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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.

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 6–8,000 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 http://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,” 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 of Manhattan, said only half-jokingly: “Do you think that’s accounting for two-thirds of our phone calls, or three-quarters?”

In Philadelphia, Dr. Shea Cronley of Advocare Society Hill Pediatrics said she was concerned that emergency rooms were starting to see a rise in flu cases, but she did not know when she would be getting her share of vaccine. “We’re waiting,” she said.

The Centers for Disease Control and Prevention has embarked on an extensive immunization drive with a goal of producing 195 million to 250 million doses of vaccine.

The vaccine is being distributed free to local jurisdictions, like city and state health departments, which are responsible for taking orders from doctors, hospitals, school systems and the like.

As of Monday, 62 states or localities had put in orders for a total of more than 1.7 million doses.

Actual delivery will lag, however, adding to the confusion about when doctors will get their share. The New York City Department of Health and Mental Hygiene said Friday that it expected to get only 68,800 doses by early this week, and New York state expected 59,000. Increasing amounts of vaccine are expected to be available in the next few weeks.