Dallas County will hold its first walk-up swine-flu vaccination clinic Wednesday, a carefully staged event that could go perilously wrong if too many people show up demanding shots.

"It is not necessary for people to get here Tuesday and spend the night outside the building," Zachary Thompson, director of the county's Health and Human Services Department, said Monday.

"We expect a rush of people, but we don't expect to see them pushing and shoving like we saw in other cities. We understand people want to get these vaccinations, but this can be safe and orderly, too."

Dallas County's 10,000 doses of the swine flu vaccine are intended to go to a specific group of people – county residents who are low-income, uninsured and also at highest risk of severe flu complications.

That would include pregnant women, people who live with or care for infants younger then six months old, health care workers, people 6 months to 24 years old and those who have asthma, diabetes and other chronic medical conditions and are 25 to 64 years old.

The county's supply of the free vaccine will be dispensed from 8 a.m. to 4 p.m. Wednesday at the health department headquarters at 2377 N. Stemmons Freeway.

The vaccinations will continue Thursday and Friday – as long as the county's supply holds up.

Vaccine seekers must prove they are residents of Dallas County to get the free shots. A driver's license or utility bill that shows a person's name and address will be required.

"It's possible we may have to turn people away," Thompson said. "As we see situations come up, we will have to decide the right thing to do."

The overriding message from the health department is that anyone who has health insurance should try to get H1N1 shots from their doctors or local pharmacies – whenever the local vaccine supply finally arrives.

As of Friday, 199,419 doses of the vaccine had been ordered for medical providers in Dallas County, not including those in the health department, said Carrie Williams, a spokeswoman for the Texas Department of State Health Services.

Just how many doses actually have arrived is not known.

But the vaccine shortage – blamed on manufacturing delays – has put pressure on the county to share its supply more broadly.

"I've been called a socialist for putting one group ahead of another," Thompson said. "But the health department was never set up to become the total H1N1 vaccine provider for the county. We are here for the safety-net population that we normally serve."

Still, the local death toll from the flu continues to rise, which drives home the seriousness of the situation.

On Monday, Dallas County reported its 15th death associated with the H1N1 flu. The 44-year-old man, who was not identified, had underlying health problems.

The county expects 5,000 people or more to show up for a flu shot on the clinic's first day. To make room for the crush, many of the department's other functions have been canceled or moved to other locations.

"The only people in the building on that day are people who couldn't be rescheduled," Thompson said.

He and other health officials rejected the idea of using a different location for the shot clinic because the department's clients are familiar with the building and can get there by bus.

"If anything goes wrong, we can pull the doctors and nurses from around the building to help," Thompson said. "We are expecting the unexpected."

The estimated cost of the vaccination effort, between $60,000 and $80,000 a day, will be covered by federal funds set aside for pandemic flu outbreaks.

County workers have spent several weeks streamlining a plan to get people in and out of the building as quickly as possible. Everyone concedes, however, that the process will require several hours of waiting.

"People should bring jackets and hats and gloves for themselves and their children," Thompson said. "It could be cold outside."

Visitors will use the main parking lot and the west entrance to the county building, where staffers and translators are planning to assist them with the two-page consent form.

Forty nurses, contracted by the county, will be stationed on the sixth floor to inoculate as many as 500 people an hour, Thompson said.

"Once they make it to the nurse, it should only take two minutes or less to get a shot," he said.

But it's unclear whether Dallas County will screen out those who are not qualified to receive its vaccine. It will depend largely on people telling the truth.

"It's an honor system," Thompson said. "A small percentage of people might lie, but if you tell me you don't have insurance, I have to believe you."

Beginning Wednesday, the Dallas County health department will be offering the swine flu vaccine for county residents who are low-income, uninsured and at highest risk of severe flu complications. Those risk categories include:

•Pregnant women

•People who live with or care for infants younger than six months old

•Health-care workers or emergency medical personnel

•People six months to 24 years old

•People 25 to 64 years old who have chronic medical conditions