Canadian influenza vaccine guidelines for 2022-23 now available

The National Advisory Committee on Immunization (NACI) has released the influenza vaccine guidelines for the 2022-2023 flu season. Canadian healthcare providers are advised to offer seasonal influenza vaccine as soon as possible after it becomes available in the fall, since seasonal influenza activity may start as early as October in the Northern Hemisphere. As with previous annual flu guidelines, the 2022-2023 guidelines continue to focus on clinical information for vaccine providers. This includes key information on “what, who, how and why” for influenza/influenza vaccine; epidemiology of influenza; vaccine products authorized for use in Canada; efficacy, effectiveness and immunogenicity of influenza vaccines; choice of seasonal influenza vaccine; vaccine administration; vaccine safety and adverse events; and information for travellers. Read: Testing, testing: How one LGBTQ+-focused clinic is looking to tackle the pandemic lapse in STI, HIV and other testing NACI recommends offering influenza vaccine annually to anyone six months of age or older who does not have contraindications to the vaccine. Particular focus should be placed on the groups for whom influenza vaccination is particularly recommended. These include people at high risk of influenza-related complications or hospitalization, those capable of transmitting influenza to those at high risk of influenza-related complications or hospitalization, and those who provide essential community services. More extensive information on vaccine preparations authorized for use in Canada is provided, including details about inactivated influenza vaccines, the new recombinant quadrivalent influenza vaccine and the live attenuated (intranasal) influenza vaccine, along with dosage schedule information, specifics about simultaneous administration of flu vaccine with other vaccines and additional vaccine safety considerations (e.g., egg-allergic individuals, Guillain-Barré syndrome). A separate section discusses the choice of seasonal influenza vaccine in children (6-23 months of age; 2-17 years of age) and adults (18-59 years; 60-64 years; ≥ 65 years; adults with chronic health conditions; pregnant women; and healthcare workers). An appendix summarizing the characteristics of vaccine products available for the 2022-2023 flu season is also provided. New or updated information in the 2022–2023 influenza vaccine guidelines: NACI notes that the 2022–2023 flu vaccine guidelines are intended to be used in conjunction with NACI’s guidance on the use of influenza vaccine in the presence of COVID-19 (available at https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/guidance-use-influenza-vaccine-covid-19.html). Administration of COVID-19 vaccines may occur at the same time as, or at any time before or after influenza immunization (including all seasonal influenza vaccines or live attenuated influenza vaccine [LAIV]) for those aged 12 years or older (as of September 2021). Supemtek (recombinant quadrivalent seasonal influenza vaccine [RIV4]), the first (and currently only) recombinant influenza vaccine licensed in Canada, is included in the 2022-2023 guidelines. It is indicated for use in adults (≥ 18 years of age). NACI concluded that Supemtek may be considered for use among the quadrivalent influenza vaccines offered to adults 18 years of age and older (Discretionary NACI Recommendation). Updated recommendations are provided on mammalian cell culture-based quadrivalent influenza vaccine (Flucelvax Quad). It is the first (and currently only) mammalian cell culture-based inactivated seasonal influenza vaccine available for use in Canada. It was originally indicated for use in in adults and children (≥ 9 years of age). However, it is now approved for use in patients two years of age or older. NACI concluded that Flucelvax Quad may be considered among the quadrivalent influenza vaccines offered to adults and children two years of age or older. Recent changes that have not yet been incorporated into the guidelines: Influvac Tetra egg-based, subunit, quadrivalent inactivated influenza vaccine is now authorized by Health Canada for use in patients six months of age or older. It was previously indicated only for persons three years of age or older. Flucelvax Quad standard dose mammalian cell culture-based quadrivalent inactivated influenza vaccine is now authorized by Health Canada for use in persons six months of age or older. It was formerly indicated for use only in patients two years of age or older. NACI notes that the updated authorized ages for use of these two vaccines supersedes the information for Influvac Tetra and Flucelvax Quad found in Table 2, Table 3 and various other sections within the 2022–2023 guidelines. Reference 1. National Advisory Committee on Immunization (NACI). An Advisory Committee Statement (ACS). Canadian Immunization Guide chapter on influenza and statement on seasonal influenza vaccine for 2022-2023. (accessed June 21, 2022)

Canadian influenza vaccine guidelines for 2022-23 now available

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