Here, and across most of Europe, vaccine to protect against the pandemic flu will be mostly given by invitation only to those at highest risk for flu complications.

That is one of the great advantages of the Spanish health system, there are a list of all the names of patients who qualify to be vaccinated.

When Spain unrolled its pandemic vaccination program last month, it designed its campaign to ensure that priority groups — including pregnant women, health workers and those with chronic health problems like diabetes, cancer and AIDS — get the shots first.

Instead of advertising that vaccine had arrived and waiting for the lines to form, Spain's National Health Service invited all those who qualify to make an appointment and get the shots first.

Field said Spain's socialized health care system allows the country to target people who need to be vaccinated quickly. It's not like the U.S., where it's the survival of the fittest and the richest.

Just this week, Americans learned that Wall Street giants Goldman Sachs and Citigroup got swine flu vaccine, even as many doctor's offices and community clinics still had none.

Another trend has also affected the trans-Atlantic vaccination picture: While Americans and Canadians appear to be clamoring for the vaccine, many Spanish appear indifferent.