Only about one in three upstate New York adults receive an annual flu vaccine, according to a review of New York state health data by Excellus BlueCross BlueShield.

The health insurance company says your decision to skip the flu vaccine this year could result in you being a person who spreads the virus.

With few exceptions, the CDC recommends that everyone ages six months and older gets the flu vaccine annually. While it’s never too early or too late in the flu season to get the vaccine, the CDC encourages doing so by the end of October.

More than 80,000 people died from the flu last season in the United States. In Monroe County, 19 people died from the flu between Oct. 1, 2017 and April 28 of this year.

The length of the upcoming flu season could depend on where you live.

Scientists from Oregon State University tracked flu cases in more than 600 areas around the U.S.

They found that in larger, crowded cities, the flu season lasted longer, regardless of climate.

That suggests weather does not play as big a role in spreading the virus, as person-to-person contact. Smaller cities tend to have a shorter, but more intense flu season.

The flu vaccine is widely available at doctor’s offices, area pharmacies, and various clinics.