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newsGP – Dengue vaccine available in Australia

ATAGI now recommends Qdenga for patients with a history of dengue fever who are travelling to endemic areas.

The dengue fever vaccine, Qdenga, is available in Australia for the first time, with GPs now able to order the vaccine for their practices.
 
The Australian Technical Advisory Group on Immunisation (ATAGI) recommends the live-attenuated tetravalent vaccine for people aged four and over with a confirmed or likely history of dengue who are travelling to dengue-endemic areas, or people without a history of dengue who are planning prolonged or repeated visits.
 
For people aged four an over without a history of dengue who are planning short-term travel, vaccination with Qdenga ‘can be considered … based on an individual risk-benefit assessment’, says ATAGI.
 
Qdenga is given in two 0.5 mL injected doses, administered at least 12 weeks apart.
 
ATAGI says both doses are essential to maximise the level and duration of protection. There is not yet sufficient evidence to inform recommendations on the use of booster doses. 
 
The dengue virus is the fastest growing communicable disease globally, with an estimated 100 million symptomatic cases annually.
 
Nearly all notified dengue cases diagnosed in Australia are acquired overseas by travellers returning from endemic countries.
 
Five of the top 10 most visited destinations for Australian travellers – Indonesia, Thailand, India, Vietnam and Fiji – are classified as having frequent or continuous dengue transmission, and account for nearly one third of short trips abroad by Australian residents.
 
In 2024 there were a record-high 2381 notifications for dengue virus infection in Australia, although this dropped to 1863 cases in 2025.
 
Dr Peter Markey, Chair of RACGP Specific Interests Public Health, told newsGP he would only advise people who have previously had dengue fever to definitely get the vaccine if they were travelling anywhere where it is prevalent.
 
‘If you haven’t had dengue before and you’re just going to Bali for a week, then the risk is small and you wouldn’t get much benefit,’ he said.
 
‘But if you’re going to Bali to live, or you’re going to live somewhere else where they have endemic dengue, then it would be appropriate to have it for the long term.’
 
There are four distinct serotypes of the dengue virus. Infection with one serotype results in lifelong protection against that serotype.
 
While severe dengue can occur with any dengue infection, a second infection from a different serotype can prove fatal, says Dr Markey.
 
‘Your first case of dengue primes you, and then the second case, which will be from a different serotype, might cause an immune response which can kill you or make you very sick,’ he said.
 
Dr Markey said developing a dengue vaccine has been difficult because of the immune basis of the disease.
 
‘The first one that came out was available only to people who had had dengue before, so it wasn’t for people who were naive to dengue,’ he said.
 
‘Now this one, obviously, it’s good for both groups.’
 
Although uncommon in Australia, dengue outbreaks have occurred in the past in northern and central Queensland and the Torres Strait.
 
These have been initiated from the introduction of the virus by infected travellers returning from overseas leading to a localised outbreak.
 
ATAGI advises that the vaccine can also be given during a local outbreak on the advice of public health authorities. 
 
For people living in those areas, Dr Markey says expert advice would be needed to determine who should receive the vaccine.
 
‘There may be a case for people with a history of the disease to have the vaccine in the setting of a local outbreak,’ he said.
 
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‘I thought my brain would explode’: How Ella’s family hike led to painful disease

Ella Stiebel’s skull was racked by pain. Days after a family hike through the Balinese jungle she became confined to a hotel room by an illness that made her too sick to eat, too weak to walk and so sensitive to light even looking at a phone screen made her wince.

“The night before we went home, I had a panic attack because I was in full belief that my brain was going to explode from the altitude on the plane,” Stiebel, a student social worker from Melbourne, said.

After 2½ weeks of sickness, a blood test confirmed the malady: she had dengue, a fever caused by a mosquito-borne virus that is spiking across popular tropical tourist destinations, and has also sparked a state of emergency in parts of Florida.

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