This is NEWS Plus Special English. I'm Mark Griffiths in Beijing.
We stay in the U.S. Only about 36 percent of U.S. adults aged 18 to 64 got the flu shot during the 2012-13 flu season.
The U. S. government recommends all American six months and older get vaccinated each year.
By comparison, almost 57 percent of children aged 6 months to 17 years old and 66 percent of seniors aged 65 and older were vaccinated.
The figures come from an analysis released by the Trust for America's Health, a Washington DC-based health advocacy organization.
According to the U.S. Centers for Disease Control and Prevention, the 2013-2014 flu season in the U.S. is beginning to "ramp" up and flu is now widespread in 35 states.
H1N1 is the most prevalent flu strain this season, which can disproportionately, and adversely impact otherwise healthy children and young adults.
Doctors say the trend of low vaccination rates among younger adults is particularly troubling this year, when they are more at risk than usual for the effects of the H1N1 strain of flu that's circulating.
The analysis found that overall flu vaccination rates remain low in the United States. Fewer than half of Americans got a flu shot during the 2012-13 season. But it was already an increase over 42 percent in the previous season.
The flu contributes to around 10 billion U.S. dollars in direct healthcare costs and high worker absentee expenses. Each year, one in five, or an average of 62 million, Americans get the flu.
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