Key messages
- Q fever is a zoonotic bacterial disease that can cause acute flu-like illness and long term complications.
- Q fever vaccine provides safe and effective protection against Q fever and is recommended for people aged 15 years and above who are at risk of infection.
- People who have previously had Q fever or have already received the Q fever vaccine should not be vaccinated due to the risk of adverse reactions.
- People are recommended to have both serological and skin tests before Q fever vaccination.
- The Australian Immunisation contains information about who should be vaccinated, pre-vaccination testing and how people are vaccinated.
Overview
Q fever is caused by the bacterium Coxiella burnetii (C. burnetii). C. burnetii infects wild and domestic animals, and their ticks. Humans are mainly infected from cattle, sheep and goats, however a wide range of animals can also spread the bacteria to humans. This includes domestic and feral dogs and cats, feral pigs, horses, rabbits, rodents, alpacas, camels, llamas, foxes, and Australian native wildlife (including kangaroos, wallabies and bandicoots).
Who is at risk?
Workers in the following occupations are at high risk of Q fever:
- abattoir and meat workers
- livestock and dairy farmers
- farm workers
- shearers, wool classers/sorters, pelt and hide processors
- stockyard/feedlot workers and transporters of animals, animal products and waste
- veterinarians, veterinary nurses/assistants/ students and others working with veterinary specimens
- wildlife workers working with high-risk animals (including Australian native wildlife)
- agriculture college staff and students (working with high-risk animals)
- laboratory workers (working with the bacteria or with high-risk veterinary specimens
- animal shooters/hunters
- dog/cat breeders, and anyone regularly exposed to animals who are due to give birth
- pet food manufacturing workers
- people whose work involves regular mowing in areas frequented by livestock or wild animals e.g. council workers, golf course workers or staff of mowing businesses in regional and rural areas.
All workers who enter workplaces in which Q fever may be present are also at risk of infection. This includes tradespeople, contractors, labour hire workers, sales representatives, buyers, emergency services workers and council workers.
Other people may be at risk of Q fever through contact with high-risk animals outside of work. It can also occur in regional and rural areas by breathing in infected dust and particles in the environment.
Other people at increased risk of Q fever include:
- family members of those in high-risk occupations (from contaminated clothes, boots or equipment)
- people who live on or near a high-risk industry (e.g. neighbouring livestock farms, stockyards housing cattle/sheep/goats, meatworks, land being fertilised with untreated animal manure)
- visitors to at-risk environments (e.g. farms, abattoirs, animal saleyards and agricultural shows)
- people in contact with high-risk animals outside of work
- people in regional and rural areas who are more likely to breathe contaminated dust and particles in the environment
- horticulturists or gardeners in environments where dust, potentially contaminated by animal urine, faeces or birth products, is aerosolised (made airborne e.g. lawn mowing).
Recommendations for Q fever immunisation
People whose work puts them in contact with high- risk animals or animal products have a high risk of getting infected with Q fever. The vaccine is strongly recommended for people aged 15 years and over who work in high-risk occupations.
Vaccination is also recommended for anyone aged 15 years and over who may come into contact with Q fever bacteria during activities outside of work or in the areas in which they live, work or visit. Your doctor will help you decide if vaccination is right for you.
Q fever vaccination and immunity can now be recorded on the Australian Immunisation Register (AIR).
For further information see the Australian Immunisation .
Q fever vaccine contraindications and precautions
Not everyone can be vaccinated. Those with a known allergy to egg proteins should not be vaccinated. Pregnant women, children under 15 years of age and those with weakened immune systems should obtain specialist advice before considering vaccination. For all others, pre-vaccination screening is necessary to identify who can be vaccinated.
For further information on contraindications and precautions see the Australian Immunisation .
Q fever vaccine effectiveness
The Q fever vaccine (Q-VAX®) has been licensed for use in Australia since 1989 and has shown to be highly effective in preventing Q fever infection. Vaccine efficacy is estimated to be 83-100%, based on the results of open placebo-controlled trials, and post marketing studies.
Pre-vaccination screening
People who are being considered for Q fever vaccination must have both serum antibody testing and a skin test before Q fever vaccination. The tests can be done on the same day. This is to identify people who have been previously infected with the Q fever organism and are not aware of it. These people are likely to have adverse reactions to the vaccine, based on hypersensitivity to the organism. People who have been previously infected with the Q fever organism should not be vaccinated.
Pre-vaccination testing is not needed for people who have:
- a documented history of previous infection with Q fever
- already received a Q fever vaccine (with documentation).
For further information on pre-vaccination screening and interpreting the serological skin test results see the Australian Immunisation .
Q fever vaccine safety
The vaccine has been shown to be safe provided the screening tests mentioned above are done. Minor skin reactions are common 3 to 4 days after the initial skin test, however, these reactions usually go away after 7 days, which is when the skin test is read by your doctor.
Common side effects to the vaccine include injection site reaction (pain, heat, swelling and redness, flu-like symptoms, headache and fever). Serious side effects are very rare. The vaccine is not a live vaccine and cannot cause Q fever infection.
Visit your doctor and discuss whether vaccination for Q fever is appropriate for you. Further information can also be found in the Australian Immunisation .
For more information, see Recommended vaccines for people at increased risk of certain occupationally acquired vaccine-preventable .
Q-VAX records
- The Q fever skin test and vaccine are not funded under the National Immunisation Program. Speak to your doctor or employer about the costs involved. Costs are also tax deductible for most at-risk occupations (see ATO Office advisory for further ).
- From 15 April 2024, Q fever vaccination (QVAX) records are stored on the Australian Immunisation Register (AIR). Vaccination providers can also report natural immunity information to the AIR.
- The Australian Q Fever will store historical records on the Q fever immune status of individuals until 30 June 2025 (it commenced full national coverage on 1 July 2002). Individuals can take their Q fever vaccination evidence (Q fever eStatement) to an immunisation provider in Australia and request their vaccinations be reported to the AIR.
Q fever vaccine providers
Clinics wanting to be added to the list of Victorian Q fever vaccine providers, should complete the following form and submit to infectious.diseases@health.vic.gov.au.
CSL have developed a guide for immunisation providers with tips and advice on establishing and conducting Q fever vaccination . It also provides advice on how these clinics may be further improved or expanded. You will need to log in or register to access these resources.
Reviewed 20 November 2024