MVEC influenza recommendations 2022

MVEC strongly supports annual influenza immunisation for anyone who wishes to be protected from influenza disease and its complications. The circulating strains of influenza disease change frequently and therefore vaccination against the current strains is required each year.

Influenza vaccines are provided for free on the National Immunisation Program (NIP) for specific at-risk groups, including:

Influenza vaccines are available from a variety of providers, such as your GP, local council or local pharmacy (pharmacist immunisers are authorised to administer influenza vaccines to people aged 10-years and over in Victoria).

Key messages for the 2022 season

  • annual influenza immunisation is strongly recommended for all people ≥ 6 months of age as the most important measure of preventing influenza disease and its complications
  • with the reopening of international borders and lower levels of influenza vaccine coverage than previous years a resurgence of influenza is expected
  • influenza vaccines and COVID-19 vaccines can be co-administered on the same day
  • reporting of influenza vaccine administration to the Australian Immunisation Register (AIR) is mandatory
  • adjuvanted quadrivalent influenza vaccines are preferentially recommended over standard formulations for adults ≥ 65 years
  • Flucelvax® Quad is a cell-based influenza vaccine registered for use in those aged ≥ 2 years and is available only for private purchase [refer to Table 1]
  • if an individual has received a 2021 influenza vaccine in late 2021 or early 2022, it is still recommended that they still receive a 2022 formulation when it becomes available. Individuals travelling internationally should receive the 2022 influenza vaccine before departure.

Table 1: The influenza strains included in the 2022 influenza vaccines for the Southern Hemisphere

Table 2: Influenza brand registered for each age group in 2022

* 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, a single dose is recommended in subsequent years.
#Adjuvanted quadrivalent influenza vaccines are preferentially recommended for people adults ≥ 65 years.
βFluarix-tetra®/FluQuadri®/Afluria Quad®/Vaxigrip tetra®/Influvac tetra®/ Flucelvax Quad® are registered for use in those aged ≥ 65 years however adjuvanted vaccines are the preferred vaccines for this age group.
^2 doses are recommended in the first year following SOT/HSCT regardless of history of influenza vaccination due to immunosuppression. The exception to this is in individuals receiving an adjuvanted influenza vaccine where only 1 dose is recommended.
shaded boxes indicate vaccines funded under the NIP for eligible individuals.
shaded boxes not registered for use in this age group.
shaded boxes indicate adjuvanted vaccines.

Co-administration of influenza vaccine with other vaccines

Influenza vaccines may be co-administered with most other vaccines on the same day. This includes live-attenuated vaccines (eg. measles and varicella) and the pertussis vaccine in pregnancy. COVID-19 vaccines can safely be co-administered with influenza vaccines however in children aged 6 months – 5 years of age an interval of 7-14 days is preferred to minimise adverse events such as fever.

The safety of co-administering Fluad® Quad and Shingrix on the same day has not been studied. Whilst these vaccines can be co-administered on the same day if necessary, it is preferred that their administration is separated by a few days.

Cell-based influenza vaccines vs egg-based influenza vaccines

Traditional influenza vaccines are made by cultivating influenza viruses in chicken eggs. Cell-based influenza vaccines are made by growing influenza viruses in animal cells lines (canine kidney). By using a cell-based platform, influenza vaccines have the potential to provide protection against influenza strains that are more closely matched to the circulating influenza strains in the community.

Cell-based influenza vaccines have been used internationally since 2012.  Flucelvax® Quad is available for private purchase for immunisation of those aged ≥ 2 years.

Expected side effects from cell-based influenza vaccines are consistent to the side effects expected from traditional egg-based influenza vaccines. The most commonly reported symptoms are local injection site reactions, including pain and redness.

Influenza vaccine in the ≥ 65 year age group

Due to a gradual decline in effectiveness of the immune system of older people (a process known as immunosenescence) immunity following vaccination with standard QIVs can be suboptimal. In addition, those aged ≥ 65 years have the highest rates of influenza disease burden and associated complications including pneumonia and death. It is for this reason that adjuvanted influenza vaccines continue to be the preferred vaccine type for the older population.

There are two adjuvanted influenza vaccines registered for use in Australia in 2022. Fluad® Quad, is registered for use in adults ≥ 65 years and funded under the NIP; and Fluzone High-Dose Quad which is registered for use in individuals aged ≥ 60 years and privately available on prescription.

Common side effects from either vaccine include injection site reactions and fever and these may occur slightly more frequently compared with standard QIV formulations.

Latex allergies

All influenza vaccines available in Australia in 2022 are latex free. People with a latex allergy can safely be vaccinated with influenza vaccines.

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.

Influenza vaccine and pregnancy, planning pregnancy and breastfeeding

Influenza vaccination is safe and strongly recommended for all pregnant women in every pregnancy at any stage of the pregnancy. Influenza vaccines can safely be co-administered with pertussis and COVID-19 vaccines.

Pregnant women are at greater risk of morbidity and mortality from influenza disease than non-pregnant women. They are more than twice as likely to be hospitalised with influenza disease as other people with influenza. Babies less than 6 months of age are at greatest risk of disease and death from influenza. Vaccinating pregnant women will also provide protection to babies for the first few months of life until they can be immunised against influenza from 6 months of age.

For pregnant women who received an influenza vaccine during pregnancy in 2021, it is recommended to re-vaccinate if the 2022 influenza vaccine becomes available before the end of pregnancy.

For women who receive an influenza vaccine before becoming pregnant, it is recommended to re-vaccinate during pregnancy to protect the unborn infant.

It is safe for women who are planning a pregnancy and for those who are breastfeeding to receive an influenza vaccine.

Authors: A/Prof 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: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator).

Date: November 29, 2022

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

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.