This flu season is expected to be more intense than the past few seasons.

“This upcoming flu season is not going to be like the past two flu seasons which were virtually non-existent because of all the social distancing and mask wearing,” Dr. Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security, said.

Australia recently reported its worst flu season in five years. How the flu season goes in the Southern Hemisphere is a strong indicator for the Northern Hemisphere’s flu season.

“It should be a flu season that is reminiscent of those pre-pandemic,” Dr. Adalja said. He recommends his patients to get a flu shot late October to early November.

Experts say the elderly are at the highest risk for severe disease.

“There are a lot of different flu vaccines and it’s important to talk to your doctor to see which might be the best for you,” Dr. Adalja said.

There are three flu vaccines preferentially recommended for people 65 year or older, by the Centers for Disease Control and Prevention Those include the Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine.

Vaccine effectiveness can vary, but recent studies show flu vaccination reduces the risk of flu illness by between 40 and 60 percent, according to the CDC.

Dr. Adalja said you can get a flu vaccine and a COVID booster shot at the same time.

“You may have a little bit more side effects when you do that but it is something you can do for convenience,” he said.

On average, up to 41 million people catch the flu every year, which can result in up to 52,000 deaths, according to the CDC.

The U.S. flu season is off to an unusually fast start, adding to an autumn mix of viruses that have been filling hospitals and doctor waiting rooms.Reports of flu are already high in 17 states, and the hospitalization rate hasn’t been this high this early since the 2009 swine flu pandemic, according to the Centers for Disease Control and Prevention. So far, there have been an estimated 730 flu deaths, including at least two children.The winter flu season usually ramps up in December or January.“We are seeing more cases than we would expect at this time,” the CDC's Dr. José Romero said Friday.A busy flu season is not unexpected. The nation saw two mild seasons during the COVID-19 pandemic, and experts have worried that flu might come back strong as a COVID-weary public has moved away from masks and other measures that tamp the spread of respiratory viruses.Community Montessori school in New Albany, Indiana, switched to virtual teaching at the end of the week because so many students were out sick with the flu. Beginning Monday, the school's 500 students will go back to wearing masks.“Everybody just wants kids on campus, that is for sure,” said the school's director, Burke Fondren. “We will do what we need to do."There may be some good news: COVID-19 cases have been trending downwards and leveled off in the last three weeks, Romero said.And in a few parts of the country, health officials think they may be seeing early signs that a wave of another respiratory virus may be starting to wane. RSV, or respiratory syncytial virus, is a common cause in kids of coldlike symptoms such as runny nose, cough and fever. While RSV continues to rise nationally, preliminary data suggest a decline in the Southeast, Southwest, and in an area that includes Rocky Mountain states and the Dakotas, CDC officials said.Experts think infections from RSV increased recently because children are more vulnerable now, no longer sheltered from common bugs as they were during pandemic lockdowns. Also, the virus, which usually affects children at ages 1 and 2, is now sickening more kids up to age 5.At the University of Chicago Medicine Comer Children’s Hospital, beds have been full for 54 days straight.“The curves are all going up for RSV and influenza,” said Dr. John Cunningham, Comer's physician-in-chief.RSV illnesses seem to be unusually severe, he added.Comer has had to turn down transfer requests from other hospitals because there was no room. Chicago-area hospitals had been able to transfer kids to Missouri, Iowa, and Wisconsin, but that's stopped. “They have no more beds, either,” Cunningham said.There’s not yet a vaccine against RSV, but there are shots for flu and COVID-19. Health officials say flu vaccinations are down in both kids and adults compared to before the pandemic, although up in children from last year.So far this season, there have been an estimated 1.6 million flu illnesses and 13,000 hospitalizations. Flu activity is most intense in some of the areas where RSV is fading, including the Southeast, according to CDC data.___Babwin reported from Chicago. Tom Davies in Indianapolis contributed to this report.

WASHINGTON, D.C. — After a so-called “twindemic” of COVID-19 and the flu failed to materialize last year, this year's flu season is expected to roar back.

“Because of all the masks and all the precautions, we basically did not have a flu season,” infectious disease expert Dr. David Dodson said of the last flu season.

However, this time around, more cases of the flu are likely to arise.

Dr. Anthony Santella, an infectious disease expert and a professor of health administration policy at the University of New Haven in Connecticut, says this year isn't one to mess around with.

“The flu is incredibly difficult to predict,” he said. “I know everyone wants that crystal ball, 'What's going to happen? When is it going to happen, even outside of COVID?' And that's very challenging.”

He said there are signs and circumstances that point to a far more active, upcoming flu season.

“Children are back at school,” Dr. Santella said. “People are back at work. People are socializing, traveling both domestically and abroad. And that means that those bugs, viruses like what we're talking about, lots of bacteria and other things are circulating.”

Right now, the CDC is tracking confirmed flu cases. Their findings show most of the country is experiencing either a minimal or low number of cases, with the exception of Mississippi, which is seeing a moderate level of flu activity.

Yet, Dr. Santella said that could change as the weather begins to get colder and people spend more time indoors, coupled with COVID fatigue.

“We know the data is pretty clear this year that people feel burdened, they feel frustrated and they feel tired by continuing to maintain those protective health behaviors,” he said.

That is why experts say getting a flu shot by the end of October is so important. The flu vaccines are developed based on the flu strains circulating in other parts of the world.

“This year, they've done things a little bit differently, where instead of having some vaccines that protect against two strains and some that protect against four, all four major vaccine candidates protect against all four strains,” Dr. Santella said.

As for those who have yet to get a COVID-19 vaccine, Dr. Santella said it’s safe to get both together.

“You can get them at the same time,” he said. “There's no harm. There's no counteracting of the products.”

Both of which are vaccines created to help people avoid the worst effects of two deadly viruses.