Why do half of us still skip the yearly flu vaccine?

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While a yearly flu immunization is recommended for everyone over age 6 months, fewer than half of Americans received a flu shot last year, according to the federal Centers for Disease Control and Prevention. CDC director Dr. Thomas Frieden said during a press briefing last week that he sees it as a “glass half empty” scenario, suggesting that doctors and public health officials could do a better job of convincing people to get the vaccine — or making it more convenient for them to do so.

I scheduled my sons’ well visits with their doctor for next month to ensure they get their jab because last year, I forgot, despite my best intentions.

Such a slip-up can in rare circumstances be deadly. Last year, more than 100 children died in the US from d no pre-existing conditions such as asthma or a suppressed immune system that would have made them more susceptible to flu complications; 90 percent weren’t vaccinated, according to the CDC. “That’s a terrible tragedy,” Frieden said. “Many of those deaths might have been prevented.”

Massachusetts has the fourth highest flu vaccination rate in the country, but it’s still low: 53 percent of residents got a flu shot during last year’s season compared to a national average of 46 percent. It’s a drop from 57 percent of state residents who got the shot during the 2012 to 2013 season.

A sustained increase in health care provider immunizations was the single bright note in the latest data presented by the CDC at the briefing. Nearly 82 percent of hospital-based providers were vaccinated nationwide, and Massachusetts had a rate of 87 percent. “We had two children die from catching the flu in our hospital in 2003 who were cancer patients who couldn’t get vaccine,” said Dr. Paul Offit, chief of the division of infectious diseases at The Children’s Hospital of Philadelphia.

While a handful of Massachusetts hospitals require their staff to be vaccinated, a July report from the state Department of Public Health found that at about one-third of Massachusetts’ acute care hospitals, fewer than 80 percent of health care personnel received a flu shot last year.

Doctors could also make more of an effort to administer flu vaccinations to pregnant women. Only 52 percent of pregnant women nationwide were vaccinated last year even though they’re at higher risk of dying from the flu or developing severe complications that lead to premature delivery.

“No otherwise healthy pregnant woman should ever have to go to the intensive care unit gasping for air and trying to save her newborn,” said Dr. Laura Riley, director of labor and delivery at Massachusetts General Hospital, who had her yearly flu shot during the briefing.

A CDC report published last Thursday found that only 65 percent of pregnant women were told by their health care providers to get vaccinated and offered an immunization at a prenatal visit. Nearly 20 percent of pregnant women weren’t informed that they needed a vaccine.

At Massachusetts General Hospital, women are offered the immunization during their office visit as soon as it becomes available; last year, 86 to 89 percent of patients were vaccinated, Riley said.

New flu vaccine options might encourage some to get the shot, though more options could also complicate the process for those who find that their vaccine of choice isn’t available at the pharmacy or doctor’s office. About 77 million doses of quadrivalent vaccine — which contains four strains of circulating influenza — will be produced this year, but many providers may only have the older trivalent formulations that contain three strains.

Frieden said that those over age 65 should consider getting a higher-dose vaccine, called Fluzone High-Dose, because it produces a stronger immune response and was found in a recent study to be 24 percent more effective at protecting seniors from the flu compared to standard dose shots, which are less effective in seniors. The higher dose shot, however, also causes more temporary side effects like pain, redness, and swelling at the injection site, headache, muscle aches, fever, and malaise, according to the CDC’s website.

For kids ages 2 to 8, the CDC recommends a nasal spray form of vaccine, which contains a live attenuated virus that offers more protection in young kids than the inactive virus found in the shot.

But Frieden emphasized that, barring any medical contra-indications, patients should get whatever flu vaccine that’s available when they go for their immunization — rather than putting it off.

“All of these vaccines work, not as well as we’d like, but they’re the best way to protect yourself from the flu,” he said. Deborah Kotz