By Jamie Ducharme
November 30, 2017
TIME Health
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The U.S. may be in for a sick winter.

Based on record-high influenza numbers in Australia, where flu season just wrapped up, U.S. health officials are bracing for a similar situation, according to a perspective piece published in the New England Journal of Medicine on Wednesday.

To make matters worse, the Australian flu vaccine—which has the same composition as the U.S. vaccine—was only effective in roughly 10% of cases, the article says.

Cases of the flu are already rolling in stateside, according to The Centers for Disease Control and Prevention.

The NEJM article, which was authored by a group of infectious disease doctors, including the director of the National Institute of Allergy and Infectious Diseases, also calls for a universal flu vaccine. Currently, medical professionals do their best to predict the strain of influenza that will circulate most widely in a given year, and tailor that year’s vaccine based on that information. This process, however, is far from foolproof, as evidenced by the Australian data.

That failure is in part due to differences between the influenza strain targeted by the treatment and the strain that actually spreads through the population. But it also has to do with the way vaccines are made, the article explains. Flu shots are often made using eggs, a process that can change the makeup of the vaccine during production and lead to inefficacy. This appears to have been the case in Australia, the authors write, and it’s another argument for a universal vaccine, which “would not be subject to the limitations of egg-based vaccine technology.”

Despite their criticisms of the flu shot, however, the authors maintain that getting one is a good idea. “However imperfect,” they write, “current influenza vaccines remain a valuable public health tool, and it is always better to get vaccinated than not to get vaccinated.” That’s especially true with a potentially severe flu season heading our way.

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