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A teenage gunman has killed 18 children and three adults at a primary school in Texas, officials say, in the latest in a surge of mass gun violence sweeping the United States.

Governor Greg Abbott said the suspect, identified as 18-year-old Salvador Ramos, was apparently killed by police officers responding to the scene.

Two officers were struck by gunfire, though the governor said their injuries were not serious.

Authorities said the suspect acted alone.

Abbott told a news conference hours after the shooting that 14 schoolchildren had been slain, along with one teacher.

But Texas state Senator Roland Gutierrez later told CNN, citing the Texas Rangers state police as his source, the death toll had climbed to 18 children and three adults.

The shooting unfolded just 10 days after 10 people were killed in Buffalo, New York, in a predominantly Black neighbourhood.

An 18-year-old man whom authorities said opened fire with an assault-style rifle has been charged over that incident.

The motive for Tuesday's massacre in Texas, the latest in a string of seemingly random mass shootings that have become commonplace in the United States, was not immediately known.

Official details remained sketchy about the circumstances of the late morning shooting at Robb Elementary School in the town of Uvalde, Texas, about 137 kilometres west of San Antonio.

Abbott said the suspect was believed to have abandoned his vehicle and entered the school armed with a handgun, and possibly a rifle, before opening fire.

Investigators believe Ramos shot and killed his grandmother before going to the school, CBS News reported, citing unidentified law enforcement sources.

"It is being reported that the subject shot his grandmother right before he went into the school," Abbott told reporters.

"I have no further information about the connection between those two shootings."

University Hospital in San Antonio said on Twitter it had received two patients from the shooting in Uvalde, a 66-year-old woman and a 10-year-old girl. Both were in a critical condition.

US President Joe Biden, who ordered flags flown at half-mast until sunset on May 28 in observance of the tragedy, planned to address the nation about the shooting, the White House said.

The student body at the school consists of children in the second, third and fourth grades, according to Pete Arredondo, chief of the Uvalde Consolidated Independent School District Police Department, who also addressed reporters.

In US schools, those grades are typically made up of children ranging from seven to 10 years of age.

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© AP 2022

Photo: A policeman talks to people asking for information outside of the Robb Elementary School in Uvalde, Texas, Tuesday, May 24, 2022. An 18-year-old gunman opened fire at the Texas elementary school, killing multiple people. Gov. Greg Abbott says the gunman entered the school with a handgun and possibly a rifle. AP Photo/Dario Lopez-Mills)

Fourteen children and a teacher have been killed in a mass shooting at a Texas primary school.

State Governor Greg Abbott said the suspect, an 18-year-old local man who has also died, opened fire at Robb Elementary School in Uvalde, about 137 kilometres west of San Antonio.

It was the deadliest shooting at a US grade school since the shocking attack at Sandy Hook Elementary in Newtown, Connecticut, almost a decade ago.

The gunman entered the school with a handgun and possibly a rifle, Abbott said.

Officials have not revealed a motive for the shooting, but said the shooter was a resident of the community.

Abbott said the shooter was probably killed by responding officers but events were still being investigated.

Uvalde Consolidated Independent School District Chief of Police Pete Arredondo said at a news conference the gunman acted alone.

It was the deadliest school shooting in Texas history.

It occurred four years after a gunman fatally shot 10 people at Santa Fe High School in the Houston area and less than two weeks after a gunman opened fire at a supermarket in Buffalo, New York, killing 10 Black shoppers and workers in what officials have described as a hate crime.

"He shot and killed, horrifically, incomprehensibly, 14 students and killed a teacher," said the governor, adding that two officers were shot and wounded but were expected to survive.

It was not immediately clear how many people, in addition to the dead, were wounded, but Arredondo said there were "several injuries".

Earlier, Uvalde Memorial Hospital said 13 children were taken there.

Another hospital reported a 66-year-old woman was in critical condition.

Robb Elementary School has an enrolment of just under 600 students, and Arredondo said it serves students in the second, third and fourth grade. He did not provide ages of the children who were shot.

A heavy police presence surrounded the school on Tuesday afternoon, with officers in heavy vests diverting traffic and FBI agents coming and going from the building.

White House press secretary Karine Jean-Pierre said President Joe Biden had been briefed on the shooting on Air Force One as he returns from a five-day trip to Asia, and would continue to receive updates.

Jean-Pierre said Biden will address the incident on Tuesday evening at the White House.

Uvalde is home to about 16,000 people and is the seat of government for Uvalde County. The town is about 120km from the border with Mexico.

Robb Elementary is in a mostly residential neighbourhood of modest homes.

A Border Patrol agent who was among the first law enforcement officers on the scene was shot and wounded by the gunman, but is expected to recover.

The tragedy in Uvalde added to a grim tally of mass shootings in Texas that have been among the deadliest in the US over the past five years.

A year before the Santa Fe school shooting in 2018, a gunman at a Texas church killed more than two dozen people during a Sunday service in the small town of Sutherland Springs.

In 2019, another gunman at a Walmart in El Paso killed 23 people in a racist attack.

The shooting comes days before the National Rifle Association annual convention is set to begin in Houston.

Abbott and both of Texas' US senators are among elected Republican officials scheduled to speak at a Friday leadership forum sponsored by the NRA's lobbying arm.

© AP 2022

Photo: A policeman talks to people asking for information outside of the Robb Elementary School in Uvalde, Texas, Tuesday, May 24, 2022. An 18-year-old gunman opened fire at the Texas elementary school, killing multiple people. Gov. Greg Abbott says the gunman entered the school with a handgun and possibly a rifle. AP Photo/Dario Lopez-Mills)

NSW is considering offering free flu vaccines amid a dramatic surge in flu cases while the COVID-19 pandemic continues putting NSW hospitals under significant pressure.

Emergency department presentations for flu have increased as staff continue to fall victim to the viruses.

About 2000 workers are absent from hospitals on an average day.

After two years with few cases, Health Minister Brad Hazzard says a "horror flu season" has "hit NSW earlier and harder than it has for many years".

"It is absolutely crucial that you go and get your flu vaccine as soon as possible," he said.

There have been 14,812 reported flu cases and 3349 have attended emergency departments with influenza-like illnesses in NSW this year, a third of them in the past week.

More than 8000 cases of COVID were reported on Tuesday, with 1234 people in hospital with the virus, 38 of them in ICU.

The flu brought more than 1100 people to emergency departments last week, with 150 admitted to hospital and six admitted to critical care units.

Health Secretary Susan Pearce said the double whammy of a flu resurgence in an unrelenting COVID-19 pandemic put emergency departments "under significant pressure".

It also comes as the health system tries to get on top of a backlog in elective surgeries.

"Please do not call triple zero or attend emergency departments for non-urgent issues," she said.

"We are urging the community to support us during this challenging period by making sure those who need emergency medical care can receive it by saving ambulances and emergency departments for saving lives," she said.

Anyone unsure whether they should go to hospital should visit healthdirect.gov.au or call Healthdirect on 1800 022 222.

Chief pediatrician Matt O'Meara said children aged six months to five years were particularly vulnerable to flu, with at least 10 per cent of youngsters in hospital with the virus so sick they needed intensive care.

Of the 165 children under five years old that presented to hospitals with a flu like illness last week, 27 were admitted.

"Parents can reduce the risk of that happening just by getting their child vaccinated," Dr O'Meara said.

About 11 per cent of children under five in NSW have been vaccinated and about 51 per cent of people aged 65 and over.

Both groups are eligible for free vaccines, as are Aboriginal and Torres Strait Islanders of any age over six months, as well as people who have serious medical conditions or are pregnant.

NSW Health public health pathology director Dominic Dwyer told AAP it was important to reduce any barrier to obtaining a vaccine in order to increase uptake.

"That can be things like availability of a vaccine, locations where you can get vaccinations, the cost of vaccinations, all of those sorts of things," Professor Dwyer said.

Queensland announced on Monday it would provide free vaccines for all for a month.

"That's an example of strategies you can take to try and increase vaccination rates ... you need a combination of approaches to get people vaccinated," Prof Dwyer said.

NSW is also looking at providing free vaccines, and the government was working with pharmacists and GPs on a strategy.

"Hopefully we will be able to follow a similar path (to Queensland) but it's a little too early yet," Mr Hazzard said.

"We've just got to make sure the system work across the board."

As well as vaccines, the simple precautionary habits people picked up during the pandemic such as mask wearing, handwashing, and staying at home when you're sick could all help reduce flu transmission, Chief Health Officer Kerry Chant said.

© AAP 2022

Image: Daniel Paquet from Regina, Canada, CC BY 2.0 <https://creativecommons.org/licenses/by/2.0>, via Wikimedia Commons