Gold Coast Public Health Update – Hepatitis B and Tetanus

This information has been provided by the Gold Coast Public Health Unit. If you require additional information or support, please contact the Gold Coast Public Health Unit on 5667 3200 or GCPHU-CDC@health.qld.gov.au.

Hepatitis B vaccination for people at higher risk

The following risk groups are NIP funded to receive hepatitis B vaccine if they are not previously vaccinated:

• Household or other close contacts of people with hepatitis B
• Sexual contacts of people with hepatitis B (+ hepatitis B immunoglobulin)
• Migrants (who have a Medicare card) from hepatitis B endemic countries
• People with chronic liver disease and/or hepatitis C
• People who inject drugs

Hepatitis B vaccine is recommended (but not funded) for others who may be at risk of hepatitis B (e.g. people in high-risk occupations, immunocompromised, GBMSM and sex industry workers). Refer to the online Australian Immunisation Handbook for more details.

Adult-formulation hepatitis B vaccine should be given in a 3-dose schedule. Anti-HBs levels should be checked 4-8 weeks after the vaccination course for higher risk individuals.

Non-responders to hepatitis B vaccine (primary 3-dose course) are recommended (but not funded) to receive:

• A single booster dose (4th dose) followed by anti-HBs levels 4-8 weeks afterwards.
• If negative, to receive 2 more doses of hepatitis B vaccine 1 month apart.
• Re-test the person for anti-HBs levels at least 4 weeks after the last dose.
• Persistent non-responders who are at high risk can be referred to QASIS who offer intradermal hepatitis B vaccination.

Preterm (<32 weeks gestation) and/or low-birthweight (<2000g) infants are recommended to receive a funded 5th dose of hepatitis B vaccine at 12 months of age.

Recommendations | Hepatitis B | The Australian Immunisation Handbook (health.gov.au)

Adolescents with tetanus-prone wounds

When adolescents present to your practice with a tetanus-prone wound, think “Do they also need their pertussis antigen?” before administering an ADT booster.

dTpa vaccine (Boostrix or Adacel) is funded through the National Immunisation Program (NIP) for all for adolescents and given through the School Immunisation Program (SIP) in Year 7 (aged 11–13 years old) or if missed at school, it can be given as a catch-up until 19 years of age.

The following steps are recommended:

• Check the adolescent’s AIR record – have they received their Year 7 dTpa booster dose?
  • If not, give a funded dose of Boostrix or Adacel instead of an ADT booster.
  • If given less than 5 years ago, a tetanus booster will not be required.

Adolescents | Pertussis (whooping cough) | The Australian Immunisation Handbook (health.gov.au)