The second-wave outbreak of swine flu will be worse than expected because people are not being vaccinated, health authorities have warned. The Centre for Health Protection presented detailed analyses of H1N1 cases yesterday in a bid to restore public confidence in the vaccine, which media reports have linked to severe side-effects, including one death and a stillbirth. The deaths of two more swine flu patients - a 57-year-old woman and a 47-year-old man - were reported yesterday. The man was said to have been in good health, while the woman had diabetes. The number of swine flu vaccinations given has plunged in recent days. In the 24 hours to 1pm yesterday, 1,563 shots were administered, compared to 1,634 in the previous 24 hours. At the outset of the vaccination programme, about 10,000 shots were being given each day. About 145,750 shots have been given since the start of the programme on December 21. About 10,950 of the shots were given to staff at public hospitals - about 10 per cent of their staff. Centre controller Dr Thomas Tsang Ho-fai conceded that the public response to the vaccination programme was not satisfactory. He feared people in high-risk groups would be infected easily when the second wave of the virus hit if they did not get vaccinated. 'We urge those people in high-risk groups to have the shots ... but at the end of the day it will be the individual's own decision,' he said. 'People should be responsible for their own health.' Dr Tsang said the vaccine was safe. 'Reports of these adverse events do not necessarily mean vaccination is the cause. Many of the events naturally occur irrespective of vaccination,' he said. A 58-year-old doctor has been confirmed to have developed Guillain-Barre syndrome (GBS) after being vaccinated, but it was unclear whether it was caused by the vaccine. GBS can be caused by other factors. In other possible connections, a 37-year-old woman who was 28 weeks' pregnant lost her baby three weeks after being vaccinated, and a 66-year-old woman died at home after receiving a shot over Christmas. But Dr Tsang said: 'If the vaccine was not safe, many overseas countries would have already stopped the vaccination programme, but so far no country has done so.' Some 64.7 million doses have been administered on the mainland and only four deaths have been reported as connected with the shots, the centre said. In Spain, where two million shots have been given, no deaths or serious side effects have been reported. During the first month of the vaccination programme, up to January 21, there were 34 severe H1N1 cases, seven fatal, and none of the patients had been vaccinated, Dr Tsang said. Data showed about 54 per cent of primary schoolchildren had adequate antibody levels for human swine flu, he said. 'This suggests that a substantial number of primary school pupils will already have immunity against human swine flu infection in the coming second wave. At the moment, we do not regard them as a special target group recommended for vaccination,' Dr Tsang said. Some half a million shots have arrived in the city. Another batch of 2.5 million will arrive in the next few days, so there would probably be no problem with supply, Dr Tsang said.