Eligibility criteria

Funded influenza vaccine is available each year for people who meet the following criteria set by PHARMAC:

1. People 65 years of age or older; or

2. People under 65 years of age who:

• have any of the following cardiovascular diseases:
  • ischaemic heart disease, or
  • congestive heart failure, or
  • rheumatic heart disease, or
  • congenital heart disease, or
  • cerebrovascular disease; or
• have either of the following chronic respiratory diseases:
  • asthma, if on a regular preventative therapy, or
  • other chronic respiratory disease with impaired lung function;^a or
• have diabetes; or
• have chronic renal disease; or
• have any cancer, refer to the vaccine precaution below^#, excluding basal and squamous skin cancers if not invasive; or
• have any of the following other conditions:
  • autoimmune disease,^b or
  • immune suppression or immune deficiency, or
  • HIV, or
  • transplant recipient, or
  • neuromuscular or CNS disease/disorder,^c or
  • haemoglobinopathy,^d or
  • children on long-term aspirin, or
  • a cochlear implant, or
  • error of metabolism at risk of major metabolic decompensation, or
  • pre- or post-splenectomy, or
  • Down syndrome, or
• pregnant women (any trimester); or

3. Children aged 4 years or under who have been hospitalised for respiratory illness or have a history of significant respiratory illness, including:

• Children aged 6–59 months (under 5 years) who have been hospitalised with measles.

Unless meeting the criteria set out above, the following conditions are excluded from funding:

• asthma not requiring regular preventative therapy, or

  • PHARMAC has confirmed that people with a respiratory condition that is prescribed a preventer inhaler meet the eligibility criteria for a funded influenza vaccination regardless of whether or not they routinely collect the inhaler, i.e. are adherent with treatment. They acknowledge that there may be barriers resulting in some people with respiratory conditions not collecting their preventer inhaler but that this does not affect their eligibility to receive a funded influenza vaccine.

• hypertension and/or dyslipidaemia without evidence of end-organ disease.

Also refer to the New Zealand Pharmaceutical Schedule on the PHARMAC website www.pharmac.govt.nz/tools-resources/pharmaceutical-schedule/community

a. Chronic respiratory diseases may include: chronic bronchitis, chronic obstructive pulmonary disease, cystic fibrosis, emphysema.
b. Autoimmune diseases may include: coeliac disease, Crohns disease, Graves’ disease, Hashimoto’s thyroiditis, lupus, rheumatoid arthritis:
    Immune suppression or immune deficiency includes diseases modifying anti-rheumatic drugs (DMARDS) or targeted biologic therapies.
c. Neuromuscular and CNS diseases/disorders include: celebral palsy, congenital myopathy, epilepsy, hydrocephaly, motor neurone disease,
    multiple sclerosis, muscular dystrophy, myasthenia gravis, Parkinson’s disease, spinal cord injury.
d. Haemoglobinopathies including: sickle cell anaemia, thalassemia.