COLUMBUS (AP) — The Ohio Department of Health says flu activity has now been upgraded to its highest level, about two weeks after the state said hospitalizations were much worse than a year ago.

Last year, flu activity wasn’t elevated to “widespread” until mid-January. The Dayton Daily News reports there have been 401 flu-associated hospitalizations statewide since health officials made the upgrade announcement Monday.

There were 8,661 flu-associated hospitalizations in 2016.

The Ohio Department of Health and the Centers for Disease Control and Prevention are recommending everyone six months and older get a flu shot as soon as possible.