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Most doctors are encouraging patients to get the new H1N1 swine flu vaccine, but a small number of physicians say they have reservations. They're concerned about the vaccine's safety and its effectiveness. Today, a Food and Drug Administration advisory committee is meeting outside Washington to consider the safety of the vaccine. Here's NPR's Joanne Silberner.

JOANNE SILBERNER: It's difficult to find doctors who don't believe in the new H1N1 swine flu vaccine, but there are some out there. Some of those doubting doctors are concerned about all vaccinations. That's not the case, though, with pediatrician Laurence Murphy in Burke, Virginia. He's gotten a seasonal flu vaccine, but he has issues with the new H1N1 vaccine. To start, he feels the government has oversold it.

Dr. LAURENCE MURPHY (Pediatrician): They pushed it so hard without mentioning the normal human immune system is very good at adapting to things and fighting things and doing well.

SILBERNER: H1N1 has made a swing through his community. He's seen plenty of sick kids. But no one in his practice has had to go to the hospital. His second issue? He says the government did not have time to test the new vaccine's safety.

Dr. MURPHY: That takes time. They didn't have time to do that, because of the -they had to rush it because of the rapidity of it.

SILBERNER: But Margaret Hamburg, head of the Food and Drug Administration, says the vaccine has been adequately tested.

Dr. MARGARET HAMBURG (Food and Drug Administration): It's true that this vaccine was developed in a historic timeframe. However, it was done exactly like the seasonal flu vaccine in terms of the development process.

SILBERNER: There are new flu viruses in circulation every year and new vaccines. With H1N1 the FDA did the same thing it does each year with seasonal flu vaccines - it certified that manufacturers were using the same production methods and the same equipment, and that the manufacturers would check each lot for purity.

The new vaccine got more initial testing than is typical for seasonal flu vaccines. It got tested in several thousand people. That said, a one in a million problem isn't going to show up till the vaccine is used in close to a million people. Another thing that concerns Dr. Murphy.

FDA Commissioner Hamburg says had the new flu virus appeared a little earlier, it probably would have just been included with the regular seasonal vaccine. Earlier this month she sent out her first Dear Doctor letter as commissioner. This one detailed the development and manufacture of the vaccine.

Dr. HAMBURG: We felt it was important to reach out to health care providers, because consumers want to know and they trust their doctors.

SILBERNER: But the letter didn't convince pediatrician Laurence Murphy. He's still not recommending it. Meanwhile, the Centers for Disease Control and Prevention is having one or two press conferences a week and at most of them officials repeat the mantra: The vaccine is made the same way as seasonal flu vaccine.

Anne Schuchat of the CDC says she's not sure how many doctors are objecting.

Dr. ANNE SCHUCHAT (Centers for Disease Control and Prevention): I hear the same reports that others do about individual providers that really are skeptical about the vaccine. And I just think it's critical for the consumer, the public, to get good information.

SILBERNER: The American Medical Association, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists are all actively endorsing the new vaccine. But their members are still having a hard time finding it. Last week's total vaccine count was 42 million doses available, far below the 100 million once predicted.

Joanne Silberner, NPR News, Atlanta.

INSKEEP: We can't make decisions for you, but we can get you lots of information. And you can get tips on preventing flu and also sign up for our health podcast at our Web site, NPR.org.

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