The best way to protect your patients from the risk of serious influenza is to offer annual influenza vaccination. This page contains information about the 2023 influenza vaccination program.

Updated ATAGI advice on administering seasonal influenza vaccines in 2023

Updated advice from the Australian Technical Advisory Group on Immunisation (ATAGI) on the administration of 2023 seasonal influenza vaccines is available on the Department's website at Australian Technical Advisory Group on Immunisation (ATAGI).

Key points

• Influenza vaccination is recommended. Seasonal influenza activity is expected to continue in 2023 following the resurgence of influenza virus circulation arising from the reopening of international borders in 2022.
• Influenza vaccine can be co-administered (given on the same day) with any COVID-19 vaccine.
• If a person has had the 2022 influenza vaccine in late 2022 or early 2023, they are still recommended to receive a 2023 formulation of influenza vaccine when it becomes available.

Eligibility for free influenza vaccine

Free seasonal influenza vaccine is funded under the National Immunisation Program (NIP) for the following groups at higher risk of complications from influenza:

• all Aboriginal and Torres Strait Islander people aged 6 months and over
• all children aged 6 months to less than 5 years of age
• all individuals aged 5 years and over with medical risk conditions, namely:
• cardiac disease, including cyanotic congenital heart disease, coronary artery disease and congestive heart failure
• chronic respiratory conditions, including suppurative lung disease, chronic obstructive pulmonary disease (COPD), severe asthma (for which frequent medical consultations or the use of multiple medications is required), cystic fibrosis, bronchiectasis and chronic emphysema.
• chronic neurological conditions, including hereditary and degenerative central nervous system (CNS) diseases (including multiple sclerosis), neuromuscular disorders, spinal cord injuries and seizure disorders
• immunocompromising conditions, including immunocompromised due to disease or treatment (e.g. malignancy, transplantation and/or chronic steroid use), asplenia or splenic dysfunction and HIV infection
• diabetes and other metabolic disorders, including Type 1 diabetes, Type 2 diabetes and chronic metabolic disorders
• chronic renal failure
• haemoglobinopathies
• children aged 6 months to 10 years on long term aspirin therapy
• pregnant women (influenza vaccine can be given at any stage of pregnancy)
• people aged 65 years and over (a vaccine that is specifically designed to produce a higher immune response is available for this group).

Refer to the Australian Immunisation Handbook for detailed advice, including eligibility.

Vaccine strains

The Australian Influenza Vaccine Committee (AIVC) recommendation for the composition of influenza vaccines for Australia in 2023 introduces one new strain to the NIP vaccines when compared to the composition of the vaccines for Australia in 2022: a new A (H1N1) like virus strain:

• an A/Sydney/5/2021 (H1N1)pdm09-like virus – new strain for 2023.
• an A/Darwin/9/2021 (H3N2)-like virus;
• a B/Austria/1359417/2021 (B/Victoria lineage)-like virus; and
• a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

Influenza vaccines

Four influenza vaccines will be available under the National Immunisation Program in 2023:

• Vaxigrip Tetra® and Fluarix Tetra® for eligible people aged 6 months to 64 years
• Afluria® Quad for eligible people aged 5 years to 64 years
• Fluad® Quad for people aged 65 years and over

Getting prepared - 2023 influenza vaccination program resources

• The influenza vaccination provider toolkit and influenza vaccine information sheet will assist providers with managing roll-out and implementation of their flu vaccination program in 2023.
• An influenza vaccination update webinar has also been prepared by NSW Health and RACGP to assist immunisation providers.
• A poster resource targeting influenza vaccination for children aged 6 months to less than 5 years of age.
• A brochure resource targeting all the maternal vaccines including influenza vaccine.
• Pharmacist immunisers can administer influenza vaccines to all individuals aged 5 years and over including NIP vaccines to eligible people. Further information is available at Pharmacist initiation and administration of vaccines.
• Visit our frequently asked questions and answers about influenza vaccination.
• Influenza vaccination resources in other languages can be ordered from the Better Health Centre.
• The National Centre for Immunisation Research and Surveillance (NCIRS) - Influenza includes the following resources:
  • Influenza vaccines for Australians factsheet
  • Influenza vaccines for Australians FAQs
  • Influenza vaccination during COVID-19 -FAQs for Aboriginal and Torres Strait Islander people
    
  • Webpage Supporting conversations about vaccinations with Aboriginal and Torres Strait Islander people for immunisation providers (GPs, nurses, pharmacists) providing influenza vaccination to Aboriginal and Torres Strait Islander families. The webpage includes a summary table of vaccination resources and a conversation guide for providers Talking about flu vaccination with Aboriginal and Torres Strait Islander families. 
    
• The Sharing Knowledge About Immunisation (SKAI) communication package is an evidence-based suite of communication tools aimed at improving conversations between vaccination providers and parents of young children, pregnant women and families about vaccination.
• Information factsheet - Is an influenza vaccine recommended for my child?
  
• Information factsheet – Why does my child need a flu shot?
• Information factsheet – The influenza vaccine for pregnant women

Reporting influenza vaccinations to the Australian Immunisation Register

It mandatory to report administration of influenza vaccines, COVID-19 vaccines and all other NIP vaccines to the Australian Immunisation Register (AIR). All immunisation providers must apply to have access to the Australian Immunisation Register. Access to the AIR is through PRODA. More information about PRODA access can be found on Services Australia.

Influenza vaccine supply

Distribution of National Immunisation Program influenza vaccines will commence when supplies arrive at the NSW Vaccine Centre from vaccine suppliers under Australian Government contract. The NSW quota of NIP influenza vaccines arrive at the NSW Vaccine Centre over many weeks. Not all stock is available at the one time. To ensure your practice or pharmacy receives influenza vaccines refer to the advice 'Ordering influenza vaccine'.

Ordering influenza vaccines

The timing of NIP influenza vaccine availability may be different to the availability of privately purchased influenza vaccines.

• For immunisation providers with an existing vaccine ordering account, a pre-allocation confirmation process will open on Monday 6th March 2023. Immunisation providers will receive an email from the NSW Vaccine Centre.
• Providers who do not approve their pre-allocated order in time, can place an online order through the usual process, once online ordering opens. Only online orders are accepted. Refer to the influenza vaccination provider toolkit for further information about the pre-allocation process.
• Each delivery received must be confirmed as received on the online vaccine ordering system. This includes pharmacies receiving stock of NIP influenza vaccine for people aged 5 years and over.
• Once a complete order of influenza vaccines has been received and the provider has confirmed receipt, a subsequent order can be placed (if required).
• Restrictions may be placed on the number of influenza vaccine doses that can be ordered and these may change over time based on vaccine supply and demand.
• Only order enough vaccines required for use in a maximum 4-week period. This helps to ensure that enough quantities of vaccine are available to all providers. Please ensure you have fridge capacity for the volume of vaccines ordered.
• Vaccination clinics should only be scheduled once vaccines have been received.
• Keep vaccines in their original cardboard packaging to protect them from light and temperature changes.
• Please ensure that free influenza vaccines are only given to eligible people (see 'Eligibility for free influenza vaccine').

For further information please refer to the influenza vaccine information sheet developed to assist providers with managing the various influenza vaccine presentations and eligibility for each vaccine.

Influenza vaccine safety

Data on the safety of the influenza vaccines is continuously monitored by the TGA and AusVaxSafety. There is extensive surveillance that demonstrate that the influenza vaccines used in Australia have an excellent safety profile. Weekly updates are available on AusVaxSafety.

Other influenza vaccine safety resources

• Influenza vaccination post Guillain-Barre Syndrome (GBS) guideline
• Avoiding shoulder injury related to vaccine administration and NCIRS education module

Other resources

Influenza vaccination information for healthcare workers