
Callaghan was delighted and got one straightaway.
Now, feeling shielded from influenza, she worries only about all the other germs swarming around in her classroom.
On Friday morning, she saw a student in the nurse's office who had just thrown up. "I'm thinking, 'Oh, gosh. I'm glad he wasn't in my classroom yet.' "
She went straight to his desk, spritzed disinfectant and scoured the whole area.
Staff writers Maria Glod, Ylan Q. Mui and Joshua Partlow contributed to this report.