The flu hasn't hit Europe as hard as it has the United States, health officials say, but when and if it does, don't expect a call for vaccination of the entire population.
Only the U.S. and Canada actually encourage everyone older than 6 months to get the flu vaccine.
Apparently, not a single country in Europe asks the general population to seek that same kind of protection, according to Robb Butler, the World Health Organization technical officer in vaccine preventable diseases and immunizations in the organization's Europe office in the Netherlands.
That's because global health experts say the data aren't there yet to support this kind of blanket vaccination policy, nor is there enough money. In fact, some scientists say the enthusiasm for mass vaccination in the United States may hurt efforts to create a better vaccine.
This year, a year in which the vaccine is supposed to be a good match to the virus, the Centers for Disease Control and Prevention estimates the vaccine is only 62% effective.
And in the segments of the population that are most susceptible to the extreme effects of the flu -- like the elderly, who make up the majority of the cases of flu-related deaths -- the vaccinations are even less effective.
So is why is everyone urged to get vaccinated?
Simply put, it's a clearer policy, and some protection is better than none at all, according to Dr. William Schaffner, the chair of the department of preventive medicine at Vanderbilt University. He was also on the national committee that made the decision to encourage everyone to get vaccinated.
"It was debated by the CDC Advisory Committee on Immunization Practices for many years, and the indication for the use of influenza vaccine for an increasing number of groups on a piecemeal basis didn't make sense," Schaffner said.
In 2010, the CDC expanded its guidance encouraging the vaccination of vulnerable population groups.
"When you do the back-of-the-envelope calculations (of all the separate groups recommended for vaccination), you are actually already making a recommendation that 75% of the population get it," Schaffner said. "And when it became apparent the issue of shortages was largely put on the back burner, then in 2010, we said, 'Let's simplify this and recommended this vaccine for anyone over 6 months old.'"
It also helps that the flu vaccine is easy to get, he said. Pharmacies offer it. Companies sometimes bring in nurses to give shots to their employees on site. In Europe, only doctors are legally allowed to administer the vaccine, according to Butler.
There may be another economic reason for more Americans to get vaccinated -- one in three U.S. workers get no paid time off when they are sick, according to the Bureau of Labor Statistics. Generally, Europeans have much more generous sick leave policies.
"Although flu can be unpleasant, if you are otherwise healthy, the illness will usually clear up on its own and you will recover within a week," according to Britain's National Health Service website.
In a contrast to U.S. policy, the World Health Organization recommends only six "priority populations" get "the flu jab," as it's called in Britain.
These six groups are nursing home residents, people with chronic medical conditions like asthma, the elderly, pregnant women, health care workers, and children from ages 6 months to 2 years, Butler said. They are more vulnerable to the severe effects of the flu or come into contact more often with this highly contagious virus.
"We think the recommendations we have right now (are) a good start," Butler said. "Universal campaigns are quite challenging and expensive.
"We have 53 countries in our region that all have different recommendations based on different studies and evidence, and the depth of evidence in Europe right now is pretty limited in terms of flu vaccines. We would need more evidence that more than these six key, target high-risk groups that are prioritized can benefit. "
Online speculation says the U.S. call for general vaccination is merely a plot by drug companies to make a big profit.
Shaffner says he hears that a lot, but it's simply not true.
"I have received e-mails after people hear me encourage people to get the influenza vaccine, and they tell me I'm part of some sort of pharmacy company conspiracy and that I'm compromised by them. But influenza vaccines are not real blockbuster money-making drugs," Shaffner said.
"If I could take some of these skeptics and bring them to the Advisory Committee on Immunization Practices meeting, they would see how carefully the members debate these issues -- and it really is all for the benefit of the children and adults to prevent infectious diseases."
Michael Osterholm, director of the Minnesota Center of Excellence for Influenza Research and Surveillance at the University of Minnesota, believes people should get the vaccine, but he worries that the current policy gives the impression the vaccine is more effective than it actually is.
"This enthusiasm to get more people vaccinated gets in the way of a critical look at the science," Osterholm said.
Osterholm co-authored "The Compelling Need for Game-Changing Influenza Vaccines," which came out last October. It is an exhaustive study of this country's vaccine war on flu.