A scramble for shots is under way as the death toll from a miserable flu strain spreading through the country continues to rise.

Influenza has reached epidemic proportions in the United States with 7.3 percent of deaths last week caused by pneumonia and the flu, the U.S. Centers for Diseas Control and Prevention said Friday.

A total of 20 children have died from flu-associated illnesses, and the CDC reports nine out of 10 regions in the United States had "elevated" flu activity, confirming that seasonal flue has spread and reached high levels several weeks before the usual time of late January or February.

New York Governor Andrew M. Cuomo declared a Public Health Emergency for all of New York State Saturday.

Cuomo issued an Executive Order which allows pharmacists to administer flu vaccinations to patients between six months and 18 years of age. The order is in effect for 30 days.

New York has already reported 19,128 cases of the flu, nearly five times the amount of cases reported all of last flu season. Two deaths in New York were children.

"We are experiencing the worst flu season since at least 2009, and influenza activity in New York State is widespread, with cases reported in all 57 counties and all five boroughs of New York City," Cuomo said.

Federal health officials said Friday that there is still some flu vaccine available and it's not too late to benefit from it. But people may have to call around to find a clinic with shots still on the shelf, or wait a few days for a new shipment.

"We're hearing of spot shortages," said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

Colorado offers an example. Kaiser Permanente, which has 535,000 members in the state, stopped giving flu shots this week. But it expected to resume vaccinations when new shipments arrive, expected this weekend.

Public health authorities were correct in their forecast of which flu strains would emerge this season and therefore what vaccine to make – one against influenza A as well as influenza B. An

A strain, called H3N2, predominates this season, though the B strain has caused about 20 percent of cases.

"We have a good vaccine but not a great vaccine," Dr. Arnold Monto of the University of Michigan, a co-author of the vaccine-effectiveness study, said in an interview. "Every year we see vaccine failures."

Officials said while flu activity remains high in most states, some areas are actually seeing a decrease in activity, such as the South and Southeast, which were particularly hit hard early on in the season.

According to the agency, the proportion of outpatient visits for influenza-like illnesses (ILI) this past week was at 4.3 percent, which is still above the national baseline of 2.2 percent. New York City and 24 states are experiencing high ILI activity, and 16 states are reporting moderate ILI activity.

Since 47 states are reporting widespread flu activity, it is still urgent to get vaccinated if you have not yet received the flu shot. Those particularly at risk are children, senior citizens or those with an underlying health condition.

Last week, the agency said it is likely the increased flu activity will continue for a while. Based on the last 10 flu seasons, ILI remained at or above baseline for about 12 weeks – and up to 16 weeks during the 2005-2006 season. ILI remained above baseline for 19 weeks during the 2009 H1N1 pandemic.

The Associated Press and Reuters contributed to this report.