Key messages

  • There is an outbreak of hepatitis A in Victoria with over 150 cases and at least one confirmed death.
  • Of the confirmed cases, most are male, many of whom report male-to-male sexual activity, and some have identified as people who inject drugs. Homeless people who are sleeping rough and adult prisoners are emerging risk groups.
  • Offer free hepatitis A vaccine to all men who have sex with men (MSM), people who have injected drugs in the past 12 months, homeless people who are sleeping rough, and adult prisoners. The two-dose hepatitis A vaccination is free for these groups until 30 June 2019.
  • Consider hepatitis A infection and take blood for serology (IgM) in patients presenting with a compatible clinical illness who are MSM, PWID, rough sleepers or have other risk factors. Advise that sexual activity should be avoided while results are pending.
  • Notify all suspected cases of acute viral hepatitis without waiting for serology results to the Department of Health and Human Services by calling 1300 651 160.

To combat an outbreak of hepatitis A in Victoria a free course of hepatitis A vaccine is available until 30 June 2019 for the following high-risk groups: men who have sex with men (MSM); people who have injected drugs in the past 12 months; homeless people who are sleeping rough; and adult prisoners.

All eligible groups can access the vaccine through GP clinics, community health services and all other registered immunisation providers in Victoria, including sexual health clinics.

View the latest Chief Health Officer alert: Outbreak of hepatitis A in Victoria 

Why has the free vaccine program been introduced?

There is an outbreak of locally acquired hepatitis A in Victoria. Most cases report MSM sexual activity, and some have identified as people who inject drugs. A number of cases have visited sex-on-premises venues or report using dating apps or websites. Emerging risk groups include homeless people who are sleeping rough and adult prisoners.

Read more about hepatitis A risk in Victoria

Who is eligible to receive the free vaccine?

The vaccine is free and available until 30 June 2019 for all MSM, people who have injected drugs in the past 12 months, homeless people who are sleeping rough, and adult prisoners if they live in Victoria.

Why has this cohort been chosen?

Adults who identify as MSM and people who inject drugs appear to be at highest risk; however, local transmission to others has also been found. Emerging risk groups include homeless people who are sleeping rough and adult prisoners. It is important that all MSM, people who inject drugs, rough sleepers and adult prisoners are protected against this disease. In particular, all men who have close or intimate contact with other men they have met through a website or app, or in bars, clubs or parties are strongly encouraged to get vaccinated against the disease.

Who can administer the free vaccine?

All eligible people can access the vaccine through GP clinics, community health services and all other registered immunisation providers in Victoria, including sexual health clinics.

What hepatitis A vaccine is supplied under the program and what age group can it be administered to?

The hepatitis A vaccine brand supplied is Havrix 1440®.

Havrix 1440® is an adult formulation of inactivated hepatitis A virus vaccine. The vaccine is registered for use from 16 years of age and older.

What does this vaccine protect against?

Havrix 1440® provides protection against hepatitis A infection.

How is the Havrix 1440® presented?

Havrix 1440® presents as a 1.0ml dose in a pre-filled syringe.

Some stock will be delivered with a needle for injection, however, future stock will not contain a needle and immunisation providers will need to supply the injection needle.

How is Havrix 1440® administered?

Havrix 1440® is administered by intramuscular injection into the deltoid muscle.

How many doses are required and what is the spacing interval between doses to complete a course?

Havrix 1440® is a two dose course with the second dose given six to 12 months after the first dose.

This is a time-limited vaccine program ending 30 June 2019 so to complete the free vaccine course in a timely manner, it needs to be commenced as soon as possible.

If an eligible person received a complete course of hepatitis A vaccine previously, do they still require a free booster dose of Havrix 1440® vaccine now?

No. A complete course of hepatitis A vaccine provides protection against hepatitis A infection.

There is no current evidence that booster doses are required; in healthy individuals, it is quite possible that they will never be required.

If an eligible person did not receive a complete course of hepatitis A vaccine previously, do they require a free dose of Havrix 1440® vaccine now?

Yes. They should receive the Havrix 1440® vaccine to complete their course of hepatitis A vaccination.

The minimum spacing between the first and second dose of monovalent hepatitis A vaccine is six months.

If the hepatitis A course was commenced more than six months ago or an age appropriate paediatric formulation was given initially, the course can be completed now with the Havrix 1440® vaccine.

If a hepatitis A vaccine course was started with a brand different to Havrix 1440®, does the course need to be started again?

If the hepatitis A course was commenced with a brand different to Havrix 1440®, the course can be completed with the Havrix 1440® vaccine.

If the eligible person previously commenced their hepatitis A vaccine course using the combination hepatitis A/hepatitis B vaccine, Twinrix®, what vaccination is given to complete their course?

If the hepatitis A vaccine course was previously commenced with Twinrix® (the combination hepatitis A/hepatitis B vaccine) the person should complete their course with the Twinrix® brand.

However, Twinrix® is not a free, government supplied vaccine and would need to be purchased on prescription.

Are there any timing interval considerations for vaccine administration with hepatitis A, hepatitis B and HPV vaccines?

The hepatitis A, hepatitis B and HPV vaccines are inactivated vaccines and can be administered on the same day, or at any time before or after, each other using different injection sites separated by 2.5 cm.

Can a person who is living with HIV be vaccinated with Havrix 1440® vaccine?

Yes. Persons who are eligible for vaccination under this program, who are also persons living with HIV, can be given Havrix 1440® vaccine and it does not adversely affect either the HIV load or CD4+ cell count.

If an eligible person receives the two dose course of Havrix 1440® vaccine, is a booster dose required later?

No. A complete two dose course of Havrix 1440® provides protection against hepatitis A infection.

There is no current evidence that booster doses are required; in healthy individuals, it is quite possible that they will never be required.

Can Havrix 1440® be administered with other vaccines offered free to MSM?

Yes. Multiple vaccines can be administered on the same day at different injection sites.

For more information about free vaccinations for MSM, download the important health information for men who have sex with men fact sheet.

For more information about free vaccinations for people who inject drugs, download the important health information for people who inject drugs fact sheet.

Are there any vaccine side effects for Havrix 1440®?

The most common side effect following administration of Havrix 1440® vaccine is a mild local reaction of short duration.

Systemic adverse events such as headache and fever are much less common than the local injection site reaction.

Important information

Important health information for men who have sex with men: a guide for health professionals and immunisation providers - factsheet
Important health information for people who inject drugs: a guide for health professionals and immunisation providers - factsheet
Important health information for prisoner immunisation providers and prison staff - factsheet
Important information for homeless people who are sleeping rough - factsheet
Online vaccine order forms
Hepatitis A - Infectious diseases information and advice
Hepatitis A risk in Victoria

Consumer information

Better Health Channel: Time to immunise