Flu vaccine

Flu prevention is important to protect people and the health-care system

The goals for the 2024–25 flu season are to protect the health of individuals and communities and mitigate impacts on the healthcare system, particularly with COVID-19 and respiratory syncytial virus (RSV) also circulating. There are five products available for administration in this season’s publicly funded influenza immunization program.

Products available for 2024-25

The publicly funded vaccines available for the 2024-25 season are:

Vaccine product & company

Age indication

FluLaval Tetra
Quadrivalent inactivated vaccine (QIV) egg-based
GSK

Six months and older

Fluzone® Quadrivalent
QIV egg-based
Sanofi Pasteur

Six months and older

Flucelvax® Quad
QIV cell culture-based
Seqirus

Six months and older

Fluzone® High-Dose Quadrivalent
QIV-HD egg-based
Sanofi Pasteur

65 years and older

Fluad®
Adjuvanted trivalent inactivated vaccine (TIV-adj) egg-based
Seqirus  

65 years and older

All products should be administered at a dose of 0.5 ml except Fluzone® high-dose quadrivalent (QIV-HD), which should be administered at a dose of 0.7 ml.

Other flu vaccines not publicly funded for the 2024-25 season, including FluMist® Quadrivalent (intranasal spray) and Supemtek™ (recombinant protein vaccine) may be purchased by patients at a pharmacy.

Recommendations for 2024-25

High-risk and priority populations to receive flu vaccines as soon as they become available

The provincial supply of vaccines will be available to hospitals and long-term care homes at the end of September. Retirement homes and other settings with vulnerable populations, physicians, pharmacies, and all other providers/organizations will be provided with vaccine supply by early- to mid-October. 

Based on information provided by the National Advisory Committee on Immunization, the Ministry of Health recommends that the following high-risk individuals and priority populations be prioritized for the flu vaccine as soon as it becomes available:

  • Health-care workers
  • First responders
  • Residents, staff and care providers of congregate living settings
  • People 65 years of age and older
  • Pregnant individuals
  • Children six months to four years of age
  • Individuals in or from First Nations, Inuit, or Métis communities
  • Individuals from racialized and other equity-deserving communities
  • Individuals six months of age and older with certain underlying health conditions
  • Individuals with significant exposure to birds or mammals (such as poultry, livestock, slaughterhouse and processing plant workers, wildlife officers/researchers, and veterinarians)

The flu vaccine is recommended for all people aged six months and older without contraindication. Individuals in the following groups are particularly recommended to receive the flu vaccine when it becomes available to the public starting Oct. 28:

  • Individuals capable of transmitting influenza to high-risk groups and/or to infants under six months old
  • People who provide essential community services

Refer to the 2024/2025 Universal Influenza Immunization Program for a detailed list of patients recommended to get the flu vaccine.

Administer flu, COVID-19 and RSV vaccines at the same time 

Flu vaccines can be administered to patients six months of age or older at the same time as, or at any time before or after routine vaccines, including COVID-19 and RSV vaccines.

Consider offering flu and COVID-19 vaccines together during appointments or clinics.

There are, however, no direct studies on the co-administration of Shingrix® with Fluad® (TIV-adj) or Fluzone® High-Dose Quadrivalent (QIV-HD). With Fluad®, it is unknown how the adjuvants may interact when Shingrix® is co-administered.

Vaccines given during the same visit should be given at different injection sites on separate limbs. Alternatively, vaccines may be administered into the same muscle if separated by at least 2.5 cm/1 inch. Use a different needle and syringe for each vaccination.

Informed consent for co-administration should include a discussion of the benefits and potential risks given the limited data available on the administration of COVID-19 vaccines at the same time as, or shortly before or after, other vaccines.

Wait until Oct. 28 to run community flu vaccine clinics

Physicians should wait until Oct. 28 to run large-scale community clinics to ensure an adequate flu vaccine supply can be ordered for their clinic.

Do not book appointments before receiving flu vaccines in case of unexpected delays or restrictions on vaccine availability.

Offer available flu vaccines to patients 65 years+

Patients 65 years of age and older should not delay flu vaccination to wait for a particular vaccine product.

Among the products indicated for those aged 65 and older, there is no preferential recommendation for using Fluzone® High-Dose Quadrivalent inactivated vaccine (QIV-HD) over Fluad® adjuvanted trivalent (TIV-adj) vaccine due to insufficient evidence.

Where available, offer Fluzone® QIV-HD or Fluad® TIV-adj over standard-dose QIV for adults 65 years of age and over.

Defer flu vaccines for patients who are ill or self-isolating

Patients who have any type of severe acute illness, with or without fever, should wait until their symptoms subside before getting the flu vaccine.

Immunization should not be delayed because of minor acute illness, with or without fever.

Maintain the post-vaccination observation period

The Canadian Immunization Guide recommends a post-vaccination observation period of at least 15 minutes. If there is a specific concern about a possible vaccine allergy, an observation period of 30 minutes is a safer interval.

Ordering flu vaccines

The first set of vaccine orders to physicians is expected to be delivered in early-to-mid October. Connect with your Public Health Unit for more ordering information.


Billing

Billing codes for administering the flu vaccine vary depending on whether you are a primary care provider who is:

  • Part of a Family Health Organization (FHO) or Family Health Network (FHN)
  • Fee for service

The flu vaccine G590 is in basket for FHN physicians. 

Sole purpose for visit

  • Service: G590  flu vaccine
  • Premium: Q590A
  • Tracking code: Q130A

With assessment

  • Service: G590  flu vaccine + assessment fee code
  • Tracking code: Q130A

Flu vaccine (add-on to visit)

  • Fee: $5.65 
  • Fee code: G590 

Note: Flu vaccine assessment is not separately billable, it is included in this billing code. If an assessment is performed in the same visit as the flu vaccine but is unrelated to the flu vaccine, then the appropriate assessment fee is eligible for payment.  

Flu vaccine (sole purpose for visit)

  • Fee: $5.65 + $5.60 
  • Fee code: G590 + G700 

Note: If the flu vaccine is the sole reason for the visit, G700 may be eligible for payment in addition to G590.  Eligibility requirements for G700 are on page J3 of the current OHIP schedule.

If you are administering the flu vaccine at the same time as a COVID-19 vaccine, you can bill G590 ($5.65) for the flu vaccine in addition to the applicable COVID-19 vaccine fee codes. If these two vaccines are the sole reason for the patient’s visit, G700 can be applied. 

G700 is not eligible for payment if both of these apply: 

  • A consultation or assessment is payable to the same physician for the same patient on the same day
  • That physician has a financial interest in the facility where the service is rendered

Note:

  • G700 is not eligible for payment for a service provided in a hospital
  • G700 is not eligible for payment when the service marked with ( + ) is not eligible for payment
  • G700 is payable at 15 per cent of the listed fee when the service is rendered to a patient who has signed the ministry's Patient Enrolment and Consent to Release Personal Health Information form and who is enrolled to a physician or group of physicians who are signatories to a ministry alternate funding plan agreement paying physicians primarily by capitation rather than fee for service. This applies regardless of which physician of the group renders the service to the enrolled patient