"I have heard of many women losing their babies after getting severe swine flu. So I'll do all I can to prevent that even though I worry about the vaccine," Guo, 26, said as she was waiting for her jab at Chaoyang Hospital.

She was one of about two dozen people lining up at the Beijing hospital for the free shots this week amid simmering public anxiety about A(H1N1) influenza, fuelled by a sudden spike in deaths and government warnings of more to come.

China's official swine flu death toll stood at a mere 53 as of mid-November, despite the first cases being reported in the spring, but has since soared to more than 440 reported fatalities, with half of those in the past two weeks.

Health ministry officials, who had warned for months of a "grim" winter flu outlook, last week raised the alarm even further, saying infections could soar anew during upcoming holidays and vowing to ramp up vaccination efforts.

China has so far inoculated more than 34 million people, the largest campaign in the world, and the tally has been rising by more than two million per week.

The government has stepped up pronouncements vouching for the safety of the jabs amid public skepticism over Chinese pharmaceuticals and following two deaths in patients who had received the shots.

Chinese laboratories were at the forefront of worldwide efforts to develop and mass-produce a swine flu vaccine, but the quick clinical trials and production cycle led to concerns that the shot was perhaps unsafe.

An official last week told reporters some public concern was understandable but said adverse reactions were reported in only one out of a million jabs.

"One thing is certain -- the most effective way to control the flu is through vaccinations," said Liang Wannian, vice director of the health ministry's medical emergencies departments.

Liang said the government had ordered ramped-up vaccination efforts nationwide amid fears of a spike in cases during February's Lunar New Year, or Spring Festival.

That is China's biggest holiday of the year and sees hundreds of millions of people swamp the nation's roads, railways and airports to return home to their families.

"We are coming up on the New Year and Spring Festival holidays when much of the population is on the move, which could spread A(H1N1) to areas where it currently does not exist," Liang said.

The World Health Organisation's representative in China, Michael O'Leary, told AFP that the UN body advises vaccinations for people with pre-existing illnesses, which could be dangerously exacerbated by A(H1N1).

But while saying the masses of holiday travellers could raise transmission risks, he said the overall threat from swine flu was no worse than that posed by the normal flu.

"So far, this has been no more serious than normal influenza. Both the spread of H1N1 and mortality rates are not particularly unusual," he said.

But public scepticism remains significant in a country with a history of major public health scares.

This was fuelled last month when renowned medical whistle-blower Zhong Nanshan, who helped expose the scale of the 2003 Severe Acute Respiratory Syndrome outbreak, said the true A(H1N1) death count was being covered up.

The government responded by ordering more accurate case reporting by officials.

People like Yuan Zhaobo, a truck driver from northern Shanxi province who stood in the queue at Chaoyang hospital, said they are taking no chances.

"I'll travel home for the holidays with all the other people and have got to protect myself. You're stupid not to do so," he said.

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