By JOHN O'NEIL

he flu season is months away, but a vaccine expert from the Mayo Clinic is calling on doctors to start preparing a concerted effort to increase flu vaccinations, citing a study that found vaccinations cut deaths or hospitalizations from influenza by up to half among people older than 65.

The study, published this month in the journal Clinical Infectious Diseases, tracked more than 100,000 people through two flu seasons.

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The lead author, Dr. Eelko Hak of the Veterans Affairs Medical Center in Minneapolis, wrote that the benefits were even greater among people over 65 with existing illnesses.

In an accompanying editorial, Dr. Gregory A. Poland of the Mayo Clinic pointed out that roughly as many Americans died from influenza in an average year as from H.I.V., 20,000.

Up to 90 percent of those who die are over 65, but just 60 percent of the elderly are vaccinated, he said.

"If an equally safe and effective vaccine to prevent H.I.V. infection were available next month," Dr. Poland asked, "would it take decades to offer it to 60 percent of the at-risk population?"

In an interview, Dr. Poland said he thought that the biggest barrier to more widespread inoculation was a false perception about the dangers of influenza.

"We call every respiratory and gastric illness in winter the flu," he said. "People think flu is a minor illness."

In reality, he said, "Influenza has a very distinct set of clinical symptoms, including the sudden onset of high fever and severe fatigue that literally drives people to bed."

The Centers for Disease Control and Prevention, he added, recommends shots for infants from 6 to 23 months and their household contacts, for everyone 50 or older and for everyone older than 6 months with a chronic illness.