Where's the Swine Flu vaccine, Barry?

President Obama has declared the swine flu outbreak a national emergency, allowing hospitals and local governments to speedily set up alternate sites for treatment and triage procedures if needed to handle any surge of patients, the White House said on Saturday.

The declaration came as thousands of people lined up in cities across the country to receive vaccinations, and as federal officials acknowledged that their ambitious vaccination program has gotten off to a slow start. Only 16 million doses of the vaccine were available now, and about 30 million were expected by the end of the month. Some states have requested 10 times the amount they have been allotted.

Flu activity - virtually all of it the swine flu - is now widespread in 46 states, a level that federal officials say equals the peak of a typical winter flu season. Millions of people in the United States have had swine flu, known as H1N1, either in the first wave in the spring or the current wave.

Although there has been no exact count, officials said the H1N1 virus has killed more than 1,000 Americans and hospitalized over 20,000. The emergency declaration, which Mr. Obama signed Friday night, has to do only with hospital treatment, not with the vaccine. Government officials emphasized that Mr. Obama's declaration was largely an administrative move that did not signify any unanticipated worsening of the outbreak of the H1N1 flu nationwide. Nor, they said, did it have anything to do with the reports of vaccine shortages.

Federal officials predicted last spring that as many as 120 million doses could be available by now, with nearly 200 million by year's end. But production problems plagued some of the five companies contracted to make the vaccine. All use a technology involving growing the vaccine in fertilized chicken eggs; at most of them, the seed strain grew more slowly than expected.

The manufacturers are "working hard to get vaccine out as safely and rapidly as possible," Dr. Frieden said. But since it is grown in eggs, "even if you yell at them, they don't grow faster."

Since last winter's more isolated cases of swine flu, the expectation that the virus would return with a vengeance in this flu season had posed a test of the Obama administration's preparedness. Officials are mindful that the previous administration's failure to better prepare for and respond to Hurricane Katrina in 2005 left doubts that dogged President George W. Bush to the end of his term.