Influenza Vaccine

Most commonly acquired vaccine preventable infection amongst travellers (almost 100 times > Hep A)
Cost $10-22
Influenza vaccine efficacy
- During periods of high virus circulation, when vaccine match is good, influenza vaccination is approximately 45% effective against hospitalisations due to influenza – Influenza Specialist Group
- Cochrane Acute Respiratory Infections Group study 2014
  - 15.6% of unvaccinated participants developed Influenza-Like Illness symptoms, of which
  - 2.4% developed laboratory-confirmed influenza
  - 9.9% of vaccinated participants developed Influenza-Like Illness symptoms, of which
  - 1.1%, respectively, developed laboratory-confirmed influenza

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 under the NIP in 2024 are latex-free, making them safe for individuals with latex allergies
Guillain–Barré syndrome (GBS)
- People with a history of Guillain–Barré syndrome (GBS) whose first episode was not after influenza vaccination have an extremely low risk of recurrence of GBS after vaccination. Influenza vaccination is recommended for these people
- Influenza vaccination is generally not recommended for people with a history of GBS whose first episode occurred with 6 weeks of receiving an influenza vaccine.
- Vaccination can be considered in special circumstances, such as when an alternative cause for GBS, such as Campylobacter jejuni infection, was found or the risk of influenza disease is considered high.

Adverse Events Reporting

Requirement: All adverse events following immunization must be reported through the usual state or territory mechanisms.

Disposal of Vaccines

Expiration: Some vaccine brands expired in December 2023, others will expire in February 2024.
Protocol: Dispose of expired vaccines according to local protocols.

Australian Immunisation Register (AIR)

Reporting: All influenza vaccinations, including NIP-funded and privately purchased, must be reported to the AIR.

Vaccine Composition 2024

Egg-Based Vaccines:
- A/Victoria/4897/2022 (H1N1)pdm09-like virus
- A/Thailand/8/2022 (H3N2)-like virus
- B/Austria/1359417/2021 (B/Victoria lineage)-like virus
- B/Phuket/3073/2013 (B/Yamagata lineage)-like virus
Cell-Based Vaccines:
- A/Wisconsin/67/2022 (H1N1)pdm09-like virus
- A/Massachusetts/18/2022 (H3N2)-like virus
- B/Austria/1359417/2021 (B/Victoria lineage)-like virus
- B/Phuket/3073/2013 (B/Yamagata lineage)-like virus

Specific Vaccines: Flucelvax Quad®:

a cell-based vaccine
NIP funded for people aged 5 – 64 years with medical conditions
There is no preferential recommendation between Flucelvax Quad® and standard dose of eggbased influenza vaccines

Start: Recommended annually from April to prepare for the peak season (June to September).
Duration: Continues as long as the influenza virus circulates and vaccine remains valid.

Young Children: First-time recipients aged 6 months to less than 9 years should receive 2 doses spaced at least 4 weeks apart.
Pregnant Women: Recommended to receive the vaccine at any stage during pregnancy.
Travelers: Those traveling to areas where influenza circulates, including year-round in the tropics.
Annual Update: Even if vaccinated in late 2023 or early 2024, a 2024 vaccine is recommended when available.

Children Aged 6 Months – 5 Years

Recommendation: Vaccination recommended due to high risk of complications.
Dosage: Two doses in the first year of vaccination, spaced at least 4 weeks apart.
Annual Requirement: Annual dose required in subsequent years.
Vaccine Co-administration: Increased risk of fever if administered with pneumococcal vaccine (Prevenar 13®).

Pregnant Women

Recommendation: Vaccination recommended at any stage of pregnancy.
Timing: Can be administered before or during the influenza season.
Annual Revaccination: Recommended annually, even during pregnancy.
Co-administration: Safe to administer with pertussis vaccine (between 20 and 32 weeks), COVID-19 vaccine, and other indicated vaccines.

Aboriginal and Torres Strait Islander People Aged 6 Months and Over

Recommendation: Vaccination strongly recommended due to higher disease burden.
Access: Important to offer vaccination opportunistically.

People Aged 65 Years and Over

Recommendation: Vaccination recommended due to high risk of complications.
Preferred Vaccine: Fluad® Quad (adjuvanted vaccine) preferred over standard quadrivalent vaccines.
Alternative: Standard quadrivalent vaccine acceptable if adjuvanted vaccine unavailable.

Medically At-Risk Individuals (Aged 6 Months and Over)