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Others who should be first in line for vaccinations are parents with children under age 6 months; young people ages 6 months to 24 years; and non-elderly adults with pre-existing health problems. Health care and emergency service workers also should be among the first to get vaccinated.

The recommendation came from the Advisory Committee on Immunization Practices in Atlanta, and is based on early studies of the swine flu virus – a form of influenza Type A, subtype H1N1 – that show which groups are most susceptible to illness and serious complications.

Pregnant women have shown an especially high risk for respiratory complications that result in hospitalization or death. On the other hand, people over age 65 have for the most part been spared from the swine flu and are not a priority for vaccination. They are still being encouraged to get a seasonal flu shot.

The Centers for Disease Control and Prevention will release final guidelines on vaccine priorities in the coming weeks.

The recommendations are based on government predictions that about 120 million doses of vaccine will be available in the fall. But as a vaccine has not yet been completed or tested, the actual number of doses may be much smaller.

Therefore, the advisory committee came up with a group of 40 million people who should be the very top priority for vaccination. The list includes pregnant women, parents of babies under age six months, children under age 5, and children up to age 18 who have pre-existing health problems.

It’s unlikely such extreme prioritization would be necessary, but flu vaccine production is unpredictable, said Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases, during a press conference.

“Exactly how many (doses) and exactly when (they will be available) is hard to pinpoint,” Schuchat said. “We may have plenty of vaccine right away. We don’t know exactly what supply and demand will be at any one time and in any one community.”