Australian Technical Advisory Group on Immunisation (ATAGI) advice for immunisation providers regarding the administration of seasonal influenza vaccines in 2017

It is important to read this statement in conjunction with The Australian Immunisation Handbook 10th edition available on the Immunise Australia website.

Page last updated: 06 March 2017

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Key points:

  • Annual vaccination is the most important measure to prevent influenza and its complications.
  • Annual influenza vaccination is recommended for any person ≥6 months of age who wishes to reduce the likelihood of becoming ill with influenza.
  • Recent evidence suggests protection against influenza may start to decrease from 3 to 4 months following vaccination and early vaccination needs to be balanced with this. While influenza continues to circulate, it is never too late to vaccinate.
  • Only quadrivalent influenza vaccines (QIV) formulations are available in Australia in 2017. Age restrictions apply according to vaccine brand (refer to Table 1).
  • QIVs are funded on the National Immunisation Program (NIP) in 2017 for the following groups:
    • Aboriginal and/or Torres Strait Islander children aged 6 months to <5 years
    • Aboriginal and/or Torres Strait Islander persons aged ≥15 years
    • All persons aged ≥65 years
    • All persons aged ≥6 months who have certain medical conditions which increase the risk of influenza disease complications; for example, severe asthma, lung or heart disease, low immunity or diabetes (refer to Table 3).
    • Pregnant women (during any stage of pregnancy).
  • Influenza vaccination is also strongly recommended, but not funded, for other groups who are at increased risk of influenza and its complications (refer to Table 3 footnote).
  • Persons with egg allergy, including anaphylaxis, can be safely vaccinated with influenza vaccines. Persons with a history of anaphylaxis to egg can be vaccinated with a full vaccine dose in medical facilities with staff experienced in recognising and treating anaphylaxis.
  • Providers are reminded to report all vaccines given to the Australian Immunisation Register.

The influenza virus strains included in the 2017 seasonal influenza vaccines are:

  • A (H1N1): an A/Michigan/45/2015 (H1N1)pdm09* like virus
  • A (H3N2): an A/Hong Kong/4801/2014 (H3N2) like virus
  • B: a B/Brisbane/60/2008 like virus
  • B: a B/Phuket/3073/2013 like virus

* New strain (differs from strain in 2016 vaccine)

Table 1. Seasonal influenza vaccines available for use in Australia in 2017, by age

FluQuadri Junior
0.25 mL

(Sanofi Pasteur)

FluQuadri
0.50 mL

(Sanofi Pasteur)

Fluarix Tetra
0.50 mL

(GSK)

Afluria Quad
0.50 mL

(Seqirus)
<6 months
No
No
No
No
6 to 35 months (<3 years)
Yes
No
No
No
≥3 years to 18 years
No
Yes
Yes
No
≥18 years
No
Yes
Yes
Yes

Please note that Seqirus Afluria Quad is NOT registered for use in children aged <18 years.

Table 2. Number of doses and volume per dose for influenza vaccines, by age

Age Dose volume Number of doses required
in the first year of influenza vaccination
Number of doses required
if previously received any doses of influenza vaccine
6 months to <3 years
0.25 mL
2
1
≥3 years to <9 years
0.50 mL
2
1
≥9 years
0.50 mL
1*
1

* Two doses, at least 4 weeks apart, are recommended for persons with certain immunocompromising conditions (i.e. haematopoietic stem cell transplant or solid organ transplant) receiving influenza vaccine for the first time post transplant (irrespective of their age).

Table 3. Medical conditions associated with an increased risk of influenza disease complications and for which individuals are eligible for free vaccination under the NIP*

Category Vaccination strongly recommended for individuals with the following 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 6 months to 10 years These children are at increased risk of Reye syndrome following influenza infection

*Annual influenza vaccination is also strongly recommended for the following persons, although they are not eligible for free NIP influenza vaccines: Aboriginal and/or Torres Strait Islander children aged 5 years to <15 years; persons with Down syndrome; persons with class III obesity (body mass index ≥40 kg/m2); persons with chronic liver disease; children aged 6 months to <5 years; residents of aged care and long-term residential care facilities; persons who may transmit influenza to children or adults at increased risk of influenza complications (e.g. healthcare workers); homeless people; persons involved in the commercial poultry or pork industry, or in culling poultry or pigs during periods of confirmed avian or swine influenza activity; persons providing essential services; persons travelling during the influenza season, especially if it is known before travel that influenza is circulating in the destination region.