There is a lot of flu vaccine out there, but in some parts of the country you may have to wait a few days to get your shot.

The reason has nothing to do with a supply shortage. The problem has more to do with a huge surge in demand. This year, more and more people are getting the flu vaccinations and are doing so earlier because they are worried about getting a one-two hit of flu and COVID-19.

The Centers for Disease Control and Prevention (CDC) said manufacturers are expected to ingest between 194 and 198 million vaccine doses for the 2020-2021 flu season. This corresponds to a dose increase of 20 million compared to the 2019-2020 season and 38.7 million more than in the 2017-2018 season.

As of October 16, 154.6 million doses of the vaccine had been distributed across the country. This is an 18.7% increase over 2017, the last year with comparable available numbers, according to the CDC. The CDC recommends that anyone aged six months and over get a flu shot.

“We’re seeing what I call regional sales challenges that have to do with a huge surge in demand early in the season,” said Dr. Litjen Tan, Chief Strategy Officer for the Immunization Action Coalition, told the Center for Infectious Disease Research and Policy News at the University of Minnesota. “It is very regional and not essential to disrupt the national level or cause a vaccination problem.”

The flu vaccine also changes every year. As a result, manufacturers will have to wait for viruses to be selected before formulating this year’s vaccine, according to the CDC. With such a tight deadline, problems during production can lead to delays.

The production and distribution of the flu vaccine in the US is mainly handled by the private sector. The CDC has no authority over where or when doses of the vaccine are distributed.

Vaccine manufacturers expected a pandemic increase in demand for flu vaccines this year and increased production. In July, GlaxoSmithKline, one of several vaccine manufacturers, began shipping approximately 50 million flu vaccinations in anticipation of increased demand.

“We don’t want the health system to be overwhelmed,” said Dr. Leonard Friedland, the company’s director of scientific affairs and public health, told the Wall Street Journal in August. “We don’t want a patient on an influenza ventilator (intensive care unit) when that hospital bed and ventilator could potentially be used for a (COVID-19) patient.”

Sanofi, which provides the flu vaccine for people 65 and older, broadcast television commercials and worked with doctors to find creative ways to give the vaccine during the pandemic.

“It is one thing to produce, ship, and market 80 million doses of influenza vaccine, but if the vaccine doesn’t land in your arms, you haven’t achieved your goal,” said Elaine O’Hara, director of Sanofi announced the commercial operation in North America to WSJ.

For its part, AstraZeneca has helped physicians build mobile flu protection clinics, Fred Peruggia, executive director of marketing for respiratory biologics for the company, told Becker’s Hospital Review.

The good news is that flu season is slow to start, although some people may have to wait a few extra days to get vaccinated. According to the CDC, only 1.2% of patient visits for the week of October 17 were due to flu-like illnesses. This is considered low and is below the national base of 2.6%.

But Dr. Tan said people shouldn’t trust talk of a mild flu season to postpone vaccination, especially as the third wave of COVID-19 wash across the country.

“Aside from the morbidity and mortality of individual patients, we will see that (intensive care units) are overwhelmed,” said Dr. Tan, also co-chair of the National Influenza Vaccination Summit for Adults, told CIDRAP News. “Some states are currently reporting critical numbers of hospital beds. So imagine all of our flu visits. “