Ashlynn Ulmer started to scream just looking at the approaching needle. She tilted her head back onto her mother’s shoulder, tears running rampant while the nurse’s gentle words fell on deaf ears.

But a mere two minutes later, she was happy to show off her Band-Aid and sticker, proof of her bravery.

Ashlynn, who has Down syndrome, couldn’t get the nasal spray vaccination against the H1N1 virus, or swine flu, because her pulmonologist advised against it, said her mother, Beth Ulmer.

“She has underlying conditions and she picks up everything,” Beth said. “I just hopefully want to prevent any tragedies. … She’s already picked up parvo(virus) and scarlet fever. She’s had pneumonia several times. I’m hoping this will do the job.”

Beth Ulmer and her three children, like many other families, took advantage of Thursday’s first dispersal of free H1N1 vaccinations the Washoe County Health Department made available to high-risk populations. By 1 p.m., the time the department opened its doors, there were between 500 and 600 people in line. The line began to form as early as 6:30 a.m.

“We anticipate being able to get at least 100 people an hour through the line and we’ll keep vaccinating as long as we can,” Washoe County Health Department spokeswoman Judy Davis said just before 1 p.m.

WCHD nurse Cory Sobrio said the first hour on Thursday was going slowly and he was hoping to have more people funnel through the complex and into the room where the shots were being administered. But, he added, the task of immunizing people is an important job.

“It’s a neat feeling,” he said. “It’s great to know people are getting this vaccine. There are a lot of people in the community right now that could be exposed potentially, especially for people that have no past immunity for this type of virus. They could end up real sick real quick.”

Those who fall into the high-risk category include pregnant women, health care and emergency responders and young people from ages 6 months to 24 years.

According to the Centers for Disease Control and Prevention, 86 children under 18 have died from the 2009 strain of the swine flu. Half of the deaths of children since Sept. 1 were between ages 12 and 17. The percentage of doctors visits to complain of flu-like symptoms or illness has reached a national average of 6.1 percent, which is particularly high in October, the CDC reported.

The Preckwinkles of Sparks have carefully watched the news on such statistics and promised to get their two sons, Louis, 8, and Jett, 9 months, immunized as soon as possible. Louis is a second grader at Bud Beasley Elementary School.

“It was just a relief to know that if I can get my kids vaccinated, I was going to,” said Raymond Preckwinkle, the father. “I watch the TV and read the newspaper all the time.”

Raymond was vaccinated by shot because he has diabetes.

Raymond’s wife, Amanda, said she worries for Jett.

“His immune system is very small,” she said. “And this one (Louis) goes to school every day and there were confirmed cases at his school, quite a few of them. At least we’re protected. It made me really, really nervous with the little one. So many children have been dying.”

Beth Ulmer drove an hour from Minden and was one of the first 30 people to arrive. She said it was easier on her pocketbook to get the free shots for her kids and herself.

“Keeping all the kids healthy is the main thing,” she said. “I think it’s more of the hearing all the things going on and you don’t hear as much of seasonal flu deaths. This is the newest thing.”

Davis said the nasal spray is becoming a popular choice for vaccination because it’s painless — the more favorable option among children. The nasal syringe is put into one nostril and the nurse shoots it until the automatic stopper kicks in. The process is repeated for the other nostril.

“It’s a big hit with the kids,” Davis said. “You can only use it between the ages of 2 and 49 and you have to be healthy and have no underlying conditions and you can’t be pregnant. Kids are much more willing to do the spray.

“We are very, very pleased with the seriousness with which people are taking this issue,” Davis said. “We are delighted with the turnout and we really want to thank people for being so patient and supportive and aware of how to keep their community healthy.”

The two clinics being offered next week for high-risk populations take place on Tuesday and Thursday from 1 to 7 p.m. at the health department at 1001 E. Ninth St. in Reno.