NASHVILLE (AP) - Health officials in Tennessee are urging more people to get vaccinations for the flu after at least 11 people have died from complications of the virus so far this season.

The Tennessean (http://tnne.ws/JHnxlE) reports nine people from Nashville and its surrounding counties have died while two deaths have been reported in the Cumberland region. The Tennessee Department of Health is investigating other reports that have not yet been confirmed.

Vanderbilt University infectious disease professor Dr. William Schaffner is tracking cases in Nashville and surrounding counties. He says people die from the flu each year, but nine deaths in an eight-county area at this point in flu season is "noteworthy."

"We're in the midst of a substantial influenza year," Schaffner said.

Tennessee Department of Health Director of Immunization Dr. Kelly Moore said there are normally two or three deaths during a typical flu season. She s aid the predominant virus circulating is H1N1, the same strain responsible for the 2009 pandemic.

"We didn't have the benefit of a vaccine back in 2009," Moore said. "We have kept this particular strain in our vaccine ever since 2009. This season's vaccine contains it."

She advised that people get vaccinated as soon as possible. Several versions of the vaccine are available including one being offered for the first time that guards against four different flu strains. Traditional vaccines guard against three strains.

The CDC recommends vaccination for anyone 6 months or older.

"This particular strain is harder on young adults and children than it is on the elderly," Moore said.

She said healthy people who get sick should be aware of complications that can arise from the flu.

"Pneumonia typically follows your influenza illness by four or five or six days," she said. "You have the flu, you start to get better, then all of a sudden you backslid e. You start to feel a lot worse again. That could be a sign of bacterial pneumonia."