Unfortunately, on the one hand, awareness about the vaccine is pathetically low in India and, on the other, the government has not made it mandatory. ``The vaccine is underutilised in our country,'' says Dr Nitin Shah, consultant paediatrician, Hinduja National Hospital, Mumbai. Most people don't know that it gives nearly 70-90% protection from influenza and complications arising from the infection, while being completely safe and without side-effects.

The lack of knowledge about the potential risk of influenza is also pathetic. Most people dismiss it as a severe form of common cold, little knowing that if left untreated in highrisk patients, it can be fatal. In the US alone, influenza kills nearly 36,000 people every year. And this is despite the fact that awareness about the vaccine is much higher in the West. No such statistics are available for India but experts believe that the figures could be even higher. ``It's really sad that no influenza infections are reported in hospitals. Even general practitioners are not trained enough to differentiate between influenza and common cold,'' rues Prof A K Prasad, chairman, Influenza Foundation of India.

While the highest infection rates are reported among children between the ages 5-9, it's those below two years who are at high risk. Globally, the attack rate in children is reported at 20-30% while it's 5-10% in adults.

For the high-risk group, a combination of factors -- pollution, cigarette smoke, primary flu and overcrowding can lead to an attack of pneumonia and, in many cases, death. ``Unlike the West, we still don't have a concept of preventing it, we only look at cures,'' says Dr Randeep Guleria, senior consultant, department of medicine, AIIMS.

Prasad is optimistic that the scenario will improve. ``Just as awareness of the hepatitis B vaccine spread and its cost came down from Rs 1,000 to Rs 25, I am sure the same will hold true for influenza vaccine (which costs Rs 540 at present),'' he says. A heart patient, he regularly takes the influenza vaccine. At AIIMS, Dr Guleria has seen the number of elderly getting vaccinated go up by nearly 20% in the last two-three years.