"The sad news of this boy's death is a reminder that while most flu illness is mild, severe illness and death is a part of the picture of this pandemic," Toronto Public Health officer David McKeown told a press conference.

"And it's for this reason that immunization is recommended for everyone," he said.

Evan Frustaglio, 13, fell ill with a fever and nausea on Saturday during a hockey tournament and was taken to a walk-in clinic the next day to see a doctor.

He was sent home with Tylenol and over-the-counter medication for nausea after being misdiagnosed with a case of milder seasonal influenza. He later died at home.

"We're in pretty big shock here losing a 13-year-old boy as healthy as can be and within 48 hours went from having a small symptoms of the flu ... to dying in our home," his father Paul Frustaglio told public broadcaster CBC.

Monday, Canada's largest-ever vaccination program got underway nationwide to combat the spread of the potentially deadly A(H1N1) virus.

Aboriginals, youths and medical staff -- groups believed to be most at risk of serious infection -- were the first to receive swine flu shots.

McKeown said Toronto, Canada's largest metropolis, was scheduled to open up specialized vaccination clinics to the general public on November 2, but has instead pushed up general access to the clinics to Thursday.

"Because of the increasing circulation of the H1N1 virus, today I'm announcing we've decided to move forward the start dates for our public clinics," he said.

"The second wave of H1N1 flu is most definitely upon us," commented Ontario Chief Medical Health Officer Arlene King. "Influenza activity is up quite significantly."

Elsewhere in the country, long lines formed outside medical clinics as thousands sought to be the first to get flu shots.

The swine flu has so far contributed to at least 88 deaths in Canada, more than 1,500 hospitalizations and close to 300 critical care ward admissions, according to Health Canada.

A preteen girl who died in an Ottawa hospital on Saturday is believed to be the first Canadian fatality in the second wave of the pandemic now sweeping the country.

related report
WHO recommends swine flu vaccine for wary Chinese
The World Health Organization encouraged Chinese citizens to be vaccinated against swine flu Tuesday, calling the shot "safe and effective" after an opinion poll revealed wariness about quality.

Michael O'Leary, the WHO's new representative in China, said tests had shown side effects from the homegrown A(H1N1) vaccine were "mild and temporary" and should not keep those most vulnerable to the virus from being inoculated.

"In China, over 12,000 people took part in field trials" before the country launched its mass swine flu vaccination programme last month, O'Leary said in comments emailed to AFP.

"They demonstrated that the vaccine is safe and effective, with occasional mild and temporary symptoms as expected. We recommend the use of this vaccine for use among priority groups in China."

He added, "the risk of disease is much higher than the risk of vaccine. Global deaths from H1N1 have reached at least 5,000. In contrast, the vaccine has caused zero deaths."

China, which has the world's largest population at 1.3 billion, has launched the mass vaccination campaign in a bid to stave off large outbreaks, especially as winter -- and the regular flu season -- sets in here.

The government has said it plans to inoculate five percent of the population, or 65 million people, against swine flu by year's end. So far, 300,000 people have received the vaccination.

But on Monday, the state English-language China Daily published a survey revealing that more than half of all Chinese do not plan to be vaccinated against swine flu because they are unsure about the safety of the shot.

The poll, carried out with popular web portal sohu.com, said more than 54 percent of the 2,000 respondents said they did not want the A(H1N1) vaccine -- a huge turnaround from two months ago, when 76 percent said they did.

Only 30 percent of those polled said they definitely would like to receive the shot. About 15 percent said they would make a decision based on what other people did.

More than 33,000 cases of A(H1N1) influenza had been reported in China as of Friday, according to health ministry figures, with the number of infections accelerating in recent weeks. Two deaths have so far been confirmed.

Health authorities have repeatedly warned they are facing a "grim" task of preventing outbreaks and keeping the death toll low.

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