Six influenza vaccines, two of which will be adjuvanted and will be available exclusively for those over the age of 60 will be released this year as stated in a circular on “Instructions for Seasonal Flu 2023-2024 – Influenza Vaccination”, by Deputy Health Minister Irini Agapidakis.

At the same time, vaccination instructions are given in the circular and it is stated that the influenza vaccine is prescribed based on the instructions of the National Immunization Program.

It is recalled that last year any of the groups recommended to be vaccinated could be vaccinated without a medical prescription. This report has caused the strong reaction of pharmacists.

In particular, the vaccines that will be released are:

Vaxigrip Tetra (Vianex) QIVe 15 mcg of each antigen, from 6 months

Fluarix Tetra (GSK) QIVe 15 mcg of each antigen, from 6 months

Flucelvax Tetra (Sequirus) QIVc 15 mcg of each antigen, from 2 years (EMA)

Influvac – sub Unit Tetra QIVe 15 mcg of each antigen, from 6 months

Efluelda** (Vianex) QIV-HD 60 mcg of each antigen from 60 years

Fluad Tetra** (Sequirus) aQIV 15 mcg of each antigen + MF59 adjuvant, from 65 years

What we need to know about new vaccines

The enhanced quadrivalent inactivated QIV-HD and aQIV vaccines are highly immunogenic and qualified for the prevention of laboratory-confirmed influenza and hospitalizations in persons 60 years of age and older. They have a satisfactory safety profile and although the incidence of adverse events was higher than after vaccination with conventional influenza vaccine, overall it was low.

It is noted that although the boosted quadrivalent inactivated QIV-HD (high-dose vaccine) and aQIV (adjuvanted vaccine) are preferred in persons aged 65 years and older over conventional influenza vaccine, it is emphasized that if unavailable, influenza vaccination should not be delayed and recommended to be carried out with any vaccine.

The EEE recommends especially for people aged 75 and over due to immunosenescence to be vaccinated with the above-mentioned enhanced vaccines.

According to the National Vaccination Program of our country, the influenza vaccination recommendations for the upcoming season 2023/24 include the following population groups or situations of increased risk as a priority:

People aged 60 and over

Children (6 months and older) and adults with one or more of the following aggravating factors or chronic diseases:

  • Chronic respiratory diseases, such as asthma, chronic obstructive pulmonary disease.
  • Heart disease with severe hemodynamic disturbance
  • Immunosuppression (hereditary or acquired)
  • Organ transplantation and bone marrow transplantation
  • Sickle cell anemia (and other hemoglobinopathies)
  • Diabetes mellitus or other chronic metabolic disease
  • Chronic kidney disease
  • Chronic liver diseases
  • Neurological-neuromuscular diseases
  • Down syndrome
  • Pregnant women regardless of gestational age, lactating and lactating women.
  • People with morbid obesity (Body Mass Index >40Kg/m2) and children with BMI >95th CI.
  • Children who take aspirin long-term (eg for Kawasaki disease, rheumatoid arthritis and others).
  • People who are in close contact with children younger than 6 months or care for or live with people with an underlying illness, which increases the risk of flu complications. Closed populations, such as staff and internal students (of schools, military and police schools, special schools, etc.), new recruits, institutions for the chronically ill and accommodation units for the elderly, detention centers.
  • Workers in health service provision areas (medical and nursing staff, other workers, students of health professions in clinical practice) and in refugee-immigrant accommodation centers.
  • Homeless.
  • Veterinarians, poultry farmers, pig farmers, breeders, slaughterers and general people who come into systematic contact with birds or pigs.

Vaccine administration instructions

Influenza vaccine should be given early and before the start of the usual flu season, as it takes about 2 weeks to develop an immune response. Preferably, the vaccination should be completed at least 4-6 weeks before the start of the annual epidemic wave of influenza in Greece (ie mid-to-late November). In addition, vaccination continues throughout the flu season for people who are eligible for vaccination and did not get vaccinated in time.

Influenza vaccination generally includes only 1 dose of the vaccine per year.

* Infants and children aged =6 months are given 0.5 ml (the entire dose), according to the instructions from official European or other drug agencies (FDA, EMA, etc.).

Co-administration with the coronavirus vaccine

The flu vaccine can even be given on the same day as the coronavirus vaccine – but at different anatomical sites – as well as any other day before and after the coronavirus vaccine.

Influenza vaccination and COVID-19 infection

  • Asymptomatic people who have been in contact with a confirmed case of COVID-19 and have a negative laboratory test can be vaccinated as normal.
  • Symptomatic patients with COVID-19 infection or other respiratory infection should postpone their vaccination until symptoms of the disease have resolved.

Prescribing flu shots

The influenza vaccine is prescribed according to the guidelines of the National Immunization Program.

We underline that every flu vaccination must be registered by the health professional who administers it in the National Immunization Registry.