Which Cities Control Hepatitis A Outbreaks the Best?

As the hepatitis A outbreak expanded during 2017, local health leaders took action to reach their most at-risk populations.

And these actions paid immediate dividends.

Since March 2017, the Centers for Disease Control and Prevention’s (CDC) Division of Viral Hepatitis has been assisting several state and local health departments with hepatitis A outbreaks, spread through person to person contact.

The CDC notified all state and local health departments about clusters of hepatitis A, genotype IB infections in people who are homeless and/or use injection and non-injection drugs.

Hepatitis A is very contagious, and usually spreads when a person unknowingly ingests the virus from objects, food, or drinks contaminated by small, undetected amounts of stool from an infected person, says the CDC.

Given that just a single dose of the hepatitis A vaccine is 90 percent effective at preventing infection, what can cities do to increase immunizations?

It appears various cities are tackling their hepatitis A outbreaks differently, but with one common denominator, local leadership.

Hepatitis A vaccination uptake increased significantly after local leaders started speaking to the public about the severity of this disease.

These local health leaders worked with nurses, homeless outreach workers and law enforcement officers who took vaccination efforts into soup kitchens and assistance centers, where vaccination campaigns began.

And the immunization benefits are being realized immediately.

As an example, in San Diego, public health officials declared a public health emergency on Sept. 1, 2017, with a broad range of actions. These actions included installing portable toilets and regularly washing city sidewalks with a bleach solution to help make conditions more sanitary for those living on the streets.

In Salt Lake County Utah, the Board of Health temporarily required food service workers to be vaccinated for hepatitis A following a recent outbreak.

In Ann Arbor, Michigan, local leaders extended community clinic hours to become more accessible. 

In Kentucky, state legislators approved legislation requiring students to obtain hepatitis A immunization prior to school matriculation.

In the USA, there are three FDA approved hepatitis A vaccines:

• Vaqta and Havrix are approved for people ≥12 months of age in a 2-dose series
• A combined hepatitis A and hepatitis B Twinrix vaccine is approved for people ≥18 years of age in the United States

Adults with hepatitis A might have the following symptoms:

• fatigue,
• low appetite,
• stomach pain,
• nausea,
• and jaundice, that usually resolves within 2 months of infection.

Children, less than 6 years of age do not have symptoms or have an unrecognized infection. Antibodies produced in response to hepatitis A infection last for life and protect against reinfection.

The CDC Vaccine Price List provides current HAV vaccine contract prices and general information.

Most community health centers, pediatricians, and pharmacies offer hep A vaccines.

Vaccine discounts can be found here.

Vaccines, like any medicine, can have side effects, says the CDC. You are encouraged to report negative side effects of vaccines to the FDA or CDC.