It's time get a flu vaccination. Here's who needs one and why

 It's time to get a flu vaccine, and pediatricians are urging people to get them after last winter, when the U.S. saw the most flu-related child deaths in 15 years.

October is the ideal month to get protected, experts say, because flu cases typically begin climbing in November.

"The best time is today. If you haven't already had it, get it. I got mine yesterday," said Dr. Laura Riley, of the American College of Obstetricians and Gynecologists.

Don't like shots? This year marks the first time that some people can try vaccinating themselves at home using the nasal spray vaccine FluMist.

Here's what to know

Just about everyone age 6 months and older, according to the Centers for Disease Control and Prevention and major medical societies. Despite lots of recent misinformation and confusion about vaccines, the flu recommendations haven't changed.

Flu is particularly dangerous for people 65 and older, pregnant women, young children, and people of any age who have chronic health problems including asthma, diabetes, heart disease and weak immune systems.

About 71% of seniors roll up their sleeves every year, but less than 50% of other adults do. Last year, just under half of children got a flu vaccine, down from over 60% a few years ago.

Flu vaccines may not block all infections, but they do a really good job of preventing severe illness and hospitalization, said Dr. Sean O'Leary, of the American Academy of Pediatrics.

Tens of thousands of Americans die from the flu every winter. But during last year's harsh season, the CDC counted 280 children who died of flu-related complications. Nearly half had no prior health problems and about 90% hadn't been fully vaccinated.

Another concern from last season: The CDC counted more than 100 children who developed a rare flu complication - brain inflammation that can lead to seizures, hallucinations, or even death. Very few were vaccinated.

It's important for mothers-to-be to understand that a bad case of flu can put them in the hospital or cause their baby to be born prematurely, Riley said.

Flu shot protection also carries over to newborns, and infants too young for their own vaccinations are especially vulnerable to flu.

Riley stressed that years of flu vaccinations show that recommendation is safe for mother and baby.

High-dose shots and those with a special immune booster are designed for people 65 and older, but if they can't find one easily they can choose a regular all-ages flu shot.

For the shot-averse, the nasal spray FluMist is available for ages 2 to 49.

FluMist has been available for more than 20 years, but the at-home option is newly available for certain adults on the vaccine's website. If they're deemed eligible according to their age and a medical questionnaire, they'll be shipped FluMist timed to arrive on a particular day, with instructions on how to administer it to themselves or their children.

The Food and Drug Administration approved the home administration option last year, too late to roll out for that season. It's currently only available in 34 states, according to manufacturer AstraZeneca, which hopes to expand access.

They're supposed to be free under Medicare, Medicaid and most private insurance plans if people use an in-network provider. Local health departments also can provide free or low-cost flu vaccinations for people who qualify.

As for the at-home FluMist option, the same insurance rules are supposed to apply, but there will be an out-of-pocket delivery fee.

Yes, said Dr. Philip Huang, director of Dallas Health and Human Services. They're safe to give together and "that's a good way to get them taken care of," he said.

However, there still may be difficulty in finding COVID-19 shots - especially through a government-funded child vaccination program - given confusion after a federal advisory board quit recommending them but said people could decide for themselves.

Associated Press