Vaccination efforts slow spread of Hepatitis A

Florida’s surgeon general is cautiously optimistic that education and vaccination efforts during the past few months are working to contain the spread of hepatitis A, which caused the declaration of a public-health emergency in August.

The state Department of Health said 33 new hepatitis A cases were reported last week, bringing the total this year to 3,221, as of Saturday. But while the numbers continue to rise, the pace has slowed from this spring and summer when the state routinely had up to 90 new cases reported each week.

“I think what we are seeing now is, as we are vaccinating more individuals the number of cases in those areas is going down,” Surgeon General Scott Rivkees, who doubles as secretary of the Department of Health, told The News Service of Florida in an interview Thursday. “This is something we are constantly working on.”

Hepatitis A is caused by a contagious virus that infects the liver. It can be spread through human feces if, for example, people do not wash their hands thoroughly after going to the bathroom. It also can be spread through sex and intravenous drug use.

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Rivkees has overseen an effort to combat the spread through vaccinations and hiring part-time employees, spending $2.9 million since Aug. 1.

Department spokesman Alberto Moscoso said the agency is projected to spend $12 million on vaccinations and part-time staff by June 30, the end of the current budget year.

In some counties, the department has gone door to door in neighborhoods encouraging people to get vaccinated. Rivkees is also asking the Legislature to set aside another $9 million to continue to vaccinate at-risk populations.

County health departments have administered 123,276 vaccinations this year to people who are considered “high risk,” which includes homeless people and drug users, according to state data. Nearly 47 percent of those shots, or 57,593, have been administered since Aug. 1, when Rivkees declared a public-health emergency. 

The shots administered since August have more than tripled the number of vaccinations the state administered in all of 2018, when the virus first started taking hold.   

Florida has an estimated 491,000 at-risk people who are susceptible to being infected with hepatitis A, according to the federal Centers for Disease Control and Prevention. To stop the spread of the virus, the CDC recommends that 80 percent of the at-risk population be vaccinated. That translates to about 392,000 people.

Rivkees estimated that the state has been successful in vaccinating 68 percent of the at-risk population in the 10 counties with the highest rates of hepatitis A, including Pasco, Pinellas, Volusia, and Orange counties. As of Saturday, Pasco had reported 409 cases, while Pinellas had reported 377, Volusia had reported 291 and Orange had reported 191.

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“Every county is different in terms of their demographics and in terms of their populations. But the general approach is absolutely the same: Go after the high-risk populations,” Rivkees said, adding, “I’m extraordinarily proud of our county health departments that have taken a major role in addressing this virus and the many partners we’ve engaged in helping  us do this.” 

Organizations working with health officials include homeless shelters, jails, and detention centers. Rivkees testified before the Senate Health Policy Committee in September that the vaccinations were voluntary, but incentives were being offered such as bus passes and socks to entice homeless people to be vaccinated.

In addition to county health departments, the vaccinations are being administered by other health-care providers. In all, state data shows that 292,843 vaccinations had been administered in the state as of Saturday.

Despite the recent success he sees, the surgeon general was hesitant to say when the outbreak will end. He noted it took Utah and California two years to end hepatitis A outbreaks. And neither state had the number of cases that Florida has faced.

“Nobody can predict,” Rivkees said when asked about the end of the outbreak. “But all I can say is since we declared a public- health emergency, the number of new cases of hepatitis A cases that we’ve seen statewide is under half of what we were seeing before we declared a public-health emergency.”