Influenza vaccination

The Massachusetts Department of Public Health (MDPH) recommends annual influenza vaccination for everyone 6 months and older with any licensed, age-appropriate flu vaccine (IIV, RIV4, or LAIV4) with no preference expressed for any one vaccine over another. For people 65 years and older, three flu vaccines are preferentially recommended: Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine.

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General resources

The CDC has released the ACIP flu recommendations in this report: Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2022-2023 Influenza Season. You may review the 4-page pdf summary here 2022-23 Summary of Flu Vaccine Recommendations suitable for printing. 

The CDC Seasonal Influenza Vaccination Resources for Health Professionals resource page has information about the current influenza season, dosage and administration, vaccine composition, storage and handling, target groups for vaccination, supply and distribution, effectiveness and safety, and patient education.  

The CDC Strategies for Increasing Adult Vaccination Rates resource page highlights strategies to increase adult vaccination rates, including making a strong recommendation, reminder systems, and how to improve coverage rates for high-risk populations.  

The CDC Flu Vaccine Safety Summary for Clinicians page reviews seasonal influenza safety resources including key facts and safety associated with each type of vaccine.  


Planning clinics and campaigns

The National Adult and Influenza Immunization Summit created resources to assist in the planning and operation of vaccination clinics, including annual flu clinics, school-based clinics, and vaccination clinics. This document summarizes key points in running a successful clinic, and provides links to many other useful resources. Learn more: Tools to Assist Satellite, Temporary, and Off-Site Vaccination Clinics  

CDC also has a clinic resource page entitled Guidance for Planning Vaccination Clinics Held at Satellite, Temporary, or Off-Site Locations, which outlines the logistics and considerations needed to plan a vaccination clinic. 

Public providers interested in holding vaccination clinics may benefit from enrolling in the Vaccine Reimbursement Program for Public Providers. Commonwealth Medicine, the health care consulting division of UMass Medical School, manages this program that reimburses public providers for vaccines and their administration by billing health plans.  

Influenza vaccines may be given at the same time as other vaccines, including COVID-19 vaccines. CDC's clinical guidance for the use of COVID-19 vaccines states that any vaccine may be given on the same day or any day before or after COVID-19 vaccination, at a different anatomic site. If administered at the same time, COVID-19 vaccines and influenza vaccines that might be more likely to cause a local reaction (aIIV4 or HD-IIV4) should be administered in separate limbs, if possible. Learn more: Coadministration of COVID-19 vaccines with other vaccines.  

Screening forms

Always screen patients for contraindications and precautions before a vaccine is administered, even if the same vaccine was administered previously. A patient’s health status or the recommendations for contraindications and precautions may have changed since the last dose was given. Screening helps prevent adverse reactions, such as anaphylaxis. At each visit, use a standardized screening tool to assess patients consistently and correctly. Screening forms can be found at the Immunization Action Coalition website.  

Clinic Vaccine Administration Record (DOC) is an important tool for vaccination clinics. It serves as a centralized location to keep track of required documentation for vaccinations, including brand and lot number of vaccine administered, dose, and route of administration.  

The Withdrawal of Permission Sample Form for Schools  can be modified by districts/schools to fit their needs. It can be used for parents to withdraw previously given permission for a child to receive a vaccination at school.  

MDPH has developed Model Standing Orders for influenza and other vaccine preventable diseases.  

For guidance on how to properly store vaccines, please visit the Vaccine Management page as well as the CDC Vaccine Storage and Handling Toolkit

Influenza vaccination of healthcare personnel (HCP)

Healthcare personnel are at high risk for influenza exposure and illness and may be a source of influenza virus transmission in healthcare settings. Annual influenza vaccination is the best method of preventing influenza and potentially serious complications. The Healthy People 2020 goal for influenza vaccination among healthcare personnel is 90%. You may also review the Influenza Vaccination Coverage Among Health Care Personnel during the 2021-22 influenza season (PDF).

As a condition of licensure, MDPH regulations require health care facilities, including hospitals, ambulatory surgical centers, dialysis centers, clinics, nursing homes, rest homes, and adult day health programs to offer free-of-charge, annual influenza vaccine to all personnel (full and part-time employees, contracted employees, volunteers, house staff, and students), and document receipt of influenza vaccine administered and declination of immunization. Licensed facilities are also required to report information to MDPH documenting compliance with the vaccination requirement. MDPH has a website with hospital circular letters related to season influenza vaccination requirements for health care personnel. Read the MDPH flu vaccination report for healthcare personnel.

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