Michael Macdonald, THE CANADIAN PRESS

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HALIFAX, N.S. - Some Nova Scotians suffering from chronic illnesses can expect to be made eligible for the swine flu vaccine as early as this week, the province's public health officer said Tuesday.

Dr. Robert Strang said he and his staff have lost sleep over the province's decision last week to restrict vaccinations to certain high-risk groups while leaving others to wait their turn as the H1N1 virus spreads.

"We need to vaccinate everybody, ultimately, but we have to go at this in a very targeted approach to make sure that those who need the vaccine the most are the ones getting the vaccine," he told a news conference.

"I know that's challenging for folks. ... It's been a very tough time for our team, making these decisions. A lot of us are not sleeping very well at night. This puts people at some risk."

So far, about nine per cent of the province's population has received the vaccine.

On Friday, when the province learned it would not be getting as much vaccine as it was initially promised, officials decided to limit vaccinations to children between six and 59 months old, pregnant women, First Nations communities and front-line health workers.

Those under 65 with a chronic medical condition are also considered members of a high-risk group, but they were not offered the vaccine because there simply wasn't enough to go around, Strang said.

More than 472,000 Nova Scotians - more than half of the province's population - are living with chronic ailments, which include everything from asthma to cancer.

Strang said the next vaccine shipment probably won't be large enough to cover the entire group. That means the province will again limit distribution to those who need it most.

"In that group, there's many layers of people at different risk," he said.

People receiving chemotherapy, children with cystic fibrosis and those with severely suppressed immune systems will be among those who will be included in the expanded high-risk group, he said.

When asked why some province's were offering shots to different groups, Strang said each province had its own way of doing things.

In New Brunswick, for example, health officials decided "they couldn't back away" from a decision to offer shots to school-age children even though the province also received a reduced supply of vaccine.

Strang said New Brunswick could run out of vaccine this week - a prediction that seemed to becoming true with the announcement that clinics there were being postponed until next week.

Meanwhile, Strang said he understands people are confused, frustrated and angry about the way Nova Scotia is distributing the H1N1 vaccine.

"They may feel that every day that we are changing our decisions and they're not sure why we're changing," he said.

The province was blindsided when told about the sudden shortfall on Friday, he said.

"We could not prepare for an unexpected vaccine shortage. ... It's one example of how, in the middle of responding to a pandemic with a new virus, there's a constantly changing flow of information."

The shortage stems from production problems that arose at vaccine producer GlaxoSmithKline Inc. The company recently switched from making the adjuvanted version of the vaccine, which contains a booster compound, to making special unadjuvanted batches for pregnant women and young children.

GlaxoSmithKline had warned Ottawa that the switch would slow production. But sources say the company apparently underestimated how much the changeover would reduce supply.

Nova Scotia was expected to start offering pregnant women the unadjuvanted vaccine on Wednesday.

Strang said the federal government and the provinces were initially expecting a poor turnout at vaccine clinics because recent public opinion polls had suggested Canadians were feeling apathetic about getting a shot.

"We were anticipating a modest uptake," he said.

But attitudes quickly changed when Canadians learned that swine flu was to blame for the sudden deaths last week of a 13-year-old boy from the Toronto area and a 10-year-old girl from Cornwall, Ont.

"That (turned) the whole public attitude around vaccination on its head."

Meanwhile, the progress of the virus has not changed much in recent weeks, he said. It continues to mainly affect school-age children, the vast majority of whom display mild symptoms.

The other age group most affected is younger children, especially those under two years, who face a higher risk of severe symptoms.

Adults between the ages of 45 and 65 are also at a higher risk of developing severe symptoms, but most of those who do get very sick usually have an underlying medical condition.

British Columbia has been hit the hardest by the virus, with about 25 per cent of its population already suffering from flu-like symptoms even though flu season has yet to peak.

In a typical year, between 10 and 20 per cent of British Columbians come down with the flu.