Emergency Department-based Hepatitis A Vaccination Program in Response to an Outbreak

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Vaccinology

Background:

• A public health emergency for hepatitis A was declared in Philadelphia in August 2019.
• The emergency department (ED) serves a population with high-risk factors for hepatitis A transmission.
• This study evaluated an ED-based hepatitis A vaccination program implemented in partnership with the Philadelphia Department of Public Health (PDPH).

Purpose of the Study:

• To assess the impact of an ED-based hepatitis A vaccination program on the incidence of hepatitis A infection.
• To determine the effect of the vaccination program on hospital admissions for hepatitis A.
• To evaluate the effectiveness of a public health-ED partnership during a vaccine-preventable disease outbreak.

Main Methods:

• Retrospective review of ED visits over a 12-week period surrounding the vaccination program's implementation.
• All adult patients presenting to the ED were offered free hepatitis A vaccination, supplied by the PDPH.
• Comparison of hepatitis A diagnosis and hospital admission rates before and after the vaccination program's launch.

Main Results:

• A total of 10,033 ED visits were analyzed; 5009 before and 5024 after the program's implementation.
• 669 hepatitis A vaccines were administered within six weeks.
• Hepatitis A diagnoses decreased from 73 (67 admissions) before the program to 38 (31 admissions) after implementation.

Conclusions:

• The collaboration between the ED and PDPH effectively vaccinated a significant number of individuals during a hepatitis A outbreak.
• The program demonstrated a notable reduction in hepatitis A cases and associated hospitalizations.
• ED-based vaccination programs are effective in controlling outbreaks of vaccine-preventable diseases.