Universal Influenza Immunization Program
Find information on the Universal Influenza Immunization Program (UIIP) information for the current influenza season.
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The Universal Influenza Immunization Program (UIIP) offers influenza vaccine free of charge each year to all individuals 6 months of age and older who live, work or go to school in Ontario.
Vaccination against influenza is important this fall given the potential for the co-circulation of other respiratory diseases (such as COVID-19). Preventing the flu is important to:
- protect individual health and the health of families and communities
- protect and mitigate impacts on our health care system
Timing of Immunization
Influenza immunization should be prioritized and vaccination may begin as soon as vaccine is available for:
- hospitalized individuals and hospital staff
- long-term care home (LTCH) residents, staff and caregivers
- residents and staff of retirement homes and other congregate living settings
- individuals at high-risk for flu related complications or hospitalization
- health care workers
- first responders
Vaccination may begin on October 30, 2023 for:
- general population (including the 3 particularly recommended groups)
Immunization of high-risk groups
The National Advisory Committee on Immunization (NACI) advises that the following individuals are at a higher risk of influenza-related complications or are more likely to require hospitalization and should receive vaccine as soon as it becomes available:
- residents of congregate living settings (such as chronic care facilities, retirement homes)
- people 65 years of age and over
- all pregnant individuals
- all children 6 months to 4 years of age
- individuals who are from a First Nation, Inuit or Métis community
- members of racialized and other equity deserving communities
- individuals 6 months of age and older with the following underlying health conditions:
- cardiac or pulmonary disorders
- diabetes mellitus or other metabolic disease
- conditions or medication which compromise the immune system
- renal disease
- anemia or hemoglobinopathy
- neurologic or neurodevelopment conditions
- morbid obesity (body mass index of 40 or more)
- children and adolescents (6 months to 18 years) undergoing treatment with acetylsalicylic acid for long periods
The influenza vaccine is recommended for all individuals 6 months of age and older without contraindications. However, per NACI, individuals in the following 3 groups are particularly recommended to receive the influenza vaccine and should receive the vaccine starting October 30, 2023.
Individuals capable of transmitting influenza to those listed in the high-risk group above and/or to infants under 6 months of age
- health care workers and other care providers in facilities and community settings
- household contacts (adults and children) of individuals at high risk of influenza related complications
- persons who provide care to children 4 years of age and under
- members of a household expecting a newborn during the influenza season
- those who provide services within a closed or relatively closed setting to persons at high risk of influenza related complications (crew on a ship, for example)
People who provide essential community services
Poultry industry workers
- Although seasonal influenza vaccination will not prevent avian influenza infection, NACI recommends seasonal influenza vaccination for poultry workers, based on the rationale that preventing infection with human influenza strains may reduce the theoretical potential for human-avian reassortment of genes, should such workers become co-infected with human and avian influenza viruses.
UIIP influenza vaccine products
Publicly funded influenza vaccines available for the 2023/2024 UIIP include:
- 6 months of age and older:
- Quadrivalent Inactivated Vaccine (QIV)
- 65 years of age and older:
- High-Dose Quadrivalent Inactivated Vaccine (QIV-HD)
- Adjuvanted Trivalent Inactivated Vaccine (TIV-adj)
Influenza vaccine administration
Publicly funded influenza vaccines must be administered by a regulated health professional who is authorized under the Regulated Health Professions Act, 1991 to administer vaccines, or by a trained individual under a delegation made in accordance with the requirements set by the regulatory College of the regulated health professional.
Trained pharmacists, pharmacy technicians, pharmacy students and interns may only administer vaccines to individuals 2 years of age and older.
Publicly funded vaccine may be administered to individuals who meet the eligibility criteria for the UIIP (such as individuals who are 6 months of age and older who live, work, or study in Ontario) and without contraindications to the vaccine.
Timing of product availability
Annual UIIP vaccine supply timeline
Mid to late-September
- The province begins receiving its initial supply of influenza vaccine doses in multiple shipments from manufacturers over several weeks. Initial supply is prioritized for hospitals and long-term care homes.
Early to mid-October
- The province continues to receive shipments of influenza vaccine throughout October from the manufacturers for distribution to all providers.
- As provincial stocks are replenished, deliveries continue with priority to retirement homes, congregate care settings and then primary care and pharmacies.
Mid to late-October
- Provincial influenza vaccine supply is replenished following initial distribution and additional shipments from vaccine manufacturers.
- Deliveries and orders continue across the province and settings.
- The province receives its final shipment of doses and orders additional doses as required from vaccine manufacturers.
- Deliveries and orders continue across the province and settings.
Vaccine wastage and cold chain requirements
Vaccine wastage due to spoilage or expiry is a concern for all immunization programs in Ontario, including the Universal Influenza Immunization Program. The Vaccine Storage and Handling Guidelines have been developed to facilitate proper storage and handling of publicly funded vaccines and minimize vaccine wastage as well as promote vaccine safety and effectiveness.
When minimum cold chain requirements are not met by a health care provider or setting, the public health unit has the authority to withhold vaccines until compliance issues have been resolved or until completion of other follow-up deemed necessary to ensure appropriate vaccine storage and handling.
Influenza vaccine ordering and return process
As in previous years, the receipt of influenza vaccine doses in the province begins in mid to late September, throughout October and into November. You will be notified by your vaccine supply source (such as your local public health unit, Ontario Government Pharmaceutical and Medical Supply Service or pharmaceutical distributor) when the vaccine is available.
Influenza vaccine ordering
- All providers (except pharmacists) within K, L, N and P postal codes order vaccine from local public health unit (PHU)
- All Toronto providers (except pharmacists) within M postal code order vaccine from the Ontario Government Pharmaceutical and Medical Supply Service (OGPMSS) by faxing the Influenza Vaccine Order Form for the UIIP to
- Pharmacists within M, K, L, N and P postal codes order vaccine from a pharmaceutical distributor as designated by the ministry
Influenza vaccine return process
You are required to report all vaccine wastage.
Return only unopened vials/syringes/ampoules to your local public health unit or OGPMSS (for Toronto clients) as wastage. Influenza vaccine should be returned using your public health unit’s vaccine return form.
Discard opened vials/syringes/ampoules through biohazard waste.
Any influenza vaccine that is returned to your local public health unit is considered wasted and will not be re-used.
To minimize vaccine wastage and ensure influenza vaccine availability for Ontarians, health care providers are encouraged to maintain minimal stock of influenza vaccine in cold chain to accommodate individuals who still are seeking influenza immunization between April and August.
Please report all temperature excursions promptly to your local public health unit in order to determine vaccine stability.
Please visit your local public health unit’s website or contact them directly regarding the process of returning vaccine.
Reimbursement for vaccine administration
Fee-for-service providers (such as OHIP-billing providers)
It is important for the ministry to capture administrative data on influenza immunization for the purposes of program monitoring and evaluation. Therefore, when billing through the Ontario Health Insurance Plan (OHIP), please select the applicable OHIP billing code that is specific for influenza immunization.
Physicians are encouraged to review the delegation requirements in the General Preamble of the Schedule of Benefits for Physician Services prior to holding immunization clinics. Physicians who have concerns regarding these requirements or who have additional questions should contact their local OHIP district office.
Injection-trained pharmacists (such as HNS-billing pharmacists)
Pharmacists will be paid a fee per eligible claim for publicly funded influenza vaccines administered to eligible Ontarians (with or without a OHIP card) who are 2 years of age and older.
The claim must be submitted through the ministry's Health Network System (HNS) using the assigned Drug Identification Number. The 2023/2024 updated Notice from the Executive Officer will provide further information on Pharmacist Administration of Publicly Funded Influenza Vaccine and Claims Submission using the HNS.
Health care agency-administered doses in pharmacies
The pharmacy will be reimbursed $5.00 for each dose of publicly funded influenza vaccine administered through health care agency-administered pharmacy clinics.
For a health care agency-administered pharmacy clinic to be eligible for reimbursement by the ministry all the following criteria must be met:
- health care agency-administered pharmacy clinics must be held within the physical boundaries of the pharmacy
- the pharmacy must retain the services of a health care agency that has completed the ministry prequalification process to administer publicly funded influenza vaccine
- influenza vaccine can only be administered in a location that is within the jurisdiction of the local public health unit where the vaccine was obtained
- clinics must be open to the public (open and accessible to any eligible vaccine recipient who lives, works or attends school in Ontario) and widely advertised in the community (such as local newspaper, posters)
- only administration of publicly funded influenza vaccine will be reimbursed (vaccine administered must not be obtained from a private supplier)
- all publicly funded influenza vaccines administered must be provided free of charge to the vaccine recipients and the ministry must not be billed for the administration of the influenza vaccines through any other mechanism (such as the ministry's Health Network System)
Complete a Universal Influenza Immunization Program Pharmacy Form to receive reimbursement for influenza vaccine doses administered during a health care agency-administered pharmacy clinic. Forms should be submitted monthly, with the total doses administered over the month. The form should be submitted to the ministry by the 15th of the following month. Clicking the submit button on the form will automatically send the form to the ministry.
It is the responsibility of the pharmacy owner or pharmacist to ensure that information on the Universal Influenza Immunization Program Pharmacy Form is completed in full prior to submission.
Universal Influenza Immunization Program Pharmacy Forms without a valid Ontario Drug Benefit (ODB) number cannot be paid as the ministry has no other means of providing reimbursement.
Community clinics (held by government transfer payment organizations only)
The ministry will reimburse government transfer payment organizations $5.00 for each dose of publicly funded influenza vaccine administered through community-based clinics open to the general public. Clinics for staff are considered workplace clinics and are NOT reimbursable.
Reimbursable clinics can only be provided by UIIP approved organizations that are in current receipt of government transfer payments (LTCHs, public hospitals and CHCs, for example) provided that all of the following conditions are met:
- the clinic is open and accessible to any eligible vaccine recipient (anyone who is 6 months of age or older who lives, works or attends school in Ontario)
- the clinic is widely advertised in the community
- only publicly funded vaccine must be used
- influenza immunization must be provided free of charge to the vaccine recipients
- publicly funded vaccine must be both obtained and administered within the jurisdictional boundaries of the same public health unit
- the ministry must not be billed for these immunizations through any other mechanism
Complete a Universal Influenza Immunization Program Reimbursement Form to receive reimbursement for influenza vaccine doses administered during an eligible community clinic. Forms should be submitted monthly, with the total doses administered over the month. The form should be submitted to the ministry by the 15th of the following month. Clicking the submit button on the form will automatically send the form to the ministry.
UIIP vaccine administration reporting
For the 2023/2024 UIIP season, the ministry no longer requires vaccine utilization reports from facilities that participate in the UIIP.
Reimbursement submission requirements for eligible organizations holding public influenza vaccine clinics still apply. Please see the Reimbursement for administration section for more information.
Reporting for Health Care Worker (HCW) influenza immunization
For the 2023/2024 influenza season, long-term care homes (LTCH) and public hospitals will be requested to report HCW immunization rates by mid- to late- January 2023 to the Ministry of Health via the survey tool that has been used in the previous 3 years. Once analysis has been completed, immunization coverage rates will be published by Public Health Ontario in the Ontario Respiratory Virus Tool.
Further detail regarding data collection of health care worker influenza immunization coverage rates for the 2023/2024 influenza season, including data collection forms, will be forwarded to the Communicable Disease Managers at public health units across Ontario for distribution to public hospitals and long-term care homes in the fall.
Reporting for Long-Term Care Home (LTCH) resident influenza immunization
For the 2023/2024 influenza season, long-term care homes (LTCH) will be requested to report resident immunization rates by mid- to late-January 2023 to the Ministry of Health via the survey tool that has been used in the previous 3 years.
Further detail regarding data collection of resident influenza immunization coverage rates for the 2023/2024 influenza season, including data collection forms, will be forwarded to the Communicable Disease Managers at public health units across Ontario for distribution to long-term care homes in the fall.
Community pharmacies must be approved by the ministry to participate in the UIIP to provide pharmacist-administered influenza vaccines to individuals 2 years of age and older.
Ministry approved pharmacies have met all requirements stipulated in the User Agreement. Information about the UIIP does not apply to pharmacies that provide services to in-patients/residents in hospitals and/or long-term care homes (LTCHs).
Pharmacies can refer to this flowchart to determine who to contact for specific questions related to the UIIP.
Additional resources and information
- NACI Canadian Immunization Guide Chapter on Influenza and Statement on Seasonal Influenza Vaccine for 2023/2024 is available on the Government of Canada’s website
- Canadian Immunization Guide section on early vaccine reactions including anaphylaxis (includes details on the management of anaphylaxis)
- Adverse Events Following Immunization (AEFIs) must be reported to your local public health unit
- Vaccine Storage and Handling Guidelines describes the provincial requirements that must be followed by all healthcare providers who handle publicly funded vaccines
- Temperature Log Book (PDF)
- Health Care Provider Qs & As: Influenza Immunization Information for the 2023/2024 Influenza Season (PDF)
- Health Care Provider Qs & As: Influenza Immunization Information for individuals 6 months to 64 years of age (PDF)
- Health Care Provider Qs &As: Influenza Immunization Information for individuals > 65 years of age (PDF)
For additional information: