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COVID-19 and Influenza incidence increasing across HNECC

Typically, the start of winter has seen the numbers for respiratory diseases such as COVID-19 and Influenza increase across NSW.

In mid-May (week ending 13 May), the Hunter, New England and Central Coast region saw a 19.4% increase in reported COVID-19 case numbers, and a 40.8% increase in Influenza notifications.


Due to the decline in reporting of positive RATs, current case numbers are likely underreported, however sentinel sewer surveillance and infection rates of healthcare workers (used as an indicator of community transmission) suggests that community transmission in NSW is increasing and occurring at high levels.

The data suggests that the rise in case numbers may indicate the beginning of a fifth wave of COVID-19.

The Australian population displays a mixed level of immunity acquired through natural infection and vaccination, which declines over time. New variants can evade existing immunity, and booster vaccines for priority populations are an important measure to protect from developing severe disease, hospitalisation, and death.

People aged 90 and over continue to experience the highest burden of disease with a notable increase over the last weeks.

The Government encourages all practices to continue to support their local Residential Aged Care Facilities, Disability Support Services and vulnerable populations to provide out-reach services to ensure eligible people receive a winter dose of the COVID-19 and influenza vaccines.

To support practices further, the Government has created incentives through Medicare.
PDF Version Factsheet-Medicare Support for COVID-19 Vaccinations-20.01.2023.pdf (

ATAGI Recommendations:

All adults who have not had a COVID-19 booster or a confirmed COVID-19 infection in the past six months are eligible to receive a booster for additional protection. (ATAGI 2023 booster advice | Australian Government Department of Health and Aged Care)

ATAGI recommends a booster for:

  • All adults aged 65 years and over.
  • Adults aged 18-64 years who have medical comorbidities that increase their risk of severe COVID-19, or disability with significant or complex health needs.

ATAGI advises the following people to consider a 2023 booster dose:

  • All Adults aged 18-64 years without risk factors for severe COVID-19
  • Children and adolescents aged 5-17 years who have medical comorbidities that increase their risk of severe COVID-19, or disability with significant or complex health needs.

ATAGI currently does not recommend a booster dose for children and adolescents aged under the age of 18 who do not have any risk factors for severe COVID-19.


Rates of influenza have been stable across all ages except those aged 0 to 4 and 5 to 16 years where rates are currently increasing (NSW Respiratory Surveillance Report - week ending 13 May 2023).

It’s anticipated that community immunity against influenza is less than in pre-COVID-19 times due to reduced influenza infections during COVID-19 lock-downs plus lower influenza vaccine uptake in recent years.

People at higher risk of developing severe influenza illness are eligible for free (NIP funded) vaccination (Influenza (

ATAGI recommendations (ATAGI advice on seasonal influenza vaccines in 2023 (
  • Children aged 6 months to under 5 years of age.
  • People witch severe chronic health conditions (e.g., severe asthma, diabetes, cancer, obesity, kidney, heart, lung or liver disease, immunocompromised patients).
  • Pregnant patients.
  • Aboriginal and Torres Strait Islander people aged 6 months and over.
  • People aged 65 years and over.

Providers are encouraged to download and review the NSW Health Influenza Vaccination Provider Toolkit and Getting prepared - 2023 influenza vaccination program resources.

Travellers: People who are planning international travel should ensure they have had a 2023 influenza vaccination before departure.

COVID-19 and Influenza vaccination at the same visit

Providers are reminded that ATAGI have advised that a COVID-19 vaccination and an influenza vaccination can be administered at the same time. These services may be provided during the same attendance. While a medical practitioner is not required under law to bulk-bill an attendance for influenza vaccination, a patient who also receives a COVID-19 booster vaccination as part of the same occasion of care must be bulk billed for the MBS COVID-19 vaccine suitability assessment component of the overall service.
See Medicare factsheet.

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