Universal Influenza Immunization Program Implementation Package
Advisory Alert
September 30, 2020
*Cette information est seulement disponible en anglais.
To: All Health Care Providers
Please find attached the Universal Influenza Immunization Program (UIIP) implementation package for the 2020/21 influenza season. The attached includes a memo outlining the UIIP process, questions and answers about the products available this year, as well as information for specific age groups. The Advisory Alert summarizes the key information.
Available vaccine products and usage
- For the 2020/21 influenza season, four products will be available through the UIIP. Three products are standard dose (15 μg hemagglutinin) quadrivalent vaccines (IIV4-SD) that are authorized for use in accordance with age as outlined in Table 1 below. The fourth product is a high-dose (60 μg) trivalent vaccine (IIV3-HD) for use in seniors 65 years of age and older.
- New this year among the IIV4-SD products is a cell-culture based vaccine called Flucelvax® Quad manufactured by Seqirus.
Age considerations
- Children under nine years of age receiving influenza vaccine for the first time should receive two (0.5 mL) doses of vaccine administered four weeks apart.
- Please encourage your older patients not to delay influenza vaccination to not wait for a specific product. Both IIV4-SD and IIV3-HD protect against influenza and the most important thing is for older adults to be vaccinated.
- Currently there is insufficient evidence to recommend the use of high-dose TIV over standard-dose QIV.
- However, given the increased burden of disease associated with influenza A(H3N2) in older adults, better protection against influenza A(H3N2) may be more important than better protection against influenza B, especially in those with multiple co-morbid conditions and compromised health status.
Table 1: Influenza vaccine product characteristics for the 2020/2021 Season
| Vaccine Product | Vaccine Type | Age Indication | Dosage* and Route | Recommended Needle Gauge | Recommended Needle Length | Most Common Allergens** |
|---|---|---|---|---|---|---|
| FluLaval Tetra Multi-dose vial | IIV4-SD | 6 months of age and older | 0.5 mL Intramuscular Injection (IM) | All ages 22-25 gauge | Infants, toddlers and children ⅞inch - 1 inch Adolescents and adults 1 inch – 1½ inch | Egg protein Thimerosal |
| Fluzone® Quadrivalent Multi-dose vial or pre-filled syringe | IIV4-SD | 6 months of age and older | 0.5 mL IM | All ages 22-25 gauge | Infants, toddlers and children ⅞inch - 1 inch Adolescents and adults 1 inch – 1½ inch | Egg protein Thimerosal (only in multi-dose vial presentation) |
| Flucelvax® Quad (Cell-culture based) Prefilled syringe | IIV4-SD | 9 years of age and older | 0.5 mL IM | All ages 22-25 gauge | Children ⅞inch - 1 inch Adolescents and adults 1 inch – 1½ inch | - |
| Fluzone® High-Dose Prefilled syringe | IIV3-HD | 65 years of age and older | 0.5 mL IM | All ages 22-25 gauge | Adults 1 inch – 1½ inch | Egg protein |
*Note:
- Fractional doses should not be given. Individuals with influenza vaccine allergies should be referred to a specialist for appropriate immunization. Egg allergy is not a contraindication for influenza vaccination.
- Double dosing should not be practiced. Individuals should not receive more than one dose (0.5mL) of influenza vaccine at one time. For example, individuals should not be given two doses (2 x 0.5mL) of Fluzone® Quadrivalent during the same immunization visit.
- Individuals 9 years of age and older should not be given two doses of influenza vaccine within the same influenza season. For example, individuals 65 years of age and older, should not receive Fluzone® Quadrivalent and then later be given Fluzone® High-Dose, within the same influenza season.
** Any component of a vaccine may be a potential allergen, refer to the product monograph for further information
Safety-engineered needles
The Needle Safety Regulation, under the Occupational Health and Safety Act, which requires the use of safety-engineered needles, applies to all workplaces where health-related services are provided. The use of safety-engineered needles reduce the risk of a skin puncture or injury to the worker.
Additional information regarding the Universal Influenza Immunization Program can be found at http://www.health.gov.on.ca/en/pro/programs/publichealth/flu/.
Next steps
You should have received your influenza vaccine order form. If you did not receive it, please let us know using the contact information below.
We anticipate receiving our first allotment of vaccine the week of October 5, 2020. We will begin distribution to health care provider offices that have placed orders once we have received our shipment. Please note you will be able to re-order on or after October 19, 2020.
At this time, no vaccine supply issues or delivery delays by manufacturers are known to the province; however, this could change as we approach flu season and could impact delivery timelines and shipments. We will communicate any further information about vaccine distribution as we receive it.
Further details about the UIIP program can be found at:
http://www.health.gov.on.ca/en/pro/programs/publichealth/flu/
Should you have any questions, please contact the immunization program at 705.522.9200, ext. 301.
Sincerely,
Original Signed By
Dr. Penny Sutcliffe
Medical Officer of Health and Chief Executive Officer
NOTE: All Advisory Alerts are found on our website.
This item was last modified on September 30, 2020