Engaging Hospital Emergency Departments as Vaccinators During a Hepatitis A Outbreak

About the Program

Category: Health (Best in Category)

Year: 2018

San Diego County has been experiencing the third largest hepatitis A outbreak in the United States since the introduction of the hepatitis A vaccine in 1995. This on-going outbreak began in November 2016 and included 580 cases and 20 deaths as of February 7, 2018. This outbreak disproportionately affects the homeless and illicit drug using populations. After recognizing the outbreak, several mass vaccination events were conducted leading staff to discern that reach to these populations was limited as they may not readily seek medical services and lacked transportation services to access care. It became evident that vaccinating these difficult-to-reach populations required unique strategies. Targeting homeless and illicit drug users in the emergency department (ED) was a strategy San Diego County deployed across the county. This had been previously done in one Boston ED during their 2004 hepatitis A outbreak (http://www.jem-journal.com/article/S0736-4679(07)00643-9/fulltext). The County of San Diego Public Health Service’s Immunization Program offered the local hospital emergency departments hepatitis A vaccine and all were supportive of efforts to vaccinate the outbreak at-risk populations as these patients were assessed for issues not related to hepatitis A infections. This public-private partnership with hospitals helped reach those who may have been otherwise unreachable.