TENNESSEE, United States (AP) — Doctors have a message for vaccine-weary Americans: Don’t skip your flu shot this fall.

The weather in Jamaica is nothing compared to that of the United States but the message to Americans could also be applicable to elderly Jamaicans as we enter the cooler months.

After flu hit historically low levels during the COVID-19 pandemic, it may be poised for a comeback. The main clue: A nasty flu season just ended in Australia.

While there’s no way to predict if the US will be as hard hit, “Last year we were going into flu season not knowing if flu was around or not. This year we know flu is back,” said influenza specialist Richard Webby of St Jude Children’s Research Hospital in Memphis.

Annual flu shots are recommended, starting with six-month-old babies. Flu is most dangerous for people 65 and older, young children, pregnant women, and people with certain health problems, including heart and lung diseases.

Here’s what to know:

As people get older their immune system doesn’t respond as strongly to standard flu vaccination. This year, people 65 or older are urged to get a special kind for extra protection.

There are three choices: Fluzone High-Dose and Flublok each contain higher doses of the main anti-flu ingredient. The other option is Fluad Adjuvanted, which has a regular dosage but contains a special ingredient that helps boost people’s immune response.

Seniors can ask what kind their doctor carries but most flu vaccinations are given in pharmacies; and some drugstore websites, such as CVS, automatically direct people to locations offering senior doses if their birth date shows they qualify.

Webby advised making sure older relatives and friends know about the senior shots, in case they’re not told when they seek vaccination.

“They should at least ask, ‘Do you have the shots that are better for me?’ ” Webby suggested. “The bottom line is they do work better” for this age group.

If a location is out of senior-targeted doses it’s better to get a standard flu shot than to skip vaccination, according to the US Centers for Disease Control and Prevention.

Flu vaccines are in the “quadrivalent”, meaning they guard against four different flu strains. Younger people have choices, too, including shots for those with egg allergies and a nasal spray version called FluMist.

Australia just experienced its worst flu season in five years, and what happens in southern hemisphere winters often foreshadows what northern countries can expect, said Dr Andrew Pekosz of the Johns Hopkins Bloomberg School of Public Health.