If they don’t agree, both players will remain stood down and risk sitting the season out without pay.

After Queensland Chief Medical Officer Dr Jeanette Young confirmed that players were only exempt from the vaccination rule on medical grounds, the Titans made formal requests to the players to “obtain up-to-date influenza and, as required, pneumococcal vaccinations.”

“Doing so will enable each player to meet the requirements of the Queensland State Government’s protocols allowing Queensland-based NRL clubs to train and play,” the Titans said in a statement.

“In turn, this will allow both players to resume training and to play with the Titans when the NRL Telstra Premiership resumes on May 28.

“Both players have been asked to notify the club of their agreement with this direction by Thursday 14 May.”

The Queensland Government will not allow any NRL player who is not vaccinated to train or play games in the state.

All NRL players are required to have flu shots under the NRL’s Project Apollo health and biosecurity guidelines.

While Prime Minister Scott Morrison has also strongly supported the “no jab, no play” rules, some other states and clubs have provided players the option of signing a waiver so they could be exempted for a range of reasons from the condition.

Young said on Monday that exemptions to the flu shot condition in Queensland were only allowed on medical grounds, which meant players who refused a flu shot for ethical or religious reasons would not be allowed to play in the state.

“I sent a letter to the NRL yesterday in which I did exempt them for medical contrary indications,” Young said on Tuesday.

“If they have had an anaphylactic reaction to a previous flu vaccine or any component of a flu vaccine, you do not need to be vaccinated so I have provided that exemption.”

Kelly and Cartwright, who has pulled back from his strong “anti-vaxxer” position amid the controversy and instead argued he was “pro-choice” on vaccinations, have declared philosophical objections to receiving the shots.

It is understood they would both sacrifice around $400,000 in pay this season if they continued to reject the flu-shot condition to play.

Titans hooker Nathan Peats, along with Cartwright and Kelly, was stood down for not having the vaccinations on Friday.  But Peats, who objected originally on medical grounds after he had a bad reaction to a vaccination in 2012, has since had a flu vaccination.

National health advice has urged Australians to get a flu shot as getting flu and COVID-19 at the same time can make you very ill. Authorities have also urged people to get the vaccination so hospitals aren’t clogged with flu patients.

According to Queensland Health there has been a dramatic drop in the number of people across the state being diagnosed with influenza. As the state nears its peak flu season of August, Queensland last week recorded just six cases of flu, compared to more than 800 in mid-March.

Queensland Health authorities said coronavirus-related measures including border closures, travel restrictions and social distancing have contributed to the low results.

This article is supported by the Judith Neilson Institute for Journalism and Ideas