Q-Vax Q fever vaccine failures, Victoria, Australia 1994-2013

Vaccine. 2017 Dec 18;35(51):7084-7087. doi: 10.1016/j.vaccine.2017.10.088. Epub 2017 Nov 10.


Q-Vax®, a whole cell formalin inactivated vaccine, is currently the only licensed Q fever vaccine for humans world-wide. Efficacy is high, although vaccine failures have been described for those vaccinated within the incubation of a naturally acquired infection. In Australia, it is widely used to prevent occupational acquisition of Q fever and is the mainstay for outbreak control. A retrospective review of all notified cases of acute Q fever to the Victorian department of health, 1993-2013, revealed 34 of 659 cases were previously vaccinated and 10 cases were positive on pre-vaccination screening, precluding vaccination. Twenty-one cases described high-risk exposures for C. burnetii prior to and within 15 days post vaccination and are likely to have been vaccinated within the incubation period of a natural infection. Thirteen cases described symptom onset more than 15 days post vaccination and thus may represent the first described series of Q-Vax vaccine failures following appropriate vaccination.

Keywords: Coxiella burnetii; Q fever; Q-Vax®; Vaccine failure.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Bacterial
  • Bacterial Vaccines / administration & dosage
  • Bacterial Vaccines / adverse effects*
  • Bacterial Vaccines / immunology
  • Coxiella burnetii
  • Disease Outbreaks / prevention & control
  • Humans
  • Male
  • Middle Aged
  • Occupational Diseases / epidemiology
  • Q Fever / epidemiology*
  • Q Fever / prevention & control*
  • Retrospective Studies
  • Treatment Failure
  • Vaccination*
  • Victoria / epidemiology
  • Young Adult


  • Antibodies, Bacterial
  • Bacterial Vaccines