As many states enter into the colder months, the medical community is bracing for a possible “twindemic” of influenza and COVID-19, encouraging the public to get vaccinated before flu season begins to ramp up.

Currently, nationwide most states are seeing minimal flu cases. During the past week, only 1% of patient visits reported through the US Outpatient Influenza-like Illness Surveillance Network were attributed to influenza-like illness. This percentage is below the national baseline of 2.4%, according to the US Centers for Disease Control and Prevention’s Weekly Flu Report.

Of the deaths occurring during the following week 5.4% were due to pneumonia and influenza, lower than usual, according to the government data. There was only one influenza-associated pediatric death reported.

Despite flu season getting off to a slow start, many people are flocking to get vaccinated, triggering a shortage at some pharmacies in New York and Colorado. The Associated Press reports that pharmaceutical company Sanofi Pasteur is preparing by staggering shipments into November. The company plans to distribute nearly 250 million doses across the globe. And vaccine maker Seqirus is looking at options to squeeze out “a limited number of additional doses” to meet high demand.

“There’s considerable concern as we enter the fall and winter months and into the flu season that we’ll have that dreaded overlap” of flu and the coronavirus, Anthony Fauci, MD, of the US National Institutes of Health said Thursday.