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School and day care settings are the most "efficient ways to spread flu in the community," say researchers at Duke Children's Hospital, which may explain why the CDC is now recommending that all children -- ages six months to 18 years -- obtain a flu vaccine this year.

"If you look at communities, young children are the vector of flu," explains Chip Walter, MD, a pediatric infectious disease specialist at Duke. "They bring it home to parents, grandparents, and other family members. Studies have already shown that if you vaccinate school-age kids, you can actually reduce disease in adults."

However, since it's difficult to vaccinate that many people in the short fall and winter time frame, Walter says the time to get vaccinated is now, when the flu vaccine first becomes available. That's smart, he adds, since you never know when the first case of flu will strike.

If you don't get vaccinated early, however, you haven't missed your chance. Walter says it is prudent to get vaccinated through December and January since the peak flu month is February.

Each year, from five to 20 percent of the population gets the flu. About 200,000 people become hospitalized annually due to complications from flu, and 36,000 people die.

In the past, the vaccine was recommended for populations at high risk for contracting influenza including:

• People over the age of 65
• Anyone with a chronic disease
• Children over the age of six months who have underlying medical conditions.

The recommendations have expanded in recent years. In 2004, the flu vaccine was routinely recommended for all children 6 to 23 months of age.

It was expanded to include children up to the age of 5 years in 2006 and this year includes all children 6 months to 18 years of age.

While lines may be longer, some kids will be happier. Studies show the nasal-spray flu vaccine to be effective in people age two to 49. What's more, the nasal flu vaccine was found to be more effective in young children, while the shot was found more effective in older individuals. Walter also points to recent data which finds its duration of protection to be good through the entire flu season even when administered earlier than usual.

"Adolescents, in particular, are getting so many shots these days. If we can give them one by mist and save a needle, that's great. I like having that alternative for kids."

Some children and high-risk groups cannot receive the nasal flu vaccine for a variety of health-related reasons, so check with your doctor before getting vaccinated.