Influenza for Healthcare Providers

The following list of resources will assist healthcare providers during the influenza season. Please note: This web page is updated with the latest documents and links on a regular basis.

• Timelines for eligibility:
• Outlines the high-risk and priority groups that should be prioritized, starting in late September, to receive influenza vaccines as soon as doses are available.
• All individuals 6 months of age and older will be eligible for influenza vaccine starting October 27, 2025.
• Health Care Provider Fact Sheets:
• Influenza Immunization Information for the 2025/2026 Influenza Season
• Influenza Immunization healthcare provider fact sheet for individuals 6 months to 64 years of age
• Influenza Immunization healthcare provider fact sheet for individuals > 65 years of age
• Pharmacy Program
• Reimbursement for vaccine administration

 Influenza Vaccine Products

Several influenza vaccine products are available for Ontario’s 2025-2026 UIIP program.

• The vaccine products include protection against the strains of influenza recommended by the World Health Organization for the northern hemisphere’s 2025-2026 influenza season.
• The chart below outlines the influenza vaccine products available.
• Download and print the Middlesex-London Health Unit’s 2025-2026 UIIP Vaccine Chart (PDF) for reference.

Product / Manufacturer	Age	Dose	Format	Vaccine type and common allergens*
Fluviral (GSK)	6 months and older	15ug / 0.5ml IM	MDV	Egg based: allergens include egg protein, formaldehyde, thimerosal
Fluzone (Sanofi Pasteur)	6 months and older	15ug / 0.5ml IM	MDV and PFS	Egg based: allergens include egg protein, formaldehyde, and thimerosal (MDV only)
Flucelvax (Seqirus)	6 months and older	15ug / 0.5ml IM	PFS	Cell culture based: NO allergens
Fluzone-HD (Sanofi Pasteur) -high dose	65 years and older	60ug / 0.5ml IM	PFS	Egg based: allergens include egg protein, formaldehyde
Fluad (Seqirus) -adjuvanted	65 years and older	15ug / 0.5ml IM	PFS	Egg based: allergens include egg protein, formaldehyde, kanamycin, neomycin

*Any vaccine component could be a potential allergen. This chart identifies the most common allergens only.

• The National Advisory Committee on Immunization (NACI) indicates that egg allergy is not a contraindication for influenza vaccination and that egg-allergic individuals may be vaccinated against influenza using the full dose of any age-appropriate product.

 Notes:

• All influenza vaccine products are Trivalent (TIV) this year instead of Quadrivalent (QIV).
• There are two A strains and one B strain contained in each vaccine, following the World Health Organization (WHO)’s recommendations. Specific strains are listed in the Ministry factsheets.
• Fluzone and Fluzone High Dose (HD) are different products.
• Fluzone HD should only be administered to individuals who are 65 years of age and older.
• Delaying vaccination to wait for a specific product is not recommended. There is no preference between TIV high dose (HD) or TIV adjuvanted vaccines for those over the age of 65 years. If the products are not available, these individuals may receive the other TIV standard dose products.

Ordering Influenza Vaccine

• All HCPs who order vaccines (excluding pharmacies) must use the online Public Health Ordering System (PHOS)
• To register for PHOS, your organization’s primary contact must complete the online registration form.
• All providers may start to order influenza vaccine the week of September 22, 2025. Orders may be adjusted by MLHU to allow for equitable distribution. Once your order has been placed, you will receive an email indicating your order has been approved and a pick-up date will be provided. Please wait for the confirmation email before booking your courier. Larger or additional pre-conditioned coolers may be required for your order.
• If you have any questions about ordering, email VaccineOrders@mlhu.on.ca or call 519-663-5317 (ask to speak with the Vaccine Preventable Disease Team).

Seasonal Influenza Vaccine Consent Form

Download and print the Middlesex-London Health Unit’s Seasonal Influenza Vaccine Consent Form(PDF). HCPs and organizations may use their own consent form if preferred.

• Disclaimer: The MLHU does not use this consent form as our workflow differs; however, this has been shared for information purposes and may be adopted by the partner agency at their discretion; however, it does not constitute legal advice on how to manage consent within your setting.

Co-Administration of Influenza Vaccines with Other Vaccines

Influenza vaccines may be given at the same time, or at any time before or after other vaccines, including COVID-19 and respiratory syncytial virus (RSV) vaccines or monoclonal antibody (MAb).

• If given by injection at the same time, separate limbs should be used if possible. Injections administered into the same muscle should be spaced at least 1 inch (2.5 cm) apart. Different immunization equipment (needle and syringe) must be used for each vaccine.
• Note: There are no direct studies on the co-administration of Shingrix with Fluad (TIV-adj) or Fluzone High-Dose Trivalent (TIV-HD). With Fluad, it is unknown how the adjuvants may interact when Shingrix is co-administered.

Influenza Immunization Reporting Forms

• Reporting for Health-Care Worker (HCW) influenza immunization (Ministry of Health)

Influenza Outbreak Resources

• Visit the Middlesex-London Health Unit’s Outbreak Resources website for information and resources on the following:
• Outbreak Reporting Forms
• Line Lists
• Outbreak Management Resources
• Antivirals
• IPAC Hub related information and support

Specimen Collection and Testing

• Public Health Ontario Test Information Index
• Public Health Ontario Laboratory Services
• How To Do A Nasopharyngeal Swab

Surveillance

Local Surveillance

• Middlesex-London Health Unit Influenza Surveillance Reports
  The Middlesex London Health Unit’s Influenza Surveillance Report is published weekly during the influenza season (November to May). The purpose of the influenza surveillance report is to provide a picture of influenza activity in Middlesex London.

Provincial Surveillance

• Ontario Respiratory Virus Tool
  The Ontario Respiratory Virus Tool provides comprehensive epidemiological information of respiratory virus activity in Ontario, including COVID-19, influenza and other respiratory viruses.

National Surveillance

• Flu Watch - Public Health Agency of Canada
  Please note: This web page provides a weekly summary of influenza activity in Canada.

Resources

• Ministry of Health and Long Term Care - Influenza
• Immunize Canada Influenza Resources
• Health Care Provider Fact Sheets:
• Influenza Immunization healthcare provider fact sheet for individuals 6 months to 64 years of age
• Influenza Immunization healthcare provider fact sheet for individuals > 65 years of age