Influenza: the green book, chapter 19

Influenza immunisation information including updates for public health professionals.


Influenza: the green book, chapter 19


Influenza is an acute viral infection of the respiratory tract.

There are 3 types of influenza virus: A, B and C. Influenza A and influenza B are responsible for most clinical illness. Influenza is highly infectious with a usual incubation period of 1 to 3 days.

Published 20 March 2013
Last updated 10 November 2023 + show all updates
  1. Updated information on co-administration, seasonal timing of vaccination, trivalent vaccines, disease surveillance, vaccine uptake and risk groups. Added occupational vaccination section.

  2. Updated to include information on timing of Novavax COVID-19 vaccination.

  3. Chapter extensively revised with new and updated information.

  4. Updated to include information on the recombinant quadrivalent influenza vaccine.

  5. Updated the asthma and egg allergy sections and added information on newly licensed influenza vaccines.

  6. Updated section on administration of flu vaccine and general editing.

  7. Updated information on influenza vaccination in the elderly relating to the adjuvanted influenza vaccine.

  8. Updated information on influenza vaccination relating to the benefit of quadrivalent vaccines.

  9. Clarification regarding asthma and egg allergy; updated background on the decision to extend vaccination to children, the choice of the LAIV vaccine and the benefit of quadrivalent vaccines.

  10. Extension of the influenza programme to children section has been deleted.

  11. The flu chapter of the Green Book has been updated to reflect the latest guidance from the Joint Committee on Vaccination and Immunisation in readiness for the 2015 to 2016 influenza season.

  12. The flow chart at figure 19.2 (page 203) has been updated.

  13. Fluarix trivalent inactivated flu vaccine added to table 19.6 (version 8.0). Please note that the previous version of this chapter was incorrectly labelled v6_0, it should have been v7_0.

  14. In Table 19.6, InfluvacDesu® vaccine has been renamed Influvac®.

  15. The information regarding the administration of flu vaccine to those with egg allergy has been clarified.

  16. Information about the use of flu vaccines in those with egg-allergy has been clarified.

  17. Four-year-olds erroneously omitted from the flow chart in the children not in a clinical at-risk group have now been added.

  18. Chapter fully updated to reflect the influenza vaccination programme for winter 2014 to 2015.

  19. Chapter largely rewritten to bring it into line with the current policies and procedures for the administration of the flu vaccine for winter 2013 to 2014.

  20. Updated Body text to include a link to National Archives (chapter update patches) and NHS Choices.

  21. First published.