Seriously ill patients in hospitals and the doctors and nurses caring for them will be the first of 14 million people identified as priority cases to receive the jab in Britain, the European country hardest hit by the virus.

They will be followed by pregnant women, people with health problems, or those such as chemotherapy patients with immune systems which leave them particularly vulnerable to the A(H1N1) virus.

Out of an estimated 370,000 cases of swine flu in Britain, 108 people with the virus have died, but the vast majority had underlying health problems.

Liam Donaldson, chief medical officer for England, urged health and social care workers to be vaccinated, in the light of figures showing that only 20 percent of such workers usually have the regular seasonal flu jab.

"It's important for frontline health and social care workers to have the vaccine," he said.

Doing so would "prevent them and their families getting the virus from patients, it will stop them passing the virus on to their patients" and "it will potentially protect them from mutated strains".

The authorities' concerns were underlined by a poll conducted by the Nursing Times trade magazine this month, revealing that only half of 1,700 respondents intend to be vaccinated.

The main reason cited was concerns over the safety of the vaccine, but Donaldson denied it had been rushed on to the market.

In Britain, people will mainly be given the Pandemrix vaccine, developed by drugs giant GlaxoSmithKline, and a single dose will give sufficient protection in most cases.

Prime Minister Gordon Brown told lawmakers that Britain had been "ahead of the world" in tackling swine flu.

"It is... right to say that we have been ahead of the world in purchasing the vaccines that are necessary and ahead of the world in making sure that those people who need treatment with antivirals have it at the earliest opportunity," he said.

The spread of swine flu in Britain appears to have peaked during the summer months, but the number of new cases has started to rise again in recent weeks after children returned to school following the long holiday.

Donaldson said he was concerned about the effects on the vaccination programme of a postal strike due to take place on Thursday and Friday, which could prevent patients receiving letters telling them to receive jabs.

Countries across the world are grappling with the logistics of vaccination programmes to counter the first global pandemic in 40 years.

In the United States, health officials warned last week that deliveries of vaccine may be delayed as influenza deaths climbed above epidemic levels in most states, hitting children particularly hard.

In France, where vaccinations started Tuesday, opinion polls show that up to 65 percent of people have no intention of having the jab.

Elsewhere in Europe, Belgium, Italy and Sweden have also started immunisation programmes.

Italian authorities said doctors were more prepared to have the swine flu vaccine than the regular seasonal flu jab.

In Sweden, take-up of the vaccine is high, with between 50 and 70 percent saying they were happy to be immunised.

But in Germany, a row has broken out over accusations of a "two-tier" system under which only soldiers, policemen and key workers will be given a different vaccine from the general public, allegedly because it has fewer side effects.

The outcry has prompted Chancellor Angela Merkel herself to pledge she will have the vaccine meant for the wider public, ahead of the start of a nationwide vaccination programme next week.

Swine flu has killed more than 4,700 people in 191 countries and territories since it broke out in Mexico this year, according to the World Health Organisation.

earlier related report
Merkel in row over 'government-only' swine flu jabs
A row in Germany over a "two-tier" swine flu vaccination programme has prompted Chancellor Angela Merkel to say she'll get the jab meant for the public rather than one reserved for "essential workers".

Criticism over "government-only" flu jabs, reserved for soldiers, policemen, and essential workers, comes against the backdrop of a nationwide immunisation campaign due to start next week.

The H1N1 virus has so far affected just 23,000 people in Germany, but the government is keen on vaccinating as many people as possible to avoid a possible large-scale outbreak at the start of the winter season.

But revelations in the press that top officials and other essential workers will get the Celvapan vaccine, manufactured by Baxter, which has fewer side effects than the mass Pandemrix vaccine manufactured by GlaxoSmithKline has caused a public outcry.

Government spokesman Ulrich Wilhelm has rejected accusations of a "two-tier medical system", saying both vaccines have equal worth.

Three vaccines -- Pandemrix, Celvapan, and Focetria -- have been approved by the European Union to fight the swine flu epidemic and "there isn't a 'better' or a 'worse' one", Wilhelm told a news conference Monday.

Merkel "will be seeing her regular general practitioner, will get his advice, and then will be vaccinated" with Pandemrix, the jab meant for the general public, Wilhelm added.

A number of newspapers nevertheless worried that the government was giving the appearance of double standards.

"How can an ordinary citizen understand that a vaccine with fewer side effects has been ordered for ministers than the one intended for the masses," asked the Frankfurter Allgemeine Zeitung.

Health ministry spokesman Klaus Vater explained that the government had ordered 200,000 vaccines from Baxter last year, in the wake of the bird flu scare, as a precautionary measure to protect essential workers from swine flu.

The government later ordered 50 million vaccines from GlaxoSmithKline to allow for the double dose vaccinations of some 25 million people in Germany, or about a third of the population.

The specialist for health matters at the social-democratic party, Karl Lauterbach, told the Stadt-Anzeiger newspaper that the Pandemrix jab was not recommended for young children and pregnant women because of possible side effects.

He also strongly criticized the government's information policy saying that the present row might lead people to forgo immunisation altogether.

Recent opinion polls here have suggested that Germans are not overly concerned about the flu which appears to have killed only two people to date in the country.

An Emnit poll said 59 percent of Germans had no fear of the flu.

The European Union recently warned against complacency over the spread of swine flu and urged people to get vaccinated even though the virus has not hit as hard as first feared.

"Even if the pandemic situation isn't so dramatic in Europe right now, we have to listen to the experts who say it's not time to lower our guard," said Swedish Public Health Minister Maria Larsson, whose country holds the EU presidency.

The swine flu has killed over 4,700 people in 191 countries and territories since it first appeared in the spring, according to the World Health Organisation.

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