The flu is exploding this year, teaching epidemic levels in some parts of the country. Clinics in Boston and other areas are even running out of influenza vaccinations.
South Dakota is seeing its fair share of cases, but the outbreak is not nearly as bad as other states.
The South Dakota Department of Health reports 469 confirmed cases of influenza so far this flu season.
That includes nine deaths statewide, four of them West River.
"It's kind of scary," said Lacey Kirk, a Spearfish mother of two school-age children.
That's Kirk, who volunteers at West Elementary School, the school her kids attend, had both of them vaccinated.
"My husband's grandmother had a very, very serious incident with the flu this year," she said. "I mean, he went down to say his goodbyes."
Fortunately, she survived.
And while all nine who have died of the flu in the state have been over the age of 64, 42 percent of confirmed cases and 14 percent of hospitalizations have involved people 24 years old or younger.
So health leaders say it's a good idea for everyone to get vaccinated.
"It seems to be a little worse and little earlier, too," said Barb Graslie, the school nurse for the Spearfish School District.
That's despite the fact that she helped give out more than 500 flu shots in Lawrence County at the beginning of the flu season.
"We do a lot of kids, but we did a lot of families, too," she said of the vaccinations. "I think about 70 percent of our staff members received a free flu shot."
But the percentage of student absences in western South Dakota schools is still higher than the state as a whole.
"The week before Christmas," Graslie said, "we definitely had some higher numbers of absences. I heard of a lot of kids ill over the break."
But not Kirk's kids. She attributes that to the pre-emptive strike.
"I just trust that the doctors are recommending the right thing, and so I do it," said Kirk, "and so far it's worked out fine for us."
A state Department of Health spokesman said South Dakota has the highest rate of vaccination in the country, and he thinks that's why the flu isn't hitting quite as hard here.
School health officials also maintain that covering your mouth when you cough or sneeze, washing your hands and staying home if you feel sick are some of the best ways to combat the flu bug.