WASHINGTON -- It's flu-shot season already, and for the first time health authorities are urging nearly everyone to get vaccinated.
What a difference a year makes: Crowds lined up for hours for scarce shots during last fall's swine flu pandemic. This year, five manufacturers are supplying a three-in-one vaccine for all ages, said Stanislaus County Public Health Officer John Walker.
"We have the largest supply we've ever had," he said Monday.
Pharmacies around Modesto started offering the shots this week. A schedule of public health shot clinics will be released soon, Walker said. There's also a nasal-spray vaccine for shot-averse patients ages 3-49.
The shots and spray protect against the newest strain of seasonal flu, a more localized strain and last year's scare -- the swine flu, Walker said.
"It's important that everyone be aware of the importance of getting a vaccine every year," said Walker, adding that one shot will be enough for all but young first-timers, who might need a booster vaccine later in the season.
Most of the flu deaths each year in the United States are linked to pneumonia. A one-time vaccine against the most common type of pneumonia is recommended for seniors and other high-risk groups.
But without last year's scare factor, the question is how many people will heed the new policy for near-universal vaccination. Schoolchildren especially are apt to spread the disease.
"Influenza is serious, and anyone, including healthy people, can get the flu and spread the flu," said Dr. Anne Schuchat of the federal Centers for Disease Control and Prevention.
Here are some common questions and answers about flu:
Q: I got vaccinated against seasonal and H1N1 flu last year, so why do I need vaccine this year?
A: It protects against a different strain of the H3N2 influenza family that has cropped up, as well as last year's swine flu, part of the H1N1 family, and a Type B strain. Every year a different flu vaccine is brewed to match the constantly changing flu strains that circle the globe.
Q: Why is there a new high-dose version for seniors?
A: Your immune system weakens with age, so it doesn't respond as actively to a flu shot. Sanofi Pasteur's Fluzone High-Dose quadruples the standard dose for people 65 and older. This winter, scientists will track whether that translates into less illness. Until that proof is in, CDC officials say it's OK to choose either option.
Q: Will I need just one shot?
A: Most people will, but children younger than 9 getting their first flu vaccine will need two, a month apart, to prime their immune systems.
Q: What if my child's first vaccine was last year and she got one dose of seasonal and one dose of swine flu vaccine?
A: She wasn't primed enough and needs her two doses this year, said Dr. Michael Brady of Nationwide Children's Hospital, who co-wrote the American Academy of Pediatrics flu vaccination guidelines out Monday.
Q: Will there be enough vaccine?
A: Manufacturers project 170 million doses. That won't cover the entire population, but the CDC knows its near-universal vaccination policy won't spark a stampede for shots. Before last year, flu vaccine was recommended for 85 percent of Americans, but only about a third got vaccinated. Last year nearly all 114 million doses of seasonal vaccine were used, but as the swine flu outbreak slowed, just 90 million doses of the special vaccine were used out of nearly 162 million eventually produced for the general public.
Q: Who's at high risk from flu?
A: Young children, anyone 50 or older, anyone with chronic medical conditions such as asthma or heart disease, and pregnant women. Also, health workers and caregivers of infants can infect the vulnerable unless vaccinated.
Q: Who can use the nasal spray vaccine?
A: FluMist is for healthy people 2 to 49 or underlying health conditions. Pregnant women can't receive the nasal spray.
Q: When should vaccination start?
A: Chain pharmacies have started vaccinating; protection will last all winter. It takes about two weeks to kick in, and flu typically starts circulating around November.
Q: How do I know it's safe?
A: Unprecedented safety monitoring last year turned up no rare side effects from the special swine flu-only vaccine sold in the United States.
Q: Why should I bother since fewer people than usual died last year?
A: Last year's U.S. toll: about 12,000 deaths, 60 million illnesses and 265,000 hospitalizations. New CDC statistics last week suggest flu strain mortality varies widely, from 3,000 in an exceptionally mild year to 49,000 in a recent really bad one -- and it's impossible to predict how bad each year will be.
Bee staff writer Nan Austin contributed to this report.