The Health Ministry expects to purchase and import 350,000 doses of H1N1 swine flu vaccine in October, out of a total of 2.3 million doses to be available here by the end of March. The ministry does not know whether the 150,000 doses expected to arrive in March will be needed, as seasonal flu tends to die out in the spring when the weather turns warmer, and it takes a week or two after vaccination for the immune system to create antibodies against the virus. The ministry said on Thursday that it had an option of purchasing eight million additional H1N1 flu vaccine doses, which would cover more than the entire population. However, since some cases may require two doses instead of one, more vaccine vials than the size of the population have been ordered. Ministry deputy director-general Dr. Boaz Lev, who is now in the US on ministry business, told The Jerusalem Post by phone that the H1N1 flu "is probably here to stay," so the cases may not fizzle out when the weather gets warmer and drier. In November 2009, an additional 350,000 doses will arrive, thus doubling the supply. December will bring the largest number of doses - 1,050,000, followed by 250,000 in January and 150,000 in February. Earlier this month, the US Food and Drug Administration approved the marketing in the US of three new injectible vaccines and one nasal-spray vaccine against swine flu. The brands have been produced and tested by CSL, Novartis and Sanofi Pasteur (injectible) and MedImmune (nasal spray). The first 430,000 doses of H1N1 vaccine will be offered here to high-risk populations, starting with medical staffers, pregnant women, people with chronic illness and weak immune systems, and children. A Health Ministry poll a few weeks ago found that 25 percent of the public would categorically refuse to be vaccinated against swine flu. The ministry expects that some people who intend to be vaccinated may wait a few weeks after it becomes available to see how those getting the first shots react. Although there is strong opposition among US doctors, nurses and other health system personnel to regulations that will require them to be vaccinated, Lev said "no one is forced to undergo any vaccination in Israel. It will be recommended, and we will have an information campaign to explain it." He did not have figures on the cost of the vaccine, but said it would not come at the expense of the basket of health services' expansion for 2010. Since March, 25 Israeli deaths have been linked to swine flu, from among the thousands who have been infected. The latest death, reported by the Health Ministry on Thursday, was a 72-year-old man at Tel Aviv's Sourasky Medical Center.