Raleigh, N.C. — Beginning next fall, employees of the WakeMed hospital system will be required to get a flu shot as a condition of employment. Employees and volunteers will have to either provide proof of vaccination or an approved exemption. 

Those who can't get the vaccine will be required to wear masks during patient care. 

The policy change comes on the heels of a season that has seen the flu reach epidemic proportions nationwide.

Nine North Carolina residents died of influenza last week in what is the deadliest week so far this season for the illness in the state, public health officials said Thursday. So far, 29 children and teens have died of the virus, more than a quarter of the annual average.

This year's season is earlier than normal and the dominant flu strain is one that tends to make people sicker. Flu usually doesn't blanket the country until late January or February, but it is already widespread in more than 40 states, including North Carolina. 

The government doesn't keep a running tally of adult deaths from the flu, but estimates that it kills about 24,000 people most years.

“By immunizing our health care workers, we are not only protecting them, but we are taking the necessary steps to protect our patients from influenza,” said Dr. Chris Ingram, medical director of WakeMed Infection Prevention and Occupational Health.