In good years, people ignore the flu vaccine because they think the illness is no big deal. In bad years like this one, they complain that it doesn't work well enough.
But the biggest problem, says Dr. Gregory Poland, a vaccine researcher, is that scientists are still trying to understand the flu virus and come up with a better alternative. That means that every flu season, officials confront the challenge they face this year as deaths and hospitalizations mount: pleading with people to rally behind their best line of defense.
"Like every single man-made product, influenza vaccine is imperfect," said Poland, head of the Vaccine Research Group at the Mayo Clinic. "But I liken it to seat belts. Who would want to be in a crash without a seat belt?"
The truth is that the flu shot, with all its imperfections, is as vexing to scientists like Poland as it has been to the general public.
On Friday, federal officials estimated that this year's flu vaccine is only about 60 percent effective. That's better than nothing, said Dr. Edward Ehlinger, the Minnesota health commissioner. But, he admits, "I think we're all in agreement that we need a much better vaccine."
The flu vaccine, Ehlinger said, never has been "one of the star performers."
University of Minnesota scientist Michael Osterholm is even more blunt, calling the flu vaccine "overpromoted and overhyped."
Osterholm, a former Minnesota state epidemiologist, hastens to point out that he and his family still get flu shots. But his research suggests that, over time, the vaccine has worked on little more than half of adults under 65, and offered little if any protection to those most at risk -- the elderly.
Osterholm said researchers need at least a billion dollars to develop a better way of protecting people from a disease that kills thousands of Americans, mostly the frail and elderly, every year.