Welcome to the Department of Health Care Services Welcome to Medi-Cal Welcome to the Department of Health Care Services

Medi-Cal Logo
Click to Sign Up for MCSS emails

Update: Immunize to Prevent and Control Hepatitis A Outbreaks

September 28, 2017

Outbreaks of hepatitis A disease continue in California, primarily affecting people who are homeless or using illicit drugs. In San Diego County at least 440 cases and 16 deaths have been reported since November 2016. In Santa Cruz County at least 69 cases have been reported since April 2017. Additional cases due to the same strain of hepatitis A virus (HAV) have been identified in Los Angeles and other California counties, as well as in other states; see the CDPH Weekly Update on Hepatitis A Outbreak on the California Department of Public Health (CDPH) website for updated information.

Hepatitis A is being spread person-to-person and through contact with contaminated environments; persons infected with hepatitis A virus who do not thoroughly wash their hands can easily spread the infection to others. 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. Severe illness can occur in persons with underlying health conditions, particularly those with liver diseases such as cirrhosis, chronic hepatitis B infection or chronic hepatitis C infection.

The California Department of Public Health recommends providers offer HAV vaccine to all Californians for whom any of the following applies:

  • are homeless or at risk of being homeless.
  • use illicit drugs.
  • have chronic liver disease (including infection with hepatitis B or C).
  • are men who have sex with men.
  • seek protection from hepatitis A.
  • are children 1 – 18 years of age.

In California jurisdictions with hepatitis A outbreaks, immunization should also be offered to people who have frequent close contact with people who are homeless or using illicit drugs (homeless shelters, jails, food pantries, drug rehabilitation programs, first responders, etc.).

As a reminder, Hepatitis A vaccine given to Medi-Cal-eligible children younger than 19 years of age should be provided through the Vaccines for Children (VFC) program and not submitted as a Medi-Cal claim.

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.

Under the Patient Protection and Affordable Care Act (ACA), Hepatitis A immunizations recommended by the federal Advisory Committee on Immunization Practices (ACIP), including those provided to Californians seeking protection from Hepatitis A disease, must be covered without patient co-payments by all Covered California plans and most other private insurance plans when immunization is provided by an in-network provider.

Pharmacy providers are encouraged to stock and administer HAV vaccine to at-risk patients upon request.