Influenza immunisation program

Eligibility for government funded influenza vaccines in WA in 2020 has expanded to include WA primary school-aged children. This new state-funded vaccine includes all children born after 30 June 2007 and > 5 years.

The following individuals in WA are eligible to receive government funded vaccine:

• persons 65 years or older
• children 6 months to less than 5 years
• primary school-aged children (born after 30 June 2007 and > 5 years)
• pregnant women (any trimester)
• Aboriginal people 6 months and older
• individuals 6 months and older with medical conditions that place them at risk for complications of influenza, including:
• cardiac disease
• chronic respiratory conditions
• chronic neurological conditions
• impaired immunity
• diabetes and other metabolic disorders
• renal disease
• haematological disorders
• children aged 6 months to 10 years receiving long-term aspirin therapy.

Wherever your workplace, whatever your role, reduce your risk of catching influenza and passing it to patients or colleagues, and get vaccinated.

Healthcare workers are strongly recommended to receive the influenza vaccine due to their proximity in caring for vulnerable groups.​

WA Health urges all healthcare workers to get the influenza vaccine.

• Influenza (flu) can be a serious disease that can lead to hospitalisation and sometimes even death.
• Anyone can get sick from influenza, including people who are otherwise healthy.
• If you get influenza, you can spread it to others even if you don't feel sick.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) (external site) strongly endorses routine vaccination of all pregnant women against influenza.¹

This endorsement supports existing recommendations of the National Health and Medical Research Council (external site) and the Australian Technical Advisory Group on Immunisations.^2,3

In recognition of the benefits of protecting pregnant women and their newborns against influenza, the WA Department of Health recommends that all pregnant women be offered influenza vaccination as part of routine, comprehensive, antenatal care.

Vaccination against influenza in late autumn, regardless of gestational age, is optimal, but unvaccinated pregnant women should be immunised at any time during the influenza season.

Why should you recommend influenza vaccination for pregnant women?

Preventing influenza during pregnancy is an essential part of antenatal care because pregnant women are at an increased risk of serious illness due to influenza.⁴

Excess morbidity and mortality for pregnant women with influenza compared with non-pregnant women of similar age with influenza has been well documented.^4,5

The safety of influenza vaccination during pregnancy is well established; no study to date has shown an adverse consequence of inactivated influenza vaccine in pregnant women or their infants.^6,7,8

Active placental transfer of maternal antibodies makes influenza vaccine during pregnancy a highly effective measure to protect infants from influenza during the first 6 months of life.^9,10,11,12

Both maternal and infant benefit is now proven. Only 5 pregnant women need to be vaccinated to prevent 1 case of serious maternal or infant respiratory illness.

In 2012 the World Health Organisation (external site) declared that pregnant women should receive the highest priority for influenza immunisation. This recommendation was based on “compelling evidence of a substantial risk of severe disease in pregnant women, evidence that vaccine is effective against severe disease, and the evidence supporting secondary protection of infants under 6 months, in whom disease burden is also high”.

In addition, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the National Health and Medical Research Council recommend that all pregnant women be offered influenza immunisation during pregnancy.

Reporting reactions to influenza vaccine

Health care providers can report possible adverse events following immunisation using the online portal at AEFI-CAN WAVSS (external site)

More information

• Visit HealthyWA for consumer information about:
  • influenza vaccination (external site)
  • influenza immunisation in pregnancy (external site)
  • influenza immunisation for for children (external site)
  • influenza immunisation for people 65 years and older (external site)

References

1. Royal Australian and New Zealand College of Obstetricians and Gynaecologists statement (external site) (C-Obs 45). Endorsed November 2011. Vaccination of women planning pregnancy, pregnant or breastfeeding women, and preterm infants. In Australian Immunisation Handbook, 9th Edition. Updated July 2009.
2. Summary of ATAGI recommendations for selection of seasonal influenza vaccine for children aged ≥6 months to <5 years, adults and other risk groups. Canberra: Australian Government Department of Health and Ageing; 2010.
3. Rothberg MB, Haessler SD, Brown RB. Complications of viral influenza. Am J Med. 2008 Apr; 121(4): 258-64.
4. Webb SA, Pettilä V, Seppelt I, Bellomo R et al. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med. 2009 Nov; 361(20):1925-34. Epub 2009 Oct 8.
5. Hewagama S, Walker SP, Stuart RL, Gordon C, Johnson PD, Friedman ND et al. 2009 H1N1 influenza A and pregnancy outcomes in Victoria, Australia. Clin Infect Dis. 2010 Mar;50(5):686-9.
6. Tamma PD, Ault KA, del Rio C, Steinhoff MC, Halsey NA, Omer SB. Safety in influenza vaccination during pregnancy. Am J Obstet Gynecol. 2009 Dec;201(6):547-52. Epub 2009 Oct 21.
7. Lacroix I, Damase-Michel C, Kreft-Jais C, Castot A, Montastruc JL. French Association of Regional Pharmacovigilance Centres 2009 H1N1 influenza vaccines in pregnant women: the French Pharmacovigilance survey. Vaccine. 2011 Feb;29(7):1357-8. Epub 2010 Dec 23.
8. Moro, PL, Border K, Zheteyeva Y et al. Adverse events in pregnant women following administration of trivalent inactivated influenza vaccine and live attenuated influenza vaccine in the Vaccine Adverse Event Reporting System, 1990-2009. Am J Obstet Gynecol. 2011 Feb;204(2): 146.e1-146.e7.
9. Zaman K, Roy E, Arifeen SE et al. Effectiveness of Maternal Influenza Immunization in Mothers and Infants. N Engl J Med 2008;359:1555-1564.
10. Benowitz I, Esposito DB, Gracey KD, Shapiro ED, Vázquez M. Influenza vaccine given to pregnant women reduces hospitalization due to influenza in their infants. Clin Infect Dis. 2010 Dec;51(12):1355-61. Epub 2010 Nov 8.
11. Eick AA, Uyeki TM, Klimov A, Hall H, Reid R, Santosham M et al. Maternal Influenza Vaccination and Effect on Influenza Virus Infection in Young Infants. Arch Pediatr Adolesc Med. 2011;165(2):104-111.

Why should you recommend influenza vaccination for young children?

The National Health and Medical Research Council (external site), Australia’s peak body for developing health advice for the community and health professionals, recommends annual vaccination for individuals 6 months or older who wish to reduce their chances of becoming ill with influenza.

Annual influenza vaccination is strongly recommended for individuals 6 months or older with a medical condition that places them at higher risk of severe influenza illness.

Children with underlying medical conditions are eligible for a free influenza vaccine through the Immunise Australia program (external site).

Experience from Australia and overseas indicates that the majority of influenza-related paediatric hospitalisations and deaths occur among children without underlying medical conditions.

Several international studies have documented the benefits of immunising healthy young children against the influenza virus.^1-4

Key points to remember about influenza vaccine dosing in children

• Before administering an influenza vaccine, CHECK you have the correct vaccine for the child’s age. Ages are identified on the vaccine packaging.
• Children 6 months to under 9 years require two doses in the first year they receive the vaccine. These must be given at least four weeks apart. While two doses in the first year are recommended, one dose does provide some protection and is preferable to receiving no doses. One annual dose of influenza vaccine is required in following years even if only one dose was given in the first year.
• Healthcare providers should ensure that all influenza vaccinations administered to children are recorded in the Australian Immunisation Register (AIR). Please ensure that you enter the encounter into the AIR under the specific brand name used.

Influenza vaccine safety

AusVaxSafety (external site) is a network of GPs and clinics across Australia which allows parents/carers of children recently given a flu vaccine to report back on how their children felt after vaccination, to ensure vaccines registered for use in children are safe.

Real time vaccine safety data

Real time vaccine safety data can be accessed via the National Centre for Immunisation Research and Surveillance (external site).

Fever and injection site reactions are expected, mild adverse reactions following immunisation.

This rapid safety surveillance can provide reassurance to parents that the influenza vaccines used in children are safe. To learn more about the latest vaccine safety data visit National Centre for Immunisation Research and Surveillance (external site) or phone 1800 750 566.

Reporting adverse events following immunisation

Health care providers can report possible adverse events following immunisation using the online portal at AEFI-CAN WAVSS (external site)

For further information about the WA Vaccine Safety Surveillance System and how to report a reaction visit the health professional site.

More information

• Visit HealthyWA for consumer information about influenza immunisation for children (external site).

References

1. Heinonen S, Silvennoinen H, Lehtinen P, Vainionpää R, Ziegler T, Heikkinen T. Effectiveness of inactivated influenza vaccine in children aged 9 months to 3 years: an observational cohort study. Lancet Infect Dis. 2011 Jan;. 11(1): 23-29).
2. Katayose M, Hosoya M, Haneda T, Yamaguchi H, Kawasaki Y, Sato M et al. The effectiveness of trivalent inactivated influenza vaccine in children over six consecutive influenza seasons. Vaccine. 2011 Feb; 29(9):1844-9. Epub 2010 Dec 31.
3. Cohen SA, Chui KK, Naumova EN. Influenza vaccination in young children reduces influenza associated hospitalizations in older adults, 2002-2006. J Am Geriatr Soc. 2011 Feb; 59(2):327-32.
4. Sakkou Z, Stripeli F, Papadopoulos NG, Critselis E, Georgiou V, Mavrikou M et al. Impact of influenza infection on children’s hospital admissions during two seasons in Athens, Greece. Vaccine. 2011 Feb; 29(6):1167-72. Epub 2010 Dec 18.
5. Blyth CC, Cheng AC, Finucane C, Jacoby P, Effler PV, Smith DW, Kelly H, Macartney KK, Richmond PC. Vaccine. 2015 Dec 16;33(51):7239-44. Epub 2015 Nov 6.

Influenza causes illness in people of all ages. Immunisation is the single most important measure available to prevent infection and its complications.

Influenza immunisation is recommended annually, even if a person has been vaccinated in any previous year with an influenza vaccine that contains the same strains. This is because the immunity to influenza acquired by immunisation wanes over time.

During the influenza season, the opportunities to provide influenza vaccination to persons at increased risk of influenza should not be missed during visits for routine medical care.

People with certain immunocompromising conditions (i.e. haemotopoietic stem cell transplant or solid organ transplant) who are receiving the influenza vaccine for the first time are recommended to receive 2 vaccine doses at least 4 weeks apart (irrespective of age) and one dose annually thereafter.

Greater burdens of illness still occur in Aboriginal populations including as a result of influenza infection, and so influenza vaccination is recommended for all Aboriginal people aged 6 months and older.

The highest influenza burden in Australia is seen in the elderly and children. For this reason, influenza vaccination is recommended for all people aged over 65.

In addition, influenza immunisation is recommended, but not funded for people who are at higher risk of transmitting disease to others at increased risk of complications from influenza infection, such as healthcare and childcare workers.

Reporting reactions to influenza vaccine

Health care providers can report possible adverse events following immunisation using the online portal at AEFI-CAN WAVSS (external site)

For further information about the WA Vaccine Safety Surveillance System and how to report a reaction visit the health professional site.

More information

• Visit HealthyWA for consumer information about influenza immunisation (external site).

The WA Health Department and the Pharmacy Guild of Australia (WA) are extending the trial of distribution of National Immunisation Program influenza vaccine for persons over 65 to community pharmacies in 2020.

Under the pharmacist influenza vaccination trial, pharmacists are able to vaccinate individuals aged 65 years and older with the higher immunogenicity influenza vaccine.