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If doctors and nurses get sick with swine flu, who will take care of everybody else who catches the bug? That’s the rationale behind a recommendation out today from the WHO on who should be first in line for a swine-flu vaccine.

During a conference call today, a WHO vaccine expert, told reporters that vaccinating health workers will allow countries to “maintain a functional health system.”

Of course, health-care workers are supposed to get flu shots every year, but many of them fail to do so — this CDC survey found that in the 2005-2006 flu season, only 42% of health care workers got a flu shot.

Others who should get high priority for the swine flu vaccine include pregnant women; anyone over six months of age with a chronic health condition such as asthma or obesity; healthy adults between 50 and 64 years of age; healthy children; and healthy elderly adults.

What’s obesity doing on the list? “We still don’t know exactly if it obesity itself which is a risk factor or if it is other health conditions which arise because of obesity,” said Marie-Paule Kieny, director, Initiative for Vaccine Research at WHO. “It has been observed in several countries that people with body mass index over 30 and even more over 40 have a higher chance of severe disease.” (This case report published last week adds a bit more to the discussion of obesity and swine flu.)

The U.S. has already made a plan similar to the WHO’s recommendations to vaccinate health-care workers and pregnant women. Last week Health and Human Services Secretary Kathleen Sebelius said the U.S. is planning to launch an immunization program for school-age kids.

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WHO: Put Health Workers First In Line for Swine Flu Vaccine