Taking Communion this month at Denton (Kan.) United Methodist Church involved three elements instead of two: The bread, the grape juice, the hand sanitizer.

Although pastor Nicole Schwartz, as Communion provider, and the Communion servers have always used sanitizer beforehand, this was the first time it's been made available to everyone else - a measure many churches are taking in the midst of a seemingly scarier-than-usual flu season.

"Last year, we talked some about (offering hand sanitizer to everyone), but not to the degree that we have this year," Ms. Schwartz says. "Now, some churches have it in every pew."

And churches aren't the only ones upping their hand sanitizer use; hand-sanitizer sales have spiked, and stories of hand-sanitizer hoarding and subsequent shortages have made the news. But are these sanitizers as protective as people hope? And are they really an effective replacement for hand washing?

It really depends on the condition of a person's hands and the content of the sanitizer, according to Pamela Joggerst, team leader for infection prevention and control at Heartland Health.

"If your hands are visibly dirty, you're really just getting hand sanitizer on top of dirt," which keeps it from reaching underlying bacteria, she says. "You don't want to pile hand sanitizer on top of dirty hands."

Something else that keeps hand sanitizer from working effectively is having too low a concentration of the alcohols ethanol or isopropanol; the Centers for Disease Control and Prevention recommends a concentration of 60 to 95 percent, but some sanitizers that claim to kill germs and harmful bacteria by 99.9 percent contain an alcohol concentration of only 40 percent. When tested, these were not proven effective in eliminating bacteria, according to the CDC's Web site.

But when sanitizers do contain the recommended alcohol concentrations, Ms. Joggerst says, "that's where you get your kill."

This isn't to say hand sanitizer should replace hand washing entirely, however. Dr. Sanjay Gupta, CNN's chief medical correspondent, notes on CNN.com that although sanitizer does make your hands very inhospitable to viruses, it doesn't protect them entirely.

"You put it on your hands, and viruses simply don't want to cling to it," he says. "So it does reduce the amount of a virus that can cling to your hand but it does not kill it."

Due to this, hand washing is still the best way to go, Dr. Gupta adds. But both he and Ms. Joggerst acknowledge that hand washing isn't always a convenient option.

"We're not able to just wash our hands at any moment," she points out, adding that because of this, it's a good idea to keep hand sanitizer in your pocket or purse and to make a point to use it throughout the day, such as after you've touched a door handle or shopping cart or communal piece of office equipment.

"It just gives you one more step to protect yourself from those germs," she says.

Lifestyles reporter Erin Wisdom can be reached at ewisdom@npgco.com.