MVEC influenza recommendations 2020

The MVEC team strongly support vaccination as a way to provide protection from seasonal influenza. This will be especially important in 2020, with the emergence of COVID-19, as both illnesses may present with similar symptoms. The vaccine is usually available in April and expires in February of the following year.

Annual influenza vaccine is funded on the National Immunisation Program (NIP) schedule for the following groups:

  • Children aged 6-months to < 5-years
  • People aged ≥ 6-months of age with certain medical risk factors 
  • All adults ≥ 65-years of age
  • Pregnant women (at any stage of pregnancy)
  • All Aboriginal & Torres Strait Islander people ≥ 6-months of age

For people who do not meet this criteria, the influenza vaccine is still strongly encouraged and is available for private purchase. Influenza vaccines are available from a variety of providers, such as your GP, local council or some pharmacies (pharmacist immunisers are authorised to administer influenza vaccines to people aged 10-years and over in Victoria). 

The key messages for the 2020 season:

  • Annual influenza vaccination is recommended for all people ≥ 6-months of age.
  • All vaccines available in 2020 are quadrivalent influenza vaccines (QIVs), containing two A and two B strains.
  • All children aged 6-months to less than 5-years are now eligible to receive free annual influenza vaccines under the National Immunisation Program (NIP).
  • The dose of influenza vaccines for all ages is 0.5mL. The 0.25mL dose for young children is no longer available.
  • Two doses of the QIV (1-month apart) are recommended for children 6-months to < 9-years, the very first year they receive the QIV. 
  • For adults aged ≥ 65-years the adjuvanted QIV, Fluad® Quad, is preferentially recommended over standard QIVs.

There are 3 strain changes for the 2020 influenza vaccine:

  • A (H1N1): an A/Brisbane/02/2018
  • A (H3N2): an A/South Australia/34/2019
  • B: a B/Washington/02/2019
  • B: a B/Phuket/3073/2013

Highlights for 2020 influenza vaccine formulations:

  • Vaxigrip Tetra® is a QIV, newly registered for use in adults and children from 6-months of age.
  • Fluad® Quad is an adjuvanted QIV, newly registered for use in adults ≥ 65-years of age.
  • FluQuadri® is a QIV, previously registered for adults and children from 3-years of age. The age indication for this vaccine has now been extended to include children from 6-months of age. (FluQuadri Junior® formulation is no longer available)
  • Influvac Tetra® is a QIV, previously registered for adults from 18-years of age. The age indication for this vaccine has now been extended to include children from 3-years of age.

Table 1: Influenza brand and dosing guidelines 2020

N/A not registered for use in this age group.
* 2 doses, minimum of 4-weeks apart should be given to children < 9-years of age in the first year of receiving the influenza vaccine
¥ For all children < 9-years, a single dose is recommended in subsequent years
#Fluad® Quad is the preferred influenza vaccine brand for this patient group and is funded on the NIP for those ≥ 65-years of age. Fluarix-tetra®/FluQuadri®/Afluria Quad®/Vaxigrip tetra®/Influvac tetra® are all quadrivalent influenza vaccine (QIV). They are licensed for those ≥ 65-years of age but not the preferred vaccine of choice.

Influenza vaccine in the ≥ 65-year age group

In order to provide better protection against hospitalisation with influenza and pneumonia, higher-immunogenicity influenza vaccines continue to be the preferred influenza vaccination for the older population. This year Australia is the first country to offer an adjuvanted QIV, Fluad® Quad for people aged 65-years and over and is preferentially recommended over standard QIVs. Trivalent influenza vaccines (TIV) are no longer available.

The higher-immunogenicity QIV is safe but can cause mild side effects such as injection site reactions and fever. This may occur slightly more commonly than the standard QIV formulations.

Latex allergies

All influenza vaccines available under the NIP in 2020 are latex free. People with a latex allergy can safely be vaccinated with influenza vaccines that are available under the NIP.

Influenza vaccine and egg allergy

Based on prospective and retrospective studies of influenza vaccination in those with and without egg allergy (including egg anaphylaxis), the presence of egg allergy does not increase the risk of allergic reactions to the influenza vaccine.

The influenza vaccine can be administered in community vaccination clinics (which may or may not have direct medical practitioner supervision), general practitioner surgeries or immunisation clinics, as a single dose followed by the recommended 15 minute observation period [refer to ASCIA guideline].

Co-administration of influenza vaccine

Influenza vaccines may be safely co-administered with any other vaccines on the same day. This includes live-attenuated vaccines (e.g. measles and varicella), as well meningococcal and pneumococcal vaccines and pertussis vaccine in pregnancy.

Influenza vaccine and pregnancy

Pregnant women are more at risk of serious illness due to influenza compared to non-pregnant women. Influenza infections whilst pregnant, can lead to serious illness such as pneumonia and can cause miscarriage or premature labour. Pregnant women are more likely to be hospitalised than non-pregnant women due to the flu.

The influenza vaccination will protect the mother and baby from the risk of serious illness and hospitalisation.

  • Influenza vaccine is recommended in every pregnancy and at any stage of pregnancy.
  • Influenza vaccine can safely be given at the same time as pertussis vaccine.
  • For women who received an influenza vaccine in 2019, re-vaccinate if the 2020 influenza vaccine becomes available before the end of pregnancy.
  • For women who receive an influenza vaccine before becoming pregnant, re-vaccinate during pregnancy to protect the unborn infant.

Vaccine safety

SAEFVIC (Surveillance of Adverse Events Following Vaccination In the Community) would be happy to discuss any vaccine safety queries and we encourage online reporting of AEFI via our website.

Telephone: 1300 882 924 (option 1)
Email: saefvic@mcri.edu.au
Website: www.aefican.org.au

Resources

Authors: Dr Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute), Rachael McGuire (Research Nurse SAEFVIC, Murdoch Children’s Research Institute), Georgina Lewis (Clinical Manager SAEFVIC, Murdoch Children’s Research Institute) and Mel Addison (Research Nurse SAEFVIC, Murdoch Children’s Research Institute).

Reviewed by: Georgina Lewis (Clinical Manager SAEFVIC, Murdoch Children’s Research Institute), Dr Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute) and Francesca Machingaifa (Research Nurse SAEFVIC, Murdoch Children’s Research Institute). 

Date: March 2020

Materials in this section are updated as new information becomes available. The Melbourne Vaccine Education Centre (MVEC) staff regularly review materials for accuaracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.