Influenza Information for Health Professionals

The publicly funded influenza vaccines available for the 2021/2022 UIIP include:

  • Quadrivalent Inactivated Vaccine (QIV) for ≥6 months of age (table 1)
  • High-Dose Quadrivalent Inactivated Vaccine (QIV-HD) for ≥65 years only (table 2)
  • Adjuvanted Trivalent Inactivated Vaccine (TIV-adj) for ≥65 years only (table 2)
  • sudden onset of high fever, chills, cough and muscle aches
  • other common symptoms include:
    • headache
    • chills
    • loss of appetite
    • fatigue
    • sore throat
  • nausea, vomiting and diarrhea may also occur, especially in children

For local, provincial and national influenza surveillance information:

  • Follow PHO’s Respiratory Viruses (including influenza) Test Information Index

NOTE: On July 26, 2021, PHO Laboratory implemented changes to eligibility of multiplex respiratory virus PCR (MRVP) testing for children <18 years old seen in the Emergency Department, hospitalized patients, outbreak-associated patients, and patients in institutions not in outbreak with acute respiratory illness (ARI).

Previously, MRVP testing was routinely available for persons tested in ICU/CCU and remote communities only. Starting July 26, 2021, PHO Laboratory has made the following changes to MRVP testing:

  • To support enhanced respiratory virus surveillance, MRVP testing will be available for symptomatic children (<18 years) seen in the Emergency Department (ED). This testing, which is generally not required for clinical purposes, will be re-evaluated in fall/winter 2021.
  • MRVP testing will be available for all symptomatic hospitalized patients (ward and ICU/CCU).
  • Specimens from the first four symptomatic patients in an outbreak that request respiratory virus testing will be tested by MRVP.
  • Symptomatic patients tested in institutional settings (non-outbreak) will be eligible for MRVP testing when ordered on the PHO Laboratory requisition.
  • Influenza testing is not currently available through the Public Health Ontario (PHO) Laboratory for patients in ambulatory settings, including those at high risk for influenza complications or patients in emergency department settings who will not be admitted to hospital.

MRVP testing requests for patients with acute respiratory illness (ARI) in the settings described above should be clearly indicated on the requisition by selecting “Respiratory Viruses” or “COVID-19 Virus AND Respiratory Viruses” as appropriate in section 5 – “Test(s) Requested”. Only mark one of the three test request options. In addition, the patient’s setting and symptoms should be indicated on the requisition.

Updated September 27, 2021

Publicly Funded Influenza Vaccines for the 2021/2022 Flu Season

Table 1. Publicly funded influenza vaccine available through the 2021/2022 UIIP for individuals 6 months of age and older

Quadrivalent Inactivated Vaccine
UIPP Abbreviation
 QIV
NACI Abbreviation
 IIV4-SD – – IIV4-cc
Vaccine product
 FluLaval Tetra Fluzone® Quadrivalent Afluria® Tetra Flucelvax® Quad
Manufacturer
 GSK Sanofi Pasteur Seqirus Seqirus
Age indication
 ≥6 months ≥6 months ≥5 years ≥2 years
Vaccine type
 Egg-based Egg-based Egg-based Cell culture-based1
Micrograms of hemagglutinin
 15 µg 15 µg 15 µg 15 µg
Dosage
 0.5 mL 0.5 mL 0.5 mL 0.5 mL
Format
 MDV
  1. MDV
  2. PFS
  1. MDV
  2. PFS
 PFS
Route
 IM IM IM IM
Most common allergens2
  • Egg protein3
  • Thimerosal4
  • Egg protein3
  • Thimerosal4
  • Egg protein3
  • Neomycin
  • Polymyxin B
  • Thimerosal4
 Does not contain egg protein
Post-puncture shelf life
 28 days5 MDV: 28 days5
PFS: Not applicable		 MDV: 28 days5
PFS: Not applicable		 Not applicable
Product dimensions (cm)
 2.7 x 2.7 x 6.9 MDV: 3 x 2.9 x 6.2
PFS: 10.4 x 9.9 x 3.8		 MDV: 6.1x 6.0 x 3.1
PFS: 12.5 x 6.1 x 9.4		 15.4 x 13.02 x 2.38
  1. ‘Cell culture-based’ refers to how the influenza vaccine is made. Flucelvax® Quad is a mammalian cell culture-based QIV. Both egg-based and cell culture-based QIVs provide protection against four strains of influenza and are available in the UIIP for 2021/2022. Any of the available products can be used in the age group for which they are indicated.
  2. Any component in a vaccine may be a potential allergen. This table identifies the most common allergens.
  3. The National Advisory Committee on Immunization (NACI) indicates that egg allergy is not a contraindication for influenza vaccination and that egg-allergic individuals may be vaccinated against influenza using the full dose of any age-appropriate product.
  4. Multi-dose vial presentation only
  5. Return vials with remaining doses to PHU or OGPMSS (for Toronto clients) as wastage.

Table 2. Publicly funded influenza vaccine available through the 2021/2022 UIIP for individuals 65 years of age and older

High-Dose Quadrivalent Inactivated Vaccine

Adjuvanted Trivalent Inactivated Vaccine
UIPP Abbreviation
 QIV-HD TIV-adj
NACI Abbreviation
 IIV4-HD IIV3-Adj
Vaccine product
 Fluzone® High-Dose Quadrivalent Seqirus
Manufacturer
 Sanofi Pasteur Sanofi Pasteur
Age indication
 ≥65 years ≥65 years
Vaccine type
 Egg-based Egg-based
Micrograms of hemagglutinin
 60 µg 15 µg
Dosage
 0.7 mL 0.5 mL
Adjuvant
 No Yes
Format
 PFS PFS
Route
 IM IM
Most common allergens2
  • Egg protein2
  • Egg protein2
  • Kanamycin
  • Neomycin
Post-puncture shelf life
 Not applicable Not applicable
Product dimensions (cm)
 9.9 x 10.4 x 2.3 12.7 x 6.35 x 9.4
  1. Any component in a vaccine may be a potential allergen. This table identifies the most common allergens.
  2. The National Advisory Committee on Immunization (NACI) indicates that egg allergy is not a contraindication for influenza vaccination and that egg-allergic individuals may be vaccinated against influenza using the full dose of any age-appropriate product.

2022/2023 Vaccine Ordering

Organizations interested in becoming a vaccine provider for the Universal Influenza Immunization Program (UIIP)are required to complete an annual application process for approval to store, handle, and administer publicly funded influenza vaccine unless they are in receipt of other publicly funded vaccines (excluding COVID-19 vaccine).

The deadline to apply for the 2022/2023 UIIP is July 10, 2022 (11:59 pm EST).

More information:

Ministry of Health’s Universal Influenza Immunization Program (UIIP)

 

More Information

When caring for people with lab confirmed influenza or influenza-like illness, follow Provincial Infectious Diseases Advisory Committee’s Routine Practices and Additional Precautions in all Health Care Settings including:

  • droplet and contact precautions
  • facial protection (which may include a mask in conjunction with eye protection, or a face shield that covers eyes, nose and mouth) within two metres of a patient on droplet precautions
  • isolation in a single room or cohorted with another lab-confirmed casecontinued precautions for five days after lab confirmed influenza
  • Advise patients with to stay home from work or school while ill, and to practise frequent hand washing and cough etiquette.
  • Report confirmed cases of influenza to Toronto Public Health.
  • Report respiratory infection outbreaks in institutions and public hospitals to Toronto Public Health.
  • To report call 416-392-7411 during business hours and 3-1-1 on evenings and weekends.