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Immunize to Prevent and Control Hepatitis A Outbreaks

August 11, 2017

Outbreaks of hepatitis A disease are currently ongoing in two California counties in people who are homeless and/or using illicit drugs. In San Diego County at least 228 cases and five deaths have been reported since November 2016. In Santa Cruz County at least 27 cases have been reported since April 2017. Cases due to the same strain of hepatitis A virus (HAV) have been identified in both counties as well as in Arizona and Utah. Transmission is presumed to occur person-to-person; no commercial product has been identified as being contaminated. Based on current information, all populations who are homeless and/or using injection and non-injection illicit drugs can be considered at risk of outbreaks if exposed to HAV.

The California Department of Public Health recommends providers offer HAV vaccine to people who are homeless or might be using illicit injection or non-injection drugs:

  • in jurisdictions with hepatitis A outbreaks.
  • for people who have frequent close contact with people who are homeless or using illicit drugs (for example, in homeless shelters, jails, food pantries, drug rehabilitation programs, etc.).

HAV vaccine given by fee-for-service pharmacy providers or Managed Care Plan network pharmacy providers is covered without prior authorization. Call the Plan’s member services telephone number (on the back of the patient’s Medi-Cal Benefits ID Card) to locate a network pharmacy and confirm availability of vaccination at the pharmacy. Local health departments can help identify resources for uninsured persons.

Pharmacy providers are encouraged to stock and administer HAV vaccine to at-risk patients upon request. Serologic testing for HAV infection is not recommended for asymptomatic people, nor is serologic testing for HAV immunity recommended as screening before vaccination.