As a needle slid in and out of her arm, Eva Mendoza didn't wince or blink. She just kept talking to the nurse.

Mendoza, a 52-year-old Hughson homemaker, is a firm believer in getting her annual flu shot.

Her steadfast belief in the vaccine started seven years ago after a ferocious bout with influenza, she said in Spanish.

"I had fever and chills and was vomiting for two weeks," Mendoza said after enduring the two-second flu shot Tuesday afternoon at the Stanislaus County Health Services Agency on Scenic Drive.

"I was taking too many pills; pills for diabetes, and then suddenly I had all these other pills to take."

During those two weeks of misery, a doctor told Mendoza that her diabetes places her at high risk of becoming seriously ill from the flu.

Since then, Mendoza said, she makes sure to get a flu shot every year before Christmas.

"This assures me that I'm going to be OK all winter," Mendoza said.

Others across the country already have fallen ill. Influenza outbreaks have been reported in areas of Texas and Colorado, spreading a strain of influenza not treated by this year's vaccine.

In Northern California last week, the Kaiser Permanente health care system counted 18 influenza cases, 14 in the Sacramento area.

Floreida Quiaoit, supervising public health nurse for the Stanislaus County Health Services Agency, said at the clinic: "We haven't seen any influenza."

Part of the reason may be that people got vaccinated earlier this year, she said.

The county has administered about 5,000 flu shots since vaccination clinics began Oct. 10, she said.

The county expects to give more flu shots this winter than last, when it administered about 7,000, Quiaoit said.

"When we see a high rate (of influenza) in Texas, it just reinforces the need to get education out about prevention," she said. "If we act early, we won't find ourselves in a similar situation."

People with weakened immune systems face the highest risk of suffering severe illness or complications from the flu virus, she said.

This group includes senior citizens, children from ages 6 to 23 months, and people with chronic illnesses such as diabetes, asthma, and heart, kidney and lung diseases.

Nationwide, about 114,000 hospitalizations and 30,000 deaths each year are related to the flu, according to Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention.

The best way to prevent becoming another sad statistic is eating well, exercising regularly and getting vaccinated, Quiaoit said.

The biggest challenge in preventing a widespread flu outbreak in Stanislaus County is making vaccinations accessible to people who do not have their own transportation or who speak languages other than English, she added.

As Mendoza waited to pay $10 for her flu shot, she said her vaccination not only protects her health, but her family's.

"I always cook for my kids, I'm ironing their clothes. If I get the flu, so do they," Mendoza said. "Getting my vaccine is just another way of showing them I care."

Bee staff writer Julissa McKinnon can be reached at 578-2324 or jmckinnon@modbee.com.

Reprinted by permission of the Modesto Bee.