Evolving Hep A Transmissions Could Spur More Vaccinations. Why Not in Urgent Care?

An abstract presented at ID Week in Atlanta recently paints a grim picture of the evolution of hepatitis A transmissions. Between 2007 and 2017, the incidence of hepatitis A attributed to outbreaks (as opposed to common-source exposure) increased steadily—to the point that in 2017, 43% of hep A infections were associated with outbreaks, compared with only 5% between 2007 and 2011. In the past, large community outbreaks were most likely to be associated with asymptomatic children who would pass the virus on to adults, who would then proceed to infect other adults. That started to change when the Centers for Disease Control and Prevention issued a recommendation that all children receive the hep A vaccine. This begs the question, while there is no universal recommendation that adults be immunized against hepatitis A at present, how would transmission rates be affected if adults were encouraged to get the hep A vaccine? Urgent care providers are in a prime position to make the offer, supported by the new data. When treating patients most at risk for hep A infection—statistically, that would include travelers, men who have sex with men, and persons who use drugs—consider asking if they’d like to receive the immunization. Doing so could have positive implications for public health, those patients, and your urgent care operation.