Flu Vaccination in 2023

The following advice on the 2023 Influenza Vaccination Program was published by the Australian Government Department of Health and Aged Care on 28 February 2023.

Annual vaccination is the most important measure to prevent influenza and its complications. It is recommended for all people aged 6 months and over (unless contraindicated).

Influenza vaccination in 2023 is particularly important as influenza activity is expected to continue following a resurgence of influenza virus circulation in 2022.

Seasonal influenza vaccines funded through the National Immunisation Program (NIP) for people most at risk, are expected to be available from April 2023 subject to local supply arrangements. Privately funded influenza vaccines for people not eligible to receive an NIP-funded vaccine are expected to be available earlier.

Key Points for 2023

  • Influenza vaccines can be co-administered with any COVID-19 vaccine on the same day.
  • Vaccine providers should consider active initiatives to improve vaccination rates in at-risk cohorts including children under 5 years of age, pregnant women and Aboriginal and Torres Strait Islander peoples.
  • Higher immunogenicity vaccine Fluad Quad is funded under the NIP and is preferentially recommended over standard quadrivalent influenza vaccines in people aged 65 years and older.
  • It is mandatory to record all influenza vaccinations given on the Australian Immunisation Register (AIR).

The following information is taken from the ATAGI Clinical Advice issued in March 2023.

 Vaxigrip Tetra
0.5mL
(Sanofi) 
Fluarix Tetra
0.5mL
(GSK) 
Afluria Quad
0.5mL
(Seqirus)
FluQuadri
0.5mL
(Sanofi) 
Influvac Tetra
0.5mL
(Mylan) 
Flucelvax Quad
0.5mL
(Seqirus) 
Fluad Quad
0.5mL
(Seqirus) 
Fluzone High-Dose Quad
0.7mL
(Sanofi) 
6 to 24 months
(<2 years) 
X X X X
=>2 to <5 years X X X
=>5 to <60 years ✓+ ✓+ ✓+ X X
=>60 to <65 years ✓+ ✓+ ✓+ X
=>65 years
  • Ticks indicate age at which a vaccine is registered and available. Aqua boxes indicate availability for free under the NIP.
  • + NIP funding only for Aboriginal and Torres Strait Islander people, pregnant women and people who have certain medical conditions

The influenza virus strains included in the 2023 Southern Hemisphere seasonal influenza vaccines are shown below.

Egg-based influenza vaccines

Cell-based influenza vaccines

A/Sydney/5/2021 (H1N1) pdm09-like virus

A/Sydney/5/2021 (H1N1) pdm09-like virus

A/Darwin/9/2021 (H3N2)-like virus

A/Darwin/6/2021 (H3N2)-like virus

B/Austria/1359417/2021-like (B/Victoria lineage) virus

B/Austria/1359417/2021-like (B/Victoria lineage) virus

B/Phuket/3073/2013-like (B/Yamagata lineage) virus

B/Phuket/3073/2013-like (B/Yamagata lineage) virus

Note: The chosen egg-based and cell-based viruses will sometimes differ if one virus cannot be used for both production systems. In this case, different viruses with similar properties are selected for vaccine production

The eligibility to receive an influenza vaccine funded through the NIP remains unchanged and is available for the following groups:

  • All children aged 6 months to <5 years (two doses are recommended and funded in the first year of vaccination)
  • All adults aged 65 years and over
  • All Aboriginal and Torres Strait Islander people from 6 months of age and over
  • Pregnant women
  • People aged 5 to <65 years who have certain medical conditions (see table below)

Category

Medical conditions

Cardiac disease

Cyanotic congenital heart disease, congestive heart failure, coronary artery disease

Chronic respiratory conditions

Severe asthma, cystic fibrosis, bronchiectasis, suppurative lung disease, chronic obstructive pulmonary disease, chronic emphysema

Chronic neurological conditions

Hereditary and degenerative CNS diseases, seizure disorders, spinal cord injuries, neuromuscular disorders

Immunocompromising conditions

Immunocompromised due to disease or treatment, asplenia or splenic dysfunction, HIV infection

Diabetes and other metabolic disorders

Type 1 or 2 diabetes, chronic metabolic disorders

Renal disease

Chronic renal failure

Haematological disorders

Haemoglobinopathies

Long-term aspirin therapy in children aged 5 to 10 years

These children are at increased risk of Reye syndrome following influenza infection

Note: See the Australian Immunisation Handbook for advice on people who are strongly recommended to receive annual influenza vaccination but not eligible for NIP‑funded influenza vaccines.

Ideally people should receive their annual influenza vaccination before the start of the influenza season, with optimal protection against influenza occurring in the first three to four months following vaccination. The peak period of influenza circulation usually occurs from June to September in most parts of Australia; however, COVID-19 and increased international travel affected the seasonality of influenza in 2022 and may continue to affect it in 2023.

Influenza vaccines can continue to be offered as long as the influenza virus is circulating and a valid vaccine (before expiration date) is available.

People who are planning international travel should ensure they have had a 2023 influenza vaccine prior to departure.

The Australian Technical Advisory Group on Immunisation (ATAGI) advises that for people aged 5 years and older, COVID-19 vaccines can be co-administered with an influenza vaccine. Studies have demonstrated that co-administration of COVID-19 and influenza vaccine raises no safety concerns and preserves the immune response to both vaccines. Co-administration may result in a higher frequency of mild to moderate adverse events and can make it harder to attribute potential adverse events to specific vaccines. It is important to advise your patient that it is more likely that they may experience common adverse effects and to report any adverse events.

In children aged 6 months to <5 years, influenza and COVID-19 vaccines can be co-administered if separation would be logistically challenging. Where possible, it is recommended that vaccine administration is separated by 7-14 days due to limited data on co-administration in this age group. Co-administration may lead to higher rates of adverse effects, including fever.

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Page last updated on: 22 March 2023