2021 influenza vaccines

What are the influenza vaccines for 2021?

 Click on the link to download the Summary of 2021 influenza vaccines table.

AFLURIA® QUAD JUNIOR

  • Only for use in children aged under 3 years, i.e., 6–35 months.
  • Funded for children who met the influenza vaccination eligibility criteria.
  • Available for those who do not meet the funded eligibility criteria through general practitioners at a cost.
  • Link to the AFLURIA QUAD JUNIOR data sheet on the Medsafe website.

INFLUVAC® TETRA

  • Only for use in children aged 3–4 years.
  • Funded for children who met the influenza vaccination eligibility criteria.
  • Available for those who do not meet the funded eligibility criteria through general practitioners at a cost.
  • The INFLUVAC TETRA data sheet will be published on the Medsafe website before 17 May 2021.

AFLURIA® QUAD

  • Only for use in children and adults aged 5–64 years
  • Funded for children and adults who met the influenza vaccination eligibility criteria.
  • Available for those who do not meet the funded eligibility criteria through private immunisation providers (general practitioners or pharmacists or occupational health) at a cost.
  • Link to the AFLURIA QUAD data sheet on the Medsafe website.

FLUAD® QUAD

  • FLUAD QUAD is only approved for use in adults aged 65 years or older
  • Funded for adults who are eligible to receive publicly funded healthcare serives.
  • PHARMAC is funding this additional vaccine brand, a vaccine specifically made for those aged 65 and over, to ensure this important group has certainty of supply as early as possible, and to ensure there is enough influenza vaccine to meet demand and supply is continuous.
  • Link to the FLUAD QUAD data sheet on the Medsafe website.

What are the influenza vaccine strains for 2021?

The 2021 vaccines will be quadrivalent influenza vaccines that contain the following four influenza strains, the first two strains are new to the 2021 vaccine:

  • A/Victoria/2570/2019 (H1N1)pdm09-like virus
  • A/Hong Kong/2671/2019 (H3N2)-like virus
  • B/Washington/02/2019-like virus
  • B/Phuket/3073/2013-like virus

Where are the influenza vaccines made?

AFLURIA QUAD JUNIOR, INFLUVAC TETRA, AFLURIA QUAD and FLUAD QUAD are manufactured in the UK or the USA.

When should people be vaccinated?

It is possible to come in contact with influenza viruses all year round. However, the likelihood of influenza viruses circulating in the community significantly increases during winter.

For most people, the best time to be vaccinated against influenza is before the start of the winter season. It can take up to two weeks for the vaccine to provide the best influenza protection. However, influenza vaccinations can be given when influenza virus activity has been identified as protective antibody levels have been observed to develop rapidly from four days after vaccination.

It is recommended that women who become pregnant after winter and have not received the current influenza vaccination are offered influenza vaccination up to and including 31 December.

Why is an influenza vaccination recommended every year?

Yearly vaccination is recommended for two reasons: first, because protection from the previous vaccination lessens over time; and second, because the circulating influenza viruses can change and the strains in the vaccine usually change each year in response to the changing virus pattern.

Is there a minimum interval between an influenza vaccination at the end of 2020 and this year's vaccination?

No minimum interval is required between an influenza vaccination in 2020 and one in 2021. The 2021 influenza vaccination can be given as soon as the vaccine is available.

Needles for FLUAD QUAD and AFLURIA QUAD

The AFLURIA QUAD and FLUAD QUAD vaccines for 2021 will be supplied without needles. Influenza vaccine needles need to be purchased separately.

At the time of vaccination, the choice of needle length will be based on the vaccinator’s clinical judgment to ensure needle length is appropriate to reach muscle.

Needles are available for purchase from EBOS Healthcare or pharmacy wholesalers.

  • Orders can be placed for distribution in the lead up to the programme start date.
  • There are different needles for FLUAD QUAD and AFLURIA QUAD.
    • The order codes are described in the table below, it is important to use the correct code for the needles you want to order.
Influenza vaccine Pharmacode EBOS order code Description Pack size
FLUAD QUAD 2605627 21122020 BD
Hypodermic needle
24g x 1'' (purple)
100 needles per box
AFLURIA QUAD 2605619 21122019 BD
Hypodermic needle
25g x 5/8'' (orange)
100 needles per box

Seqirus has ordered adequate supplies of needles to support the Influenza Immunisation Programme.

EBOS Healthcare

Phone (primary care): 0800 105 501
Website: eboshealthcare.co.nz

How long does a person have to wait at the clinic after receiving an influenza vaccination?

The 20-minute waiting period continues to be the best option when the waiting area is adequate and safe.

Adolescents aged 13 years or older and adults receiving only an influenza vaccination:

  • If the risk of exposure to infectious disease in a crowded waiting rooms is higher than the low risk of anaphylactic events; adolescents and adults who meet ALL the following criteria may not need to wait for 20 minutes post-vaccination:
  1. do not have a history of severe allergic reactions,
  2. have been assessed for any immediate post vaccination adverse reactions (5 minutes),
  3. are aware of when they need to and how to seek post-vaccination advice,
  4. will have another adolescent or adult with them for the first 20 minutes post vaccination, and
  5. have the ability to contact emergency services if required.

Adolescents aged 13 years or older and adults receiving any other vaccination, and all children aged under 13 years need to remain under observation for the 20-minutes post-vaccination.

Administration of influenza vaccine and other vaccines

Spacing of influenza vaccination and the COVID-19 vaccine (COMIRNATY™)

In view of the absence of data on concomitant delivery, and to minimise confusion with any associated reactions, a gap of two weeks is generally recommended between giving mRNA-CV after any other vaccine. However, based on first principles of how these vaccines work, adverse impacts on immunogenicity or safety are unlikely with a shorter gap, so if it is clinically important to deliver in a shorter time, do not delay.

  • If it is not practicable to keep a two-week gap between vaccines, then do not delay.
  • If a live vaccine has been administered, wait four weeks before giving a COVID-19 vaccine but if not practicable, then do not delay.
  • If a COVID-19 vaccine is administered first, then maintain a two-week gap before any other vaccines.

Note: the second mRNA-CV dose is given at least 21 days after the first dose.

Spacing of influenza vaccination and non-COVID-19 vaccines

The influenza vaccine can be administered concurrently with all non-COVID-19 vaccines, including the herpes zoster (shingles) vaccine, pneumococcal vaccines and Tdap, and the National Immunisation Schedule vaccines. Separate syringes and different injection sites should be used.

Coadministration of influenza and pneumococcal vaccines

In one study, children aged 6–23 months are two to three times more likely to develop a fever of 38°C–39°C during the first 24 hours after receiving influenza and PCV13 (PREVENAR13®) vaccines at the same visit compared with children who received the vaccines on separate days.

  • Around one in 10 adults have an increased risk of experiencing fatigue, headache and/or body aches and pains during the 14 days after receiving influenza and PCV13 vaccines at the same visit.
  • Around two in 10 adults have an increase risk of redness or pain at the site of one or both injection sites when receiving influenza and 23PPV (PNEUMOVAX®23) vaccines concurrently.
  • Separating administration of these vaccines by two days can be offered, but is not essential.

Please refer to the Medsafe website www.medsafe.govt.nz for the PREVENAR 13 and PNEUMOVAX 23 data sheets.

ZOSTAVAX® and annual influenza vaccination

Annual influenza immunisation is recommended and funded for adults aged 65 years or over.

One ZOSTAVAX is recommended for adults aged 65 years to under 80 years. This dose is also funded.

  • ZOSTAVAX and influenza vaccine can be administered at the same visit.
  • ZOSTAVAX is only given as a single dose – it IS NOT administered every year that an eligible adult receives their influenza vaccination.

Can FLUAD QUAD, AFLURIA QUAD, INFLUVAC TETRA or AFLURIA QUAD JUNIOR be administered to people receiving anticoagulant mediation?

Yes. Influenza vaccines can be administered to people on anticoagulants, including aspirin, dabigatran (PRADAXA®), enexoparin (CLEXANE®), heparin, rivaroxaban (XARELTO®), ticagrelor (BRILINTA®), and warfarin. After vaccination, apply firm pressure over the injection site without rubbing for 10 minutes to reduce the risk of bruising. Please refer to the Medsafe website www.medsafe.govt.nz for the PRADAXA, CLEXANE, XARELTO and BRILINTA data sheets.

Can FLUAD QUAD, AFLURIA QUAD, INFLUVAC TETRA or AFLURIA QUAD JUNIOR be given to people with egg allergy or anaphylaxis?

Yes. These vaccines can be safely administered to people with a history of egg allergy or egg anaphylaxis at general practices, pharmacies or at the workplace, although the data sheet advises caution in people who have a history of egg anaphylaxis. Studies have shown that influenza vaccines containing one microgram or less of ovalbumin do not trigger anaphylaxis in sensitive individuals. The residual ovalbumin in one dose of FLUAD QUAD, AFLURIA QUAD, INFLUVAC TETRA and AFLURIA QUAD JUNIOR is below this limit.

Can FLUAD QUAD, AFLURIA QUAD, INFLUVAC TETRA and AFLURIA QUAD JUNIOR  be given to people with a sulfonamide (sulfer) allergy?

Yes. Sulfonamide (sulfur) antibiotics, such as cotrimoxazole, sulfasalazine, and sulfite preservatives used in food, are different to medicines containing the words sulfate or sulphate, e.g. neomycin sulphate. 

How are FLUAD QUAD, AFLURIA QUAD, INFLUVAC TETRA and AFLURIA QUAD JUNIOR produced?

FLUAD QUAD is an inactivated vaccine that contains inactivated haemagglutinin proteins from the surface of the virus and a squalene-based oil-in-water emulsion. Influenza virus is grown in embryonated hens’ eggs and inactivated with formaldehyde. The haemagglutinin protein for each strain is harvested, purified and combined with the MF59 squalene-based oil-in-water adjuvant.

AFLURIA QUAD and AFLURIA QUAD JUNIOR are split virion vaccines that contain disrupted haemagglutinin proteins from the surface of the virus. Influenza virus is grown in embryonated hens’ eggs from disease-free flocks and inactivated. The haemagglutinin protein for each strain is harvested, purified and inactivated for use in the vaccine.

INFLUVAC TETRA is an inactivated vaccine that contains inactivated haemagglutinin proteins from the surface of the virus. Influenza virus is grown in embryonated hens’ eggs and inactivated with formaldehyde.

Do FLUAD QUAD, AFLURIA QUAD, INFLUVAC TETRA and AFLURIA QUAD JUNIOR contain antibiotics?

Yes. FLUAD QUAD vaccines contain traces of kanamycin and neomycin, INFLUVAC TETRA vaccines contain traces of gentamicin, and AFLURIA QUAD and AFLURIA QUAD JUNIOR vaccines contain traces of neomycin and polymixin B due to their use during production. The vaccines should be used with caution in people with known anaphylaxis to these respective antibiotics.

Are FLUAD QUAD, AFLURIA QUAD, INFLUVAC TETRA and AFLURIA QUAD JUNIOR latex free?

FLUAD QUAD, AFLURIA QUAD and AFLURIA QUAD JUNIOR syringes do not have any components made using natural rubber latex.

INFLUVAC TETRA syringes do not contain any latex components. However, the manufacturer (Mylan) is unable to confirm that the product did not come in contact with any latex materials during the manufacturing and packaging process.

If no latex-free influenza vaccine is available, please call 0800 IMMUNE (0800 466 863) before vaccinating a person who is highly sensitive to latex with a history of severe hypersensitivity response.

Do FLUAD QUAD, AFLURIA QUAD, INFLUVAC TETRA and AFLURIA QUAD JUNIOR contain blood products?

No. No blood products are used in the manufacturing processes of these vaccines.

Do FLUAD QUAD, AFLURIA QUAD, INFLUVAC TETRA and AFLURIA QUAD JUNIOR contain thiomersal?

No.These vaccines are preservative free. They do not contain thiomersal.

Can you get influenza from FLUAD QUAD, AFLURIA QUAD, INFLUVAC TETRA or AFLURIA QUAD JUNIOR?

No. These vaccines have been made from influenza viruses that have been concentrated, inactivated, and then broken apart. Inactivated influenza vaccines such as FLUAD QUAD, AFLURIA QUAD and AFLURIA QUAD JUNIOR cannot cause influenza as the vaccines do not contain any live viruses.

Sometimes influenza vaccination is accused of causing the disease. There are two possible reasons for this. First, when vaccinated, the body responds to vaccination by producing an immune response. This can include systemic symptoms such as fever, headache or fatigue, which may mistakenly be assumed to be early signs of influenza but are the body responding to the vaccination. Second, other respiratory viruses and bacteria circulate during the winter months and influenza vaccination does not protect against these.

Most of these other viruses cause milder infections. However, some viruses and bacteria may produce influenza-like symptoms and/or quite severe illness which can lead to the suggestion that influenza vaccination is ineffective. These illnesses should not be confused with influenza.

How effective are the vaccines against influenza strains not included in the formulation?

Effectiveness can be reduced by a difference between circulating virus strains and vaccine strains. The influenza virus keeps changing and new vaccines are formulated for each northern and southern hemisphere season. There may be some cross protection against a virus type that is not in the vaccine but the amount of protection cannot be guaranteed or easily quantified.

Does the influenza vaccine protect against coronaviruses?

Influenza vaccine does not protect against coronavirus infections; however, it will help prevent a serious illness that causes hundreds of deaths each winter in New Zealand.

Could influenza vaccination increase the risk of infection with coronaviruses or make COVID-19 disease worse?

No. Influenza vaccination does not increase the risk of being infected with the SARS-CoV-2 (COVID-19) virus or any other respiratory virus.

Pharmacist vaccinators

Many community pharmacies offer purchased influenza vaccination for individuals aged 13 years or older. Some community pharmacies also provide funded influenza vaccination for:

  • pregnant women,
  • adolescents and adults aged 13–64 years who have an eligible condition, and
  • people aged 65 years or over

List of vaccinating Pharmacies