Centre for Disease Control Health Protection Department of Health Postal Address:
PO Box 40596 Casuarina Tel: 08 89228144 Fax: 08 82228310 Our Ref:DD22015/04221
Dear Immunisation Provider
RE: Free adult hepatitis B vaccine for all Indigenous people up to age 50 years - Indigenous adult hepatitis B program
Why vaccinate adult Indigenous people?
The most recent Australian data from the Australian Society for HIV Medicine Hepatitis B mapping project shows the NT to have the highest prevalence of hepatitis B in the country at 1.7% overall with 60% of those living with chronic hepatitis B being Indigenous Australians.
The key group of concern is Indigenous adults over the age of 25 years (i.e. born before universal vaccination). Hepatitis B vaccination coverage in infants and children is high at over 90%. Vaccination coverage in older adults is lower and people at high risk of hepatitis B infection such as household contacts may not be adequately vaccinated.
Who should be vaccinated?
Offer the 3 dose hepatitis B vaccine to any Indigenous adult 50 years and under who has not been previously vaccinated or does not have natural immunity from current or past hepatitis B infection. First check for a previous hepatitis B test and review the person’s problem list to see if there is hepatitis B sero-status code before vaccinating.
If you find no previous test and no previous vaccination history, test for HBsAg (to indicate current infection) and anti-HBc to indicate exposure (past or current infection). If these tests are negative offer the 3 doses of hepatitis B vaccine.
Adults who have had 1 or 2 doses of previous hepatitis B vaccine should finish the course of 3 vaccines and do not need to restart the course even if there has been a long interval between doses. Ideally the interval between dose 2 and 3 should be 5 months or longer.
Which vaccine?
Order hepatitis B vaccine from your regional pharmacy for the Indigenous adult program on the Vaccine order form .
Engerix-B® adult vaccine 1ml IMI should be given at 0, 1 and 6 months in people 20 years and over. People under 20 years can receive the paediatric Engerix-B® formulation.
• Do not test hepatitis B serology (anti-HBs) as a follow up after vaccination unless the person is in a high risk category such as a health care worker, on dialysis or a sexual partner of a person with hepatitis B infection.
ABN: 84 085 734 992 Department of Health is a Smoke Free Workplace
DEPARTMENT OF HEALTH
Hepatitis B vaccine and pregnancy
Hepatitis B vaccine can be given in pregnancy but is not routinely recommended. Consider giving it if the woman is in a relationship or living in a household with someone with
hepatitis B infection.
People on dialysis
People on dialysis need a larger dose of hepatitis B vaccine, as provided in H-B Vax II®
dialysis formulation (40ug) to be given at 0,1 and 6 months. Please order from the regional pharmacy and discuss with their primary health medical practitioner or renal team.
Thank you for assisting to reduce the burden of hepatitis B in Indigenous adults.
For further information please contact CDC on 08 892 28044 or see the NT hepatitis B vaccination and public health guidelines.
Yours sincerely
Dr Vicki Krause 27 May 2015
DD2015_04221 provider letter Hep B.pdf Page 2 of 3 www.nt.gov.au
Department of Health is a Smoke Free Workplace
DEPARTMENT OF HEALTH
Adult Hepatitis B coverage as recorded on NT immunisation register as at June 2013 (ABS estimates 2010 for population)
Dose 1
Indigenous Non Indigenous
Age Group (years)
Number Percentage (%)
Number Percentage(%)
15-19 6783 95 10367 106
20-24 3969 59 6247 51
25-29 3278 52 7731 52
30-39 1755 17 3763 14
>=40 1961 13 3513 5
Dose 2
Indigenous Non Indigenous
Age Group (years)
Number Percentage(%) Number Percentage(%)
15-19 5957 83 9242 95
20-24 3710 55 5696 47
25-29 2553 40 6984 47
30-39 1245 12 2978 11
>=40 1355 9 2483 4
Dose 3
Indigenous Non Indigenous
Age Group (years)
Number Percentage(%) Number Percentage(%)
15-19 5823 82 8602 89
20-24 3449 51 4971 39
25-29 1845 29 5988 41
30-39 794 8 2265 8
>=40 991 6 1714 3
DD2015_04221 provider letter Hep B.pdf Page 3 of 3 www.nt.gov.au
Department of Health is a Smoke Free Workplace