2023 influenza vaccination guidelines

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

2023 free flu vaccine initiative

All Queensland residents aged six months and older were offered a free influenza vaccine between 17 July and 31 August 2023 (inclusive).

If you paid for a flu vaccine received between 17 July and 31 August 2023, you can apply for reimbursement using this form. (PDF 494 kB)

Please note claims must be submitted by 30 September 2023.

Further enquiries about this initiative can be sent to fluvaccine2023@health.qld.gov.au

Reimbursement information

Non-NIP (private) influenza vaccine stock administered between 17 July 2023 to 31 August 2023 and not charged to a patient can be claimed for reimbursement.

To obtain your reimbursement for  administered non-NIP influenza vaccine, please use one of the following documents, ensuring you have met all submission requirements.

• Reimbursement instructions for GPs (PDF 428 kB)
• Reimbursement instructions for pharmacies
• Reimbursement instructions for other private providers (PDF 317 kB)
• Reimbursement instructions for individuals (patients) (PDF 494 kB)

Submissions for reimbursement should be made no more frequently than fortnightly. Submissions will close on 30 September 2023 and any requests received after this date will not be paid.

For more information, please refer to Frequently Asked Questions for Flu Vaccine Providers. (PDF 131 kB)

Vaccine strains

The 2023 seasonal influenza vaccines for the southern hemisphere include the following strains:

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

Best timing for vaccination

It is never too late to vaccinate since influenza can circulate in the community all year. 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 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 2023, who were vaccinated in early 2023. 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

Influenza vaccines can be co-administered (given on the same day at the same appointment) with any COVID-19 vaccine. Refer to the ATAGI recommendation on the “Timing of administration of other vaccines”.

Additional information - the Australian Immunisation Register

It is mandatory to record all influenza vaccinations given on the Australian Immunisation Register (AIR).

Eligibility for influenza vaccines funded by the National Immunisation Program

Influenza vaccines are funded under the National Immunisation Program (NIP) for the following groups:

• Children aged 6 months to under 5 years.
• People aged 65 years or over.
• Aboriginal and Torres Strait Islander people aged 6 months and over.
• Pregnant women at any stage of pregnancy.
• People aged 6 months or over who have a medical condition that is associated with an increased risk of influenza disease complications. A list of these conditions is available at, ATAGI advice on seasonal influenza vaccines in 2023.

Annual influenza vaccination is recommended every year for everyone ≥6 months of age.

In 2023, all NIP funded influenza vaccines available are quadrivalent vaccines (QIV) including the adjuvanted (enhanced) influenza vaccine for adults aged 65 years and older.

A single NIP 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 influenza vaccine brands (see Vaccine restrictions).

Aboriginal and Torres Strait Islander peoples

Influenza vaccination is recommended and funded under the NIP for all Aboriginal and Torres Strait Islander people from 6 months of age and over. The disease burden from influenza is significantly higher among Aboriginal and Torres Strait Islander people than non-Indigenous Australians in all age groups. Take every opportunity to offer influenza vaccination to Aboriginal and Torres Strait Islander patients.

Children

Influenza vaccine is recommended and funded under the NIP for all children aged 6 months to less than 5 years. Children aged 6 months to less than 5 years are at higher risk of complications from influenza. Even healthy children can become seriously ill from influenza.

Two doses are recommended and funded in the first year of vaccination (at least 4 weeks apart). While 2 doses in the first year are recommended, one dose will provide some protection and is preferable to receiving no doses. One annual dose of influenza vaccine is required in following years even if only one dose was given in the first year.

Across Australia in 2022, only 32.4% of children aged under 5 years of age were recorded as receiving at least one dose of influenza vaccine on the AIR. It is important to increase uptake in 2023 to protect all young children.

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.

Medically at Risk

Influenza vaccine is recommended and funded under the NIP for all people aged 6 months and over with certain medical conditions. A list of these conditions is available at, ATAGI advice on seasonal influenza vaccines in 2023. Vaccination is particularly important for people with underlying medical conditions as they are at high risk of complications from influenza.

Pregnant women

Influenza vaccination is recommended and funded under the NIP for pregnant women at any stage of pregnancy. Influenza vaccination should be offered to all pregnant women as part of routine, comprehensive, antenatal care.

Vaccination in pregnancy protects both pregnant women and their babies from influenza and its complications. While it is best given before the influenza season, it can be given at any time during the season and it will still provide some protection to the mother and to the baby for the first few months of life.

For those who received an influenza vaccine in 2022, it is recommended to also give the 2023 vaccine if available before the end of pregnancy. For women who receive an influenza vaccine before becoming pregnant, t is recommended to revaccinate during pregnancy to protect the unborn infant.

The influenza vaccine can be safely given at the same time as the pertussis vaccine (between 20 and 32 weeks) and/ or COVID-19 vaccine during pregnancy.

People 65 years and older

Influenza vaccination is recommended and funded under the NIP for all people aged 65 years and over. Vaccination is particularly important for people in this age group as they are at high risk of complications from influenza.

Fluad® Quad (an adjuvanted influenza vaccine) is funded under the NIP and is preferentially recommended over standard quadrivalent vaccine (QIV) for adults aged 65 years and over. The adjuvant boosts the immune system’s response to the vaccine and provides better protection for people aged 65 years and over.

However, if the adjuvanted QIV is not available, vaccination with another QIV is preferable to no vaccination. In this case, an adjuvanted QIV does not subsequently need to be provided. Clinical trials show a higher rate of injection site reactions in adults aged ≥65 years after receiving the adjuvanted influenza vaccine, compared with standard influenza vaccines.

Influenza vaccine safety

Contraindications: The only contraindications to influenza vaccines are:

• Anaphylaxis following a previous dose of any influenza vaccine
• Anaphylaxis following any vaccine component (excluding eggs).

Egg allergy: Is not a contraindication to influenza vaccines. If there is significant parental or health professional concern, the vaccine may be administered in a primary care setting with a longer waiting period of 30 minutes.

Latex allergy: All influenza vaccines available under the NIP in 2023 are latex free and people with a latex allergy can safely be vaccinated.

Adverse events following vaccination: Under the Public Health Act 2005, adverse events following immunisation are a notifiable condition. Notification of all adverse events following immunisation at any age should be made by submitting an Adverse Events Following Immunisation Reporting Form.

Vaccine age restrictions

• Fluad Quad^® is only available for administration to adults ≥ 65 years and older.
• Vaxigrip Tetra^® and Fluarix Tetra^® can be administered to people from 6 months of age.
• Afluria Quad^® can be administered to individuals from 5 years of age.

Dosage and Administration

All NIP funded influenza vaccines for 2023 are 0.5 mL for intramuscular injection. This includes the vaccines used from 6 months of age. More details can be found in the ATAGI advice on seasonal influenza vaccines in 2023 and in the Australian Immunisation Handbook

More information

• ATAGI advice on seasonal influenza vaccines in 2023
• 2023 Influenza vaccination – Program advice for vaccination providers
• Contact the Queensland Health Immunisation Program
• 2023 influenza vaccination guidelines
• Australian Immunisation Handbook online edition