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2021 influenza vaccination guidelines

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

Free vaccines will be available to eligible Queenslanders from mid-April.

Vaccine strains

The 2021 seasonal influenza vaccines for the southern hemisphere include the following strains:

Egg-based quadrivalent influenza vaccinesCell-based quadrivalent influenza vaccines
an A/Victoria/2570/2019 (H1N1)pdm09-like virus an A/Wisconsin/588/2019 (H1N1)pdm09-like virus
an A/Darwin/9/2021 (H3N2)-like virus an A/Darwin/6/2021 (H3N2)-like virus
a B/Austria/1359417/2021-like (B/Victoria lineage) virus a B/Austria/1359417/2021 (B/Victoria lineage)-like virus;
a B/Phuket/3073/2013-like (B/Yamagata lineage) virus a B/Phuket/3073/2013-like (B/Yamagata lineage) virus

Further information about flu vaccines can be found at the Therapeutic Goods Administration

Best timing for vaccination

The timing of vaccination should aim to achieve the highest level of protection during the peak of the influenza season. Flu season in Queensland is typically from June to September, with the peak usually in August.

Vaccinating from April provides protection before the peak season takes place. While protection is generally expected to last for the whole season, the best protection against influenza occurs within the first 3 to 4 months following vaccination.

It is never too late to vaccinate since influenza can circulate in the community all year round. Vaccination should continue to be offered as long as influenza viruses are circulating and a valid vaccine (before expiration date) is available.

It is also important to remind people that the vaccine is not immediately effective and it generally takes 10 to 14 days to be fully protected.

Revaccination late in the same year for individuals who have already received a vaccination is not routinely recommended, although not contraindicated. Revaccination may be considered for people travelling to the Northern Hemisphere in late 2020, who were vaccinated in early 2020. An individual's risk factors, risk of disease and current circulating virus strains should be taken into consideration before recommending a second dose. A second dose is not funded under the National Immunisation Program (NIP) and the individual will need to pay for the vaccine and consultation fee, if applicable.

COVID-19 vaccination timing

The Australian Technical Advisory Group on Immunisation (ATAGI) has advised the preferred minimum interval between a seasonal influenza and COVID-19 vaccination available in Australia is 7 days.

Important information - the Australian Immunisation Register

The Australian Government has mandated that all COVID-19, influenza and National Immunisation Program (NIP) vaccinations administered must be reported to the Australian Immunisation Register (AIR) commencing from:

  • 19 February 2021 for COVID-19 vaccinations,
  • 1 March 2021 for influenza vaccinations, and
  • 1 July 2021 for all NIP vaccinations.

Before administering an influenza vaccine, it is important to check the AIR to see if a COVID-19 vaccination may have been administered and if so, when it was administered. The preferred minimum interval between a seasonal influenza vaccine and a COVID-19 vaccine is 14 days.

Eligibility for 2021 season influenza vaccines

Influenza vaccines are funded under the National Immunisation Program for the following groups due to their increased risk of complications from influenza:

  • all children from 6 months to less than 5 years of age
  • all adults aged 65 years and older
  • pregnant women
  • all Aboriginal and Torres Strait Islander people aged 6 months and over
  • individuals aged 6 months and older with medical conditions which increase the risk of influenza disease complications (for a full list go to NCIRS Influenza Vaccines Fact Sheet).

All other individuals not included in the categories above can purchase the vaccine from their doctor.

In 2021, all funded influenza vaccines available will be quadrivalent vaccines (QIV) including the adjuvanted (enhanced) influenza vaccine for adults aged 65 years and older.

Only one government-funded influenza vaccine is available for eligible people each year, with the exception of eligible children up to 9 years of age receiving an influenza vaccine for the first time. These children require and are funded for 2 doses, 4 weeks apart.

Age restrictions apply to all vaccine brands (see Vaccine restrictions).

Children

The NIP is providing free influenza vaccine for all children aged 6 months to less than 5 years of age.

Please refer to the additional dosage requirements for children aged 6 months to less than 9 years who are receiving influenza vaccine for the first time.

Aboriginal and Torres Strait Islander people

Flu vaccination is strongly recommended in all Aboriginal and Torres Strait Islander people aged 6 months and older.

Medically at Risk

Vaccinations are strongly recommended for individuals who have certain medical conditions which place them at greater risk of acquiring influenza. A list of these conditions can be found in the  Australian Immunisation Handbook.

Pregnant women

Pregnant women are strongly recommended to receive influenza vaccine in each pregnancy at any stage of pregnancy. Women who acquire influenza during pregnancy have an increased risk of severe illness. Vaccination protects the mother and their infant/s from influenza in early infancy.

If not already given at an earlier opportunity, influenza vaccine can be given at the same time as the whooping cough vaccine in the second or third trimester (preferably between 20 to 32 weeks). Women should not delay receiving the influenza vaccine so they can have it at the same time as the whooping cough vaccine.

For more information go to Qld Health pregnant women or NCIRS antenatal pertussis vaccination.

People 65 years and older – enhanced quadrivalent vaccine

Vaccination is particularly important for people in this age group as they are at high risk of complications from influenza and have the highest influenza-associated death rates each year.

The quadrivalent influenza vaccine Fluad Quad®is provided for people aged 65 years and older. It is an adjuvanted (or enhanced) vaccine which is a standard dose flu vaccine with an added adjuvant to help create a stronger immune response to the vaccination. The 2021 vaccine contains the same components as the vaccine provided for other age groups but has the benefit of inducing a greater immune response in older people.

The enhanced quadrivalent influenza vaccine is the best form of protection against flu for older Queenslanders for the following reasons:

  • Older people do not respond as well to standard influenza vaccine as the immune system response decreases with age.
  • The enhanced vaccine is designed specifically to increase the immune system's response to the vaccine, especially against the influenza A/H3N2 strain which is more common and severe in people aged 65 years and older.

Vaccine restrictions

  • There are no influenza vaccines registered for use in any infant under 6 months of age.
  • Fluad Quad® is only available for administration to adults ≥ 65 years and older.
  • Vaxigrip Tetra® and Fluarix Tetra® can be administered to individuals from 6 months of age.
  • Afluria Quad® brand is NOT registered for use in any person under 5 years of age but can be given to individuals who have a medical risk factor. The complete list of conditions for funded influenza can be found in the Australian Immunisation handbook.

Dosage and Administration

All influenza vaccines for 2021 are 0.5mL for children and adults. You do not need to halve the dose of any of the influenza vaccines. Details of dosage requirements, including people with specific medical conditions, can be found in the Australian Immunisation Handbook.

From 1 March 2021, it is compulsory for all COVID-19 and influenza vaccinations given to children and adults be reported to the Australian Immunisation Register (AIR). Use your practice software or enter influenza vaccinations onto the AIR encounter screen.

Influenza Immunisation Program advice (Queensland) 2021

View a summary of the Queensland government's 2021 influenza immunisation program advice (PDF 261 kB) which provides important information specific to Queensland including:

  • which vaccines to give for specific age groups
  • information regarding people with medical conditions who are eligible for funded influenza vaccine
  • vaccine ordering and supply details.
Influenza vaccine orders can be placed weekly from Monday 12th April 2021 until the end of May.

More information

Last updated: 18 November 2021

Discussing influenza and COVID-19 vaccines with patients

Download these frequently asked questions that have been prepared to assist vaccine service providers discuss influenza and COVID-19 vaccinations with their patients.

Further information for Queenslanders on the COVID-19 vaccine can be found at the Queensland Government and the Australian Government Coronavirus (COVID-19) websites.