Impact of hepatitis A vaccination of Indigenous children on notifications of hepatitis A in north Queensland

Jeffrey N Hanna, Susan L Hills and Jan L Humphreys
Med J Aust 2004; 181 (9): 482-485.


Objective: To describe the impact of a hepatitis A vaccination program for Indigenous children in north Queensland.

Design: Enhanced surveillance of all notified cases of hepatitis A in north Queensland from 1996 to 2003.

Setting: North Queensland; population, 596 500 people, including about 6900 Indigenous children aged under five years.

Interventions: Hepatitis A vaccine was provided to Indigenous children in north Queensland from February 1999; two doses were recommended (at 18 months and 2 years of age), as was catch-up vaccination up to the sixth birthday.

Results: In the 4 years 1996–1999, 787 cases of hepatitis A were notified in north Queensland, 237 (30%) of which were in Indigenous people. The average annual notification rates in Indigenous and non-Indigenous people during this period were 110 and 25 cases per 100 000 persons, respectively. In the first 4 years after introduction of the vaccination program (2000–2003), 66 cases of hepatitis A were notified. Only nine of the 66 (14%) were in Indigenous people. The average annual notification rates in Indigenous and non-Indigenous people in 2000–2003 were 4 and 2.5 cases per 100 000 persons, respectively.

Conclusion: Hepatitis A seems to have been eradicated from Indigenous communities in north Queensland very soon after the vaccination program began. The rapid decline in notifications in non-Indigenous as well as Indigenous people suggests the program quickly interrupted chains of transmission from Indigenous children to the broader community. To our knowledge this is the first evidence that a hepatitis A vaccination program targeting a high-risk population within a community can reduce disease in the broader community. Hepatitis A vaccine should be provided to other high-risk Indigenous children elsewhere in Australia.

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  • Jeffrey N Hanna1
  • Susan L Hills2
  • Jan L Humphreys3

  • 1 Tropical Public Health Unit Network, Queensland Health, Cairns, QLD.
  • 2 Tropical Public Health Unit Network, Queensland Health, Aitkenvale, QLD.



We thank all those in the Communicable Diseases Unit and the Tropical Public Health Unit Network, Queensland Health, who assisted in the planning and implementation of the program. We particularly wish to thank all the vaccine service providers in north Queensland who have supported the roll out and maintenance of the program.

Competing interests:

Dr Hanna has received funding from vaccine companies to attend conferences and workshops.

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