General practitioners may be asked to test and vaccinate individuals, or to work with an employer (such as a meat processor) to test and vaccinate their staff.
A detailed flowchart showing the GP process is shown at the bottom of the page.
Detailed information about the use of Q-VAX®, including pre-vaccination testing, is available from CSL, including a Q-VAX Product Information Sheet. The Australian Immunisation Handbook also has valuable information. This checklist highlights the important steps in the process:
- 1. Check
- Check if a person seeking vaccination has already been vaccinated.
- Ask them to call the Australian Q Fever Register on 1300 733 837 (1300 QFEVER).
- 2. Test
- Test for previous exposure or vaccination.
- Blood test - CFT antibody test.
- Skin test - intradermal hypersensitivity test.
- 3. Vaccinate
- If both tests are negative (and there are no other contraindications), vaccinate.
- 4. Register
- Record the test results and (if given) vaccination on the Q Fever Register using your password to log on.
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Brief updates on problem issues
From time to time the Register becomes aware of issues that are problematic for patients or health professionals regarding Q fever testing and vaccination procedures. Where possible we seek to obtain professional advice on these issues as a service for patients and their health providers. Here are some current issues and information.
- 1. Timing of blood test and skin test procedures
- The Register has recently become aware that some patients undergoing routine testing may be receiving skin test antigen days or weeks before they have blood drawn for serology testing. This issue is not explicitly addressed in the Australian Immunisation Handbook 10th Edition (2013) section on Q Fever. We asked Dr Stephen Graves (Medical Director, Australian Rickettsial Reference Laboratory) for information on the timing of skin tests and blood tests in patients. Dr Graves indicated that general principles would suggest that blood be collected for serology either before or at the same visit as initial administration of skin test antigen. Skin tests involve administering small amounts of Q Fever antigen to patients and examining the injection site for a local reaction or induration. Blood tests involve testing for presence of circulating antibody to Q Fever. If blood collection is delayed for several days or weeks after the skin test procedure it is possible that the serology result could be influenced by the skin test procedure.
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Do you want to be a registered user?
Medical practitioners do not need to be a registered user of the Q Fever Register to perform Q fever testing and vaccination for a patient. Any medical practitioner can download relevant forms from this website and send completed forms to the Register and Register staff will manage data entry and complete the process of issuing a Q Fever card. Completed forms may be sent to the Register by mail, fax or as scanned .pdf attachments to an email. The important bits are to ensure the forms are complete, that the patient signs the consent form, and that the forms are clear and able to be read by Register staff when they arrive at the Register.
There are benefits for practices in becoming a registered user. Practice staff can enter patient details directly into the Register through a web browser and can look up patient Q fever status. Completed forms still need to be sent to the Register to ensure the Register has a full record of the test and vaccination procedures and a signed consent form. Information about becoming a registered user and submitting patient details is provided below.
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Becoming a registered user - Getting a password
Access to the register is limited by password to ensure privacy and accuracy of the data. Getting a password is quick and simple and is only required once. When you are issued with a password, you can submit patient details whenever you need to as well as verify a persons status (with their permission).
- 1. Download, print and complete two forms:
- The application form. This is used to confirm that you are a medical practice and therefore have the right to access the register.
- The user registration form. This is used to request a password and to record the details of the person/people from your practice who require access to the register and who will be responsible for submiting data.
- 2. Mail or scan and email the completed signed forms to the Register (details below).
- 3. The Register staff will create a user account, and call you back with your password (normally within one day of receipt of the forms).
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Completing the relevant paperwork for each patient
It is important that a record of every person tested and (if indicated) vaccinated be submitted to the Register, unless the person refuses registration. This will help prevent the risk of vaccination of previously vaccinated individuals, and save the time and expense of retesting of people that have already been tested or vaccinated. To prepare the paperwork for submission to the Register:
- 1. Download, print, and ask the patient to complete and sign the Personal Details and Consent Form. This form is used by the Register to enter each patient's details onto the Register. This form also provides the patient's signed consent to authorise the Register to store information for that patient. There are two important points about this form. First, the Register cannot enter a patient onto the Register or issue a Q Fever card if this form is not completed and signed. Second, this form is only useful for Register purposes and as a result Register policy is that copies of this form should not be retained by the health professional or employer. Depending on how completed forms are submitted to the Register it may be useful to retain copies of all paperwork for a period of time as a risk mitigation approach against inadvertent loss of paperwork during submission.
- 2. Provide evidence of the test result and vaccination status by one of the following two options:
- Download the Pre-screening and vaccination form from the Q Fever website Download Area page. This form is intended to be printed out and completed and signed by the health professional and provides a medical record of test results and vaccination status. You can attach a copy of the pathology report or other documentation to this. A copy of this form may be retained by the practice as a medical record for each patient. The Register must receive a legible copy of this form - preferably the original.
- OR, some practices may use their own form to provide medical evidence of test results and vaccination status. It should provide the same information as is on the Pre-screening and vaccination form from the Q Fever website Download Area page.
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Submitting completed paperwork to the Register for each patient
1. If your practice has not gone through the application process to become a Registered User, then you can simply collate the paperwork for each patient and send it to the Register by mail, fax or email (as scanned .PDF documents). See the contacts page for details.
2. If your practice does have a Registered User then follow these steps to submit a patient record to the Register:
- Log on to the Register (http://www.qfever.org) using your password
- Click on Register a new person and enter the patient's details from the Consent Form.
- As you do this, the Register page will assign and display a Q Fever Register Number to that newly created patient record. Be sure to write the patient's assigned Q Fever number on their Consent Form in the box in the top right corner of the form
- Click on Add Test Result Data and enter the test results. If vaccinated, click on Add Vaccination Data to add vaccination details.
- As you add each item (test results and vacc status) the Register page will assign and display a Q Fever Register Reference Number. Be sure to record the Q Fever Fever Reference Numbers on the Pre-screening and vaccination form in the boxes provided.
- Once the patient details are entered, you can then mail, fax or scan and email the Consent Form and the evidence of test results and vaccination (e.g. the Pre-screening and vaccination form) to the Register. See the contacts page of this website for deails.
3. The Q Fever Register receives the paperwork and completes a detailed check of paperwork information against entered information (reconciliation). A scanned copy of the paperwork is archived as an auditable record of identification and Q fever immune status for each patient. Once reconciliation is complete, a Q Fever Card is printed and mailed to the patient as a permanent record of their Q Fever status. This process may take up to two weeks from when paperwork is mailed - allowing time for mail receival and reconciliation and printing and mail out of cards.
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Benefits of the register
The Australian Q Fever Register was established to help protect people working in at-risk environments.
- Saves time
- Prospective employees can immediately prove that they are immune by showing their Q Fever card or phoning the Register (if they have lost their card).
- There is no need to wait one week for the test results.
- There is no need to try to find records of tests or vaccination from other employers or medical practices.
- Medical practices no longer receive requests to dig up old patient test and vaccination records.
- Saves money
- Unnecessary re-testing of individuals is avoided.
- The cost of seeking patient records is eliminated.
- Protects health
- Instantly access to a patient's immune status removes the risk of serious hypersensitivity reactions following second vaccinations.
- Providing employers with quick access to a person's immune status makes it easier for them to ensure that their workforce is properly protected.
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Getting more information
For more information, including help on accessing or using the Register, please call the Q Fever help-line:
1300 QFEVER (1300 733 837)
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