The flu is already widespread in most of Alabama and health officials are urging people to get vaccines as soon as possible.

Significant flu activity was reported in most of the public health districts in the state, according to this map. The department also recorded 15 flu outbreaks in the past week, according to a press release. Public health officials began publicly tracking flu cases at the beginning of October.

Influenza usually peaks in winter months, but seems to be spreading earlier this year. The Southeast has been hit especially hard, according to an interview with a flu epidemiologist published in STAT earlier this week.

The flu vaccine is available for everyone ages six months and older. Officials from ADPH are urging people to get the shot before the end of October.

Vaccination is especially important for older people, young children, pregnant women and people with certain health conditions such as asthma, diabetes, heart and lung disease. Most hospitalizations and deaths happen among people who are 65 years of age and older, according to the ADPH.

Because older people might not respond as well to regular flu shots, the U.S. Centers for Disease Control and Prevention recommends high-dose formulations. The Fluzone High-Dose Quadrivalent vaccine, Flubok Quadrivalent Recombinant vaccine and Fluad Quadrivalent Adjuvanted flu vaccine are recommended for those patients. However, if they aren’t available, the CDC still recommends the standard shot.