The C.D.C. urges flu shots to ease strain on pandemic-stretched hospitals.

Lockdowns helped keep last year’s flu season historically mild in both the United States and around the world, but U.S. officials fear a more serious season this fall and winter, with unmasked people out and about far more, and nearly half of adults in a new survey saying they are unlikely to get a flu shot.

At a news briefing to release the survey data on Thursday morning, top health experts said they were particularly concerned that, with the coronavirus still coursing around the country, nearly one in four people at higher risk for flu-related complications indicated they did not intend to get the flu vaccine.

Dr. Rochelle P. Walensky, head of the Centers for Disease Control and Prevention, noted that while experts did not yet know how severely the flu would hit the United States this fall, other respiratory infections had already returned, including RSV, a common cause of pneumonia and bronchitis in babies and a serious threat to older adults. The C.D.C.’s latest weekly flu report shows that only one state, Wyoming, had reached a “moderate” level of flu cases.

Because the flu was almost nonexistent last year, Dr. Walensky noted, people do not have the protective immunity they might have acquired if they had gotten sick, and she urged that everyone age 6 months and older be vaccinated. “The Covid-19 pandemic is not over, and the risk of both flu and Covid-19 circulating could put additional strain on hospitals and frontline health care professionals,” she said.

The survey was commissioned by the National Foundation for Infectious Diseases, a nonprofit organization. Its medical director, Dr. William Schaffner, said that overall vulnerability to flu could be higher this year, “with relaxed Covid-19 mitigation strategies, increased travel and the reopening of schools.”

For the survey, more than 1,110 respondents 18 and older from all 50 states and the District of Columbia answered questions in mid-August that explored attitudes about the flu; Covid-19; pneumococcal disease, which can cause pneumonia, sepsis and meningitis; and vaccination intentions.

The answers revealed a tension between beliefs about the value of the flu vaccination and the intention to get one: 61 percent of respondents agreed that a shot was the best protection against the flu, but 44 percent said they were either unsure whether they would get one or did not intend to do so.

The coronavirus pandemic, however, has had a positive effect on behaviors that could help lessen the impact of the flu. Nearly half of those surveyed said that because of the pandemic, they were more likely to stay home from work or school if they were sick, and 54 percent said they would wear a mask at least sometimes during the flu season.

But there were racial disparities: 73 percent of Black respondents and 62 percent of Latinos said they would wear a mask during flu season, compared with only 46 percent of white respondents. Black and Latino respondents were also more likely to be worried about being infected with Covid and the flu simultaneously than white respondents.

Dr. Walensky said that the flu vaccination rate nationally had held steady over the year before, at about 52 percent, but criticized what she called a “disparity gap” in flu vaccination: 56 percent for white people versus 43 percent among Black people.

Patsy Stinchfield, a nurse practitioner at Children’s Minnesota, a pediatric health care system, and the president-elect of the infectious disease foundation, said that it was safe for people to get flu and Covid shots — including boosters — at the same time.

Dr. Walensky also raised alarms about a decline in the flu vaccination rates among young children, to 59 percent from 64 percent the year before. In the 2019-2020 season, she said, 199 children died from the flu, about 80 percent of whom were not vaccinated.

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