Bethany Patten jumped out of bed, donned a face mask and headed right to Sanders Family Medicine yesterday, despite ear and sinus infections and a serious fear of needles. She is pregnant, and when she was offered a vaccine against the H1N1 flu, it was an easy choice.

"I wouldn't want to risk losing my baby over anything," said Patten, 18, of Henniker.

Patten was disappointed - a fever from her illnesses meant she couldn't get the shot yesterday - but she'll be back next week as one of the state's very first patients to get the vaccine, which has arrived more slowly and in fewer doses than public health officials originally expected.

Physician practices have started getting their first doses of the H1N1 vaccine, but not very many. At Sanders Family Medicine in Concord, only 30 shots were delivered this week. Employees at the practice have contacted pregnant patients and the parents of young children with health problems. They've also been offered shots themselves, though only a few have rolled up their sleeves so far.

At Concord Hospital, which owns the bulk of local primary care practices, the pharmacy has received 1,500 doses. The first ones were offered to health care workers, and doctors' offices are expected to get their first shots and nasal sprays early next week, said Jennifer Dearborn, a spokeswoman for the hospital.

"The challenge is not knowing how much we're going to get on a regular basis," Dearborn said.

State officials have always planned to offer the vaccine in four waves - with the patients at highest risk of complications getting the vaccine first, followed by lower-risk groups. But public health officials had hoped there would be enough vaccine available to offer the shots to the general public by mid-November. Those forecasts have changed as deliveries have trickled in. About 40,000 doses have been distributed so far, according to Marcella Bobinsky, who runs the state's immunization program.

"It is a delay, and it does concern us," Bobinsky said. "But it's such a long process, and we know that as soon as it's available to us, we'll get it out."

Unlike the seasonal flu, which won't begin to spread widely for at least another month, the H1N1 flu is already fairly widespread. Doctors' offices have reported a small but increasing number of patients exhibiting what they call "influenza-like illness," and several schools in the state have reported outbreaks.

Recent reports from the World Health Organization suggest that the H1N1 flu may carry a heightened risk of pneumonia in otherwise healthy young patients. Bobinsky urged those in high-risk groups to seek vaccine to protect themselves, and to contact their doctors to be placed on waiting lists. She called it a "very, very safe" vaccine.

"If you are in a risk group, you have every reason to want to step up and get the H1N1 vaccine," she said.

While the public waits for vaccine, public health officials continue to urge commonsense prevention advice: Wash your hands, cover your coughs and stay home from school or work if you're sick.

While few people have gotten the H1N1 vaccine so far, lots have gotten their seasonal flu shots already. So many that several local providers have run out of doses. Doctors' offices and public health officials cite unusually high demand and some production backups. Locally, the Concord Regional Visiting Nurse Association and LRGHealthcare have had to suspend their public vaccination clinics until new shipments come in.

Bobinsky said that there are still enough flu shots to go around, but interested patients may have to look harder to find a flu shot near them. Many drug stores and grocery stores still have clinics scheduled. Dearborn said that the Concord Hospital pharmacy has 1,000 doses in stock.