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������Ƶ 1 in 4 Michiganders has had a flu vaccination this season, the lowest number since coverage by flu shots spiked during the first full winter of the COVID pandemic.

That a concern to health officials as the time nears for the close-quarters sneezing, coughing and hugging of holiday parties and family gatherings.

Terms like “cold and flu” season can be misleading, said Dr. Natasha Bagdasarian, chief medical executive at the Michigan Department of Health and Human Services.

While viruses like rhinovirus and enteroviruses may cause mild congestion, “actual influenza can be quite debilitating,” said Bagdasarian, also an infectious disease expert.

The COVID and flu virus are similar in that “these are viruses that can not only make you feel rotten, they can land you in the hospital (and) they can land you on a ventilator,” she said.

“People sometimes forget — if they haven’t had influenza in a while — just how bad it can be,” said Dr. John Brooks, an infectious disease specialist and chair of the Emerging Pathogens Response Team at Grand Blanc-based McLaren Health Care, which operates 13 Michigan hospitals.

The average middle-aged adult, he said, will be sick between five and seven days — feeling ill enough that they will miss work, too, he said. Moreover, 16 pediatric deaths were blamed on the influenza virus in the previous two flu seasons. The youngest among the dead was just 1 month old, according to MDHHS.

Who should get the shot?

Flu activity in Michigan remains “minimal” now, according to the US Centers for Disease Control and Prevention.

But that could change fast, experts warn.

The CDC recommends yearly flu shots for anyone ages 6 months and older with few exceptions. That especially important for young children, older Michiganders, pregnant people and anyone else at high risk for severe complications.

Those with life-threatening allergies to any ingredient in a flu vaccine, other than egg proteins, should not get that vaccine.

Who getting the shot?

The vaccine has been a tough sell in Michigan.

Even during the 2020-21 season, as doctors worried about a “tripledemic” of COVID, flu, and respiratory syncytial virus, or RSV, just 1 in 3 Michiganders, or 34.3%, was vaccinated against the flu. That the highest rate in recent years.

The following flu season, vaccination rates fell to 30.5%, then 29.1% in 2022-23, and so far this year to 26.6%.

Or to slice it another way: Health providers have administered some 629,000 fewer flu shots this year compared to the same time in 2021, according to state data.

And the state vaccination rate lags behind the national rate, making Michigan more vulnerable to a rough flu season — the meaning of the term “going viral” long before the internet and social media used it, said Brooks, at McLaren.

“A couple of people have (the flu), and then their contacts rapidly spread it through the community, and one (case) becomes 10, becomes 100 becomes 1,000 becomes 10,000 pretty darn quickly,” he said. “That’s how viruses work in a population that is susceptible to a particular pathogen.”

Across the United States, more than 1 in 3 adults (36.6%) have had a flu vaccination this season. That similar to last season at the same time, according to estimates by the CDC.

Does the flu shot work?

This year flu vaccines are designed to protect against three flu viruses.

To be clear, it doesn’t guarantee you won’t get the flu. But like the COVID shot, a vaccine against flu reduces the chances of severe disease or death.

Health officials are careful to make that distinction, as trust in institutions has been shaken in recent years. Those still on the fence about vaccines “are no longer content with just hearing that vaccines are safe and effective,” Bagdasarian said.

“They want to know the why: ‘Why should I get this particular vaccine, and why now?’” she said.

“The ‘why’ is not because this is a vaccine that will prevent you from getting sick this winter,” she said. “It’s that this is a vaccine that — if you get exposed to influenza — will likely keep you out of the hospital, and it will likely keep you off a ventilator.”

How much does it cost?

Vaccines are usually covered by insurance.

The Michigan Vaccines For Children provides free flu vaccines to children less than 19 years of age and are either Medicaid-eligible, uninsured, underinsured, or American Indian/Alaska Native. Michigan Adult Vaccine Program provides vaccines at no cost to adults 19 years and older seen at participating providers such as local health departments, Federally Qualified Health Centers, tribal health centers, and migrant health centers.

The shot takes about two weeks to build up to full strength. This week, the state urged Michiganders to get their shot now in advance of holiday parties and family gatherings.

What about RSV and COVID vaccines?

The flu shot can be given at the same time as COVID-19 and RSV vaccines, according to recommendations by the CDC Advisory Committee on Immunization Practices, or ACIP.

The CDC recommends the RSV vaccine for all Michiganders 75 years and older and for adults ages 60–74 years who are at increased risk of severe RSV and for pregnant people.

This article is being republished through a syndication agreement with Bridge Michigan. Bridge Michigan is Michigan largest nonprofit news service and one of the nation leading and largest nonprofit civic news providers. Their coverage is nonpartisan, fact-based, and data-driven. Find them online at .