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The flu affects millions people in the U.S. every year.

As we head into the fall and winter months, we also enter flu season. Even though influenza viruses spread year-round, flu activity usually peaks between December and February, according to the CDC. But how many people actually contract the flu each year? The agency says the “burden of flu disease” can vary widely depending on a number of factors, but it still “places a substantial burden on the health of people in the United States each year.” The CDC estimates that between 2010 and 2020, the flu was responsible for anywhere from between 9 million to 41 million illnesses per year. As a result of these flu infections, it is estimated that there were between 140,000 to 710,000 hospitalizations annually during this time period, and 12,000 to 52,000 deaths every year.

Those over the age of 65 are more at risk.

While millions of Americans from all age groups are infected with the influenza virus every year, older adults bear the greatest burden. According to the CDC, it is estimated that in recent years, between 50 and 70 percent of seasonal flu-related hospitalizations have occurred among people 65 years and older. And even worse? The agency says between 70 and 85 percent of seasonal flu-related deaths have happened among those in this age group. “People 65 years and older are at higher risk of developing serious flu complications compared with young, healthy adults,” the CDC warns. “This increased risk is due in part to changes in immune defenses with increasing age.” RELATED: For more up-to-date information, sign up for our daily newsletter.

The CDC has a new warning for older adults.

In other words, people 65 and older need to get a flu shot with a higher dose this year. According to the CDC, there are three flu vaccines older adults can choose from that fall in line with the agency’s new guidance: the Fluzone High-Dose Quadrivalent vaccine, the Flublok Quadrivalent recombinant flu vaccine, and the Fluad Quadrivalent adjuvanted flu vaccine. “This recommendation was based on a review of available studies which suggests that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines,” the CDC explains. “There is no preferential recommendation for people younger than 65 years.”

You should get the flu shot as soon as possible.

Everyone should be getting their flu shot now, but if you’re over 65, you need to call your pharmacy as soon as possible. “All adults over age 65 should get a high-dose flu shot starting anytime in September and preferably by the end of October,” Douglas L. Ambler, MD, the medical director of Quality at Northwestern Medicine Regional Medical Group, said in a blog post for the healthcare company’s website. “You can get it later, but it is best not to wait.” This is especially important in light of what’s expected to be a nasty flu season following low activity amid the height of the COVID pandemic. Richard Webby, an influenza specialist working with St. Jude Children’s Research Hospital in Memphis, Tennessee, told PBS that older adults should be asking about the extra strength flu shots whenever they go to get vaccinated. “They should at least ask, ‘Do you have the shots that are better for me?’” Webby said, adding that “the bottom line is [the recommended flu vaccines] do work better” for people 65 and older. But don’t forgo a flu shot altogether if a higher dose is not available. “If none of the three flu vaccines preferentially recommended for people 65 years and older is available at the time of administration, people in this age group should get any other age-appropriate flu vaccine instead,” the CDC says.