The fear of swine flu is being compounded by new worries, this time among primary care doctors who say that they are swamped by calls from patients seeking the new vaccine, and that they are ill-prepared to cope with the nationwide drive to immunize everyone, particularly children and chronically ill adults.
The federal Centers for Disease Control and Prevention released the first doses of vaccine on Monday. But many doctors, especially pediatricians, say they know little about the program and have been deluged with questions.
At the same time, the pediatricians are struggling to figure out how to administer perhaps thousands of doses quickly in small offices with limited staff, while still dealing with other illnesses.
Some said they were considering hiring nurses just for the vaccinations and setting aside days when children would be vaccinated in alphabetical order.
At Westchester Pediatrics, an office with 6,000 to 8,000 families in Hartsdale, N.Y., exasperated doctors have added a new choice to the office answering machine: "If you have a question about the flu vaccine, please dial 6." Pressing 6 produces a further message saying that the swine flu vaccine is not yet available, and to keep checking the CDC.gov Web site for updates.
For those who are not satisfied, a sign in the office waiting room counsels patience.
Kathryn Paterno, the office manager, summed up the situation as "a nightmare."
"People want it," Ms. Paterno said of the swine flu vaccine. "When they listen to news reports, they pick out bits and pieces — 'swine flu, get it' — but they don't quite comprehend that we don't have it yet, and we're dealing with a quite affluent socioeconomic group here."
When asked whether his office had received vaccine inquiries, Dr. Herbert Lazarus, a pediatrician on the Upper West Side, said only half-jokingly: "Do you think that's accounting for two-thirds of our phone calls, or three-quarters?"