HONOLULU (KHNL) - Several thousand people in Hawaii died from the Spanish Flu Pandemic in 1918, and the islands saw even more deaths in the 1957 and 1968 pandemics.
When the next one hits, who should be the first to get a vaccine? Children? Mothers? The elderly?
The Department of Health (DOH) wants the public's opinion.
Health experts say it's not a matter of if a pandemic will happen, it's a matter of when.
There's the seasonal flu which you can get a vaccine for every winter, and then there's the pandemic flu.
"With this particular virus there is no immunity. The body, the immune cells have not seen these things before," said Dr. Vivek Nerurkar, the interim Chair of the Tropical Medicine and Infectious Diseases Department at the University of Hawaii's John A. Burns School of Medicine.
Dr. Nerurkar says it starts with a water fowl, which has receptors that can carry the virus. The water fowl can pass it on to pigs or chickens, and the pigs or chickens can pass it on to humans.
That's why the deadly bird flu that broke out in Asia has health leaders alarmed.
"Hawaii is in the crossroads. We are the gateway to the Asian countries," said Nerurkar.
Right now, the virus hasn't transformed where it can be passed from human to human, but when it does, and spreads worldwide you have a pandemic.
"We'll have a pandemic situation arising in a matter of days. That fast because once the virus comes in here by the time you know the virus is here, it's already infecting people," said Nerurkar.
Nerurkar says the challenge is a vaccine can't be made until after a pandemic hits. That's because you need a strain of the virus to make it, and in a severe pandemic, timing is everything.
"The amount of time it takes from infection to spread of the disease within the body and death is pretty short, it's probably no more than three days," he said.
In the event of a vaccine shortage, The DOH is working on vaccine allocation prioritization.
To get feedback from the community, three one-hour panel discussions will air live on KHNL.