1. National Hepatitis Coordinators’ Conference San Antonio 1/2003
Hepatitis A and Hepatitis B Vaccination in High Risk Adults: Florida’s Experience with Integrating Services
Sandra W. Roush, MT, MPH
National Hepatitis Coordinators’ Conference San Antonio 1/2003

2. Florida’s Hepatitis (A, B, C) Program
Providing leadership, policy development, and technical assistance
Development of a comprehensive prevention plan
Counseling and testing services
Vaccination for adults
Patient care services
Prevention initiatives
Allocating state hepatitis resources

3. Florida’s Statewide High Risk Adult Hepatitis Immunization Program
Initial purchase Dec. 2000:
One-time carry over (lab and vaccine)
30,100 doses B ($ 699,825)
1,246 doses A ($ 20,160)
Subsequent purchases: state and federal
Eligibility: adult high risk
Statewide memos March 2001, Dec. 2002
NO CHARGE TO CHD OR CLIENT

4. Florida Hepatitis and Liver Failure Prevention and Control Program
Escambia
Holmes
Jackson
Santa Rosa H o l m e s S a n t a R o s a J a c k s o n
Okaloosa W
Walton a l t o n W
Washington
Nassau a s h i n g o
Gadsden G a d s d e n
Leon
Jefferson
Hamilton N a s s a u
Calhoun L e o n J e f f e r s o n M
Madison a d i s o n H a m i l t o n
Liberty
Suwannee B a k
Baker e r D u
Duval v a l W
Wakulla a k u l l a
Taylor S u w a n n e e
Columbia C o l u m b i a
Bay T a y l o r
Lafayette U
Union
Clay
Gulf L a f a y e t t e n i o n
Bradford C l a y
St. John’s F r a
Franklin n k l i n B r a d f o r d S t J o h n s i
Gilchrist l c h r i s t
Alachua
Dixie A l a c h u a
Putnam P u t n a m F l
Flagler a g l e r
Levy
Florida Hepatitis and Liver Failure Prevention and Control Program
Adult Hepatitis Vaccine Program
County Participation – 10/10/2002 M a
Marion r i o n V o
Volusia l u s i a
Citrus C i t r u s
Sumter
Lake L a k e
Seminole
Hernando u m t e r S e m i n o l e O r a
Orange n g e B r e v a r d
Pasco
Osceola
Hillsborough i l l s b o r o u g h
Pinellas
Polk O s c e o l a
Brevard P o l k I n
Indian River d i a n R i v e r
Manatee
Hardee
Okeechobee M a n a t e e H a r d e e O k e e c h o b e e
St. Lucie
Highlands S t L u c i e
Desoto H i g h l a n d s
Sarasota r o t a D e S o t o
Martin
Charlotte C h a r l o t t e G l
Glades a d e s
Hepatitis A and hepatitis B vaccine available at no charge to county
Hendry
Lee P
Palm Beach a l m B e a c h
Collier B r
Broward o w a r d
Active programs using available hepatitis A and hepatitis B vaccine no charge to county
Monroe
Miami- Dade D a d e
Comprehensive hepatitis and liver failure programs funded from State Health Office

5. Hepatitis Adult High Risk Vaccination Program Sites*
Number of Counties
STD 35
HIV 30
Immunization/ Epidemiology 26
Family Planning 23
General 29
* Participation sites are not mutually exclusive; number among 48 counties responding.

6. Florida’s Adult Hepatitis Vaccination Program: UNFUNDED COUNTIES
61 eligible counties (other 6 were funded)
Received NO FUNDING
No personnel
No clinical supplies

7. Florida’s Adult Hepatitis Vaccination Program: FUNDED COUNTIES
6 counties (3 added Oct 2002)
Comprehensive A, B, C programs
Approximately 1/3 of the state population
Budgets do not include vaccine starting July 2002 (rely on state supply, approx. 1/8 of their budget)

8. Vaccine Distribution: UNFUNDED COUNTIES
Number of Doses Purchased by State
(March 01 – October 02)
Number (%) of Doses to CHD
(October 01 – September 02)
Hepatitis A
28,907
7,587 (26%)
Hepatitis B
39,200
11,400 (29%)

9. Vaccine Used/Coded October 2001 to September 2002 UNFUNDED COUNTIES
Hepatitis A
No. (%)
Hepatitis B
Doses to Counties
7,587
11,400
Dose 1
4,436 (59%)
7,705 (68%)
Dose 2
1,297 (29%)
3,779 (49%)
Dose 3
N/A
1,878 (50%)*
* 24 % hepatitis B series completion during this period

10. Vaccine Used/Coded October 2001 to September 2002 FUNDED COUNTIES
Hepatitis A
No. (%)
Hepatitis B
Dose 1
7,305
6,273
Dose 2
1,406 (19%)
3,469 (55 %)
Dose 3
N/A
2,192 (63%)*
* 35 % series completion during this time period

11. Selected* Hepatitis A Series Completion October 2001 – September 2002
Dose 1
Dose 2 %
County E
606
287
47%
County O
234
164
70%
County A
318
121
38%
County V
617
172
28%
County P
735 75
10%
County D
1,104
235
21%
* Unfunded counties

12. Selected* Hepatitis B Series Completion October 2001 – September 2002
Dose 1
Dose 2 %
Dose 3
County E
765
603
79%
395
52%
County O
392
211
54%
169
43%
County A
240
164
68% 82
34%
County V
1,352
545
40%
352
26%
County P
1,330
571
189
14%
County D
3,796
1,972
1,053
28%
* Unfunded counties

13. Number of Vaccine Doses Used: by County Size

14. Next Steps: Florida’s Adult Hepatitis A and B Immunization Program
Vaccine accountability mechanisms
Coverage assessment
Evaluation
Feasibility
Cost effectiveness/efficiency
Expand to additional clinics and other sites
Ensure a reliable vaccine supply

17. Thanks to …
HQ Hepatitis Staff, including: Jodi Baldy, Robbie Bouplon, Katrina Huffmaster, April Crowley, Sandy Teixeira
County hepatitis and other programmatic staff
HQ Bureaus of HIV/AIDS, Immunization, STD, TB/Refugee
DOH Public Information Office
NIP/CDC
NCID/CDC