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.
National Immunisation Program (NIP) funded influenza vaccines will be available to eligible Queenslanders from early April 2023.
Vaccine strains
The 2023 seasonal influenza vaccines for the southern hemisphere include the following strains:
| Egg-based quadrivalent influenza vaccines | Cell-based or quadrivalent 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)-like virus |
| B/Phuket/3073/2013-like (B/Yamagata lineage) virus | B/Phuket/3073/2013-like (B/Yamagata lineage)-like virus |
Further information about influenza vaccines can be found at the Therapeutic Goods Administration website
Best timing for vaccination
The timing of vaccination should aim to achieve the highest level of protection during the peak of the influenza season. The timing and duration of the influenza season in Queensland varies from year to year but generally occurs between May and October, with the peak commonly in August. In tropical areas the pattern can be more variable and may include clusters outside this period.
Vaccinating from April provides protection before the peak. 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. 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 for everyone ≥6 months of age. All individuals 5 years or over not included in the categories above can purchase an influenza vaccine from their immunisation provider.
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, 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
