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2019 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 2019 seasonal influenza vaccines for the southern hemisphere include the following strains:

  • A (H1N1): an A/Michigan/45/2015 (H1N1)pdm09 like virus
  • A (H3N2): an A/Switzerland 8060/2017 (H3N2) like virus
  • B: a B/Phuket/3073/2013-like virus
  • B: a B/Colorado/06/2017 like virus (not included in the TIVs)

Best timing for vaccination

The timing of vaccination should aim to achieve the highest level of protection during the peak of the influenza season. This usually occurs from June to September in most parts of Australia. 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. Some vaccine brands now have an expiry date of February 2020.

It is also important to remind people that the vaccine isn't immediately effective and it generally takes 10 to 14 days to be fully protected after vaccination.

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 2019, who were vaccinated in early 2019 before the Southern Hemisphere influenza season occurred. 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.

Who is eligible?

Generally, influenza vaccines are funded under the state and national immunisation programs 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 (State funded)
  • pregnant women at any stage of pregnancy (influenza and whooping cough vaccination can be given at the same time OR at different times during pregnancy). More information about whooping cough and influenza vaccination for pregnant women is available
  • all Aboriginal and Torres Strait Islander people aged 6 months and over
  • individuals aged 6 months and over with medical conditions which increase the risk of influenza disease complications (for a full list go to NCIRS Influenza Vaccines Fact Sheet)
  • persons 65 years and older.

All other Queenslanders can purchase the vaccine from their doctor or immunisation provider.

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

2019 season influenza vaccines

In 2019, the funded vaccines available include:

Quadrivalent influenza vaccines for:

  • all children from 6 months to less than 5 years of age
  • pregnant women (at any stage of pregnancy)
  • all Aboriginal and Torres Strait Islander people aged 6 months and over
  • all individuals aged 6 months and over with medical conditions predisposing them to severe influenza
  • individuals up to 65 years.
Trivalent influenza vaccines (TIVs) are recommended for:
  • adults aged 65 years and over
Age restrictions apply to all vaccine brands (see Vaccine restrictions).

Higher Immunogenicity Trivalent for over 65s

  • The higher immunogenicity trivalent flu vaccine is the best form of protection against flu for older Queenslanders.
  • People aged 65 years and older are at greater risk of serious complications from influenza infection, and have the highest influenza-associated death rates each year.
  • Global experts recommend the trivalent vaccine for this cohort for several important reasons:
    • Older people do not respond as well to standard influenza vaccine as the immune system response to influenza vaccine decreases with age.
    • The enhanced vaccine is designed specifically to increase the immune system's response to vaccine, especially against the influenza A/H3N2 strain which is more common and severe in people aged 65 years and older.
    • Australian surveillance data shows those aged 65 years and older are affected more by 'A' strains that are circulating in the community, than they are by 'B' strains.
    • Research also shows that older people tend ot have a level of immunity to B strains because of exposure to these strains in previous seasons.
    • Although the enhanced vaccine contains one less B strain virus, the benefits of better and broader protection against the strains included will outweigh any potential loss of protection against the missing alternative B strain virus.

In 2019, only Fluad® (TIV containing an adjuvant) is NIP-funded. Fluzone® High-Dose is not offered as part of the national influenza immunisation program for 2019 but can be purchased through the private market.

Vaccine restrictions

  • Afluria Quad® brand is NOT registered for use in any person under 5 years of age.
  • Only FluQuadri Junior can be used for children aged 6 to 35 months of age.
  • Adult (0.50mL) doses cannot be halved to make a paediatric dose.
  • Influenza vaccines are not registered for use in any infant under 6 months of age.

Fluzone® High-Dose and Fluad® are only registered for people aged ≥65 years and older.

Influenza Immunisation Program advice (Queensland) 2019

View a summary of the Queensland government's 2019 influenza immunisation program advice. This provides a pictoral summary of:

  • which vaccines to give for specific age groups
  • instramuscular injection sites
  • information regarding people with medical conditions who are eligible for funded influenza vaccine and
  • vaccine ordering and supply details
Vaccine orders can be placed weekly until the end of May.

Recording vaccines administered

All influenza vaccinations given to children and adults should be reported to the Australian Immunisation Register (AIR). Use your practice software or enter influenza vaccinations onto the AIR encounter screen.

Children

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

The free vaccine is available through general practice and other childhood immunisation providers from mid-April.

Dosage

  • 6 months to 3 years: give 0.25mL dose
  • ≥3 of age and older: give 0.50mL dose

Additional dosage requirements:

  • Children aged 6 months to under 9 years of age require 2 doses (at least 4 weeks apart) in the first year they receive the influenza vaccine.
  • If a child aged 6 months to 9 years of age has received 1 or 2 doses of any influenza vaccine in the first year the vaccine was given, only 1 dose is required in each subsequent year.
  • 2 doses (at least 4 weeks apart) are recommended for persons aged 9 years or older, following haematopoietic stem cell transplant or solid organ transplant and are receiving influenza vaccine for the first time after transplant. For further details access the Australian Immunisation Handbook.

Pregnant women

Influenza is more likely to cause severe illness in pregnant women than in healthy women who are not pregnant. Vaccination protects the mother and their infants. Influenza vaccine is recommended in every pregnancy and at any stage of pregnancy.

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).

People 65 years and older

Vaccination is particularly important for people in this age group as they are at high risk of complications from influenza.

The trivalent influenza vaccine (TIV) Fluad®,, is provided for people aged 65 years and older. It is an adjuvanted vaccine which is a standard dose flu vaccine with an added adjuvant to help create a stronger immune response to the vaccination.

It is not registered for use in people aged less than 65 years of age.

More information

Last updated: 9 April 2019