Professor David Salisbury, DoH director for immunisation, announced last week that one million patients in England have so far been vaccinated against swine flu. This accounts for just one in 10 patients in the priority groups and comes despite eight million doses of swine flu vaccine being distributed to practices and PCTs in England.

Across the UK, 10 million doses have been sent out to healthcare professionals.

Professor Salisbury said that he would have liked to have seen more patients vaccinated and called for GPs to go 'full throttle' to have as many patients in the priority groups vaccinated before Christmas, when he hopes vaccination can start on the under-fives.

Sir Liam Donaldson, the CMO for England, has said that he expects some GP practices to start vaccinating the under-fives as early as December.

But Dr George Kassianos, RCGP immunisation spokesman, warned that GPs were being held back by the need to conserve vaccine supplies: 'The fact that the swine flu vaccine is not available in single units is a great handicap.

'We do see patients all the time and we could vaccinate opportunistically but, if we open a vial, we must ensure we have 10 patients to administer it to.

'GPs end up losing valuable opportunities to vaccinate because of the lack of single vaccine units and the urge not to waste any vaccine,' Dr Kassianos added.

'We are being monitored for vaccine wastage.'

He also admitted that GPs were still struggling to encourage all priority group patients to be vaccinated.

'There is still a misconception among a number of patients that the vaccine has not been tested enough and that its side-effects can be dreadful,' he said.