Universal Influenza Immunization Program implementation for the 2023-24 season

Advisory Alert

September 18, 2023

*Cette information est seulement disponible en anglais.

To: Local health care providers


Important information about the 2023-24 Universal Influenza Immunization Program (UIIP)

Seasonal influenza presents an ongoing disease burden in Canada. Influenza vaccine is the most effective way to prevent influenza illness and influenza-related complications. With the influenza season fast approaching, please see key updates and important information about the 2023-24 Universal Influenza Immunization Program (UIIP). Influenza vaccine is an important component of managing health care system capacity during the influenza season, particularly in the context of ongoing COVID-19 and other respiratory virus activity.

A variety of influenza vaccine products will be available this year for ordering and immunization. It is important for health care providers to note the specific differences in age indication, dosage, and storage and handling requirements of the products being used. Refer to Table 2 below for vaccine product specific details that will be available for health care providers to order. For complete prescribing information, consult the product monographs available through Health Canada’s Drug Product Database.

Public Health Unit influenza vaccine allocation process

Health care providers can expect to receive their initial Public Health Sudbury & Districts influenza vaccine order form the week of September 25. The form will indicate the dates that initial orders may be picked up from Public Health Sudbury & Districts.

Table 1: Distribution of Influenza Vaccines in Ontario

WhenDistribution Initiated To
End of September to early OctoberPublic hospitals and long-term care homes
Early-to-mid OctoberRetirement homes and other settings with vulnerable populations
Early-to-mid OctoberPrimary care providers and other organizations. Pharmacists through their wholesale distributors.

Ordering information

Vaccine Administration Considerations

Prioritizing Administration

Providers should prioritize influenza vaccine administration as outlined below.

Immunize the following groups as soon as vaccine is available:

Immunize your general patient population on or after October 30, 2023. Due to allocation restrictions, please do not plan large clinics until November when the vaccine supply has been replenished.

Co-administration of influenza and other vaccines

Influenza vaccines may be administered at the same time as, or at any time before or after, administration of other vaccines (either live or inactivated), including COVID-19 vaccines for those aged 6 months and older. At this time, it is important to note that Imvamune® vaccine (for MPOX protection) and COVID-19 vaccines should not be provided concomitantly as a precautionary measure to prevent erroneous attribution of an AEFI to one vaccine or the other. Administration should be separated by 4 weeks when possible. Please consider this when providing multiple vaccines to eligible patients. Also at this time the new RSV vaccine called Arexvy® will be available for use in eligible patients shortly. While Arexvy® may be administered concomitantly with standard dose inactivated quadrivalent influenza vaccine (unadjuvanted), it has not been studied with high-dose or adjuvanted products. Further guidance on the use of the product will be forthcoming.

The National Advisory Committee on Immunization (NACI) will continue to monitor the evidence base regarding the co-administration of influenza and COVID-19 vaccines and update its recommendations as needed. Refer to the Canadian Immunization Guide, COVID-19 Vaccine chapter for additional emerging guidance on concurrent administration with COVID-19 vaccines as new products are authorized or there are COVID-19 age eligibility expansions.

Please note that there is no evidence regarding the co-administration of recombinant zoster vaccine (RZV) [Shingrix®] with adjuvanted or high-dose influenza vaccine. No immune response interference or safety concerns have been identified when RZV is administered concurrently with standard dose, un-adjuvanted vaccine.

Immunizing older adults

UIIP product information

Table 2: Influenza Vaccine Products for the 2022/2023 Season

Influenza Vaccine ProductAvailabilityEligibilityDosagePost-Puncture Shelf Life for Multi-dose Vials
FluLaval® Tetra
Quadrivalent influenza vaccine – (QIV)
GlaxoSmithKline Inc.
15 mcg/0.5mL

Multi-dose vial format (MDV)
6 months of age and older0.5 mL IM28 days
Fluzone® Quadrivalent (QIV)
Sanofi Pasteur Limited
15 mcg/0.5mL

MDV and pre-filled syringe (PFS) format
6 months of age and older0.5 mL IM28 days
Fluzone® High-Dose Quadrivalent
Quadrivalent high-dose influenza vaccine- (QIV-HD)
Sanofi Pasteur Limited
60 mcg/0.7 mL

65 years of age or older0.7 mL IMNot applicable
Trivalent adjuvanted influenza vaccine – TIV-adjuvanted (TIV-adj)
Seqirus Limited
15 mcg/0.5 mL

65 years of age or older0.5 mL IMNot applicable

UIIP package is attached

Your UIIP package is attached. Within you will find further information on the provincial procurement of influenza vaccine as well as Q&A documents outlining eligibility and indications for the UIIP vaccine products available for immunization in the 2023–24 season. We will share any additional information regarding the influenza vaccine and roll-out for Ontario as it is shared by the province.

Thank you in advance for your ongoing commitment to protecting the heath and safety of your patients through the administration of influenza vaccines. Should you have any questions, please contact the immunization program at 705.522.9200, ext. 458.


Original Signed By

Dr. Penny Sutcliffe
Medical Officer of Health and Chief Executive Officer

Reference: Public Health Agency of Canada. National Advisory Committee on Immunization. Statement on Seasonal Influenza Vaccine for 2023-2024. May 31, 2023.

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This item was last modified on September 18, 2023