BACKGROUND:
The hepatitis A virus (HAV) and hepatitis B virus (HBV) are transmitted through sexual contact and illicit drug use. HAV and HBV vaccination is the most effective method of disease prevention. Vaccinating populations that attend clinics serving at-risk clients is a proven method in controlling HAV and HBV. The lack of federal dollars to establish an adult HAV and HBV vaccination program has created major funding challenges for states.

OBJECTIVE:
To establish a statewide HAV and HBV vaccination program targeting at-risk adolescents and adults in Indiana STD Clinics.

METHOD:
Using $450,000.00 of state monies a contract was created to purchase Twinrix and adult hepatitis B vaccine. Any state or county run STD clinic was offered an opportunity to participate. The programs had to supply the staff and materials necessary to administer the vaccine. Uniform protocols were established.

RESULT:
13 of Indiana's 17 STD clinics participate in the program. All clinics had to include an adolescent component using VFC vaccine to their program as a condition of enrollment. Since the program began in July 2003 the following have been distributed: Twinrix – 2690 first dose 1025 second dose, 358 third dose; Engerix B – 2191 first dose, 983 second dose, 374 third dose; Pediatric Engerix B – 210 first dose, 78 second dose, 38 third dose; Pediatric Havrix – 43 first dose and 4 second dose.

CONCLUSION:
Establishing an adult hepatitis A and B vaccination program is an effective method of disease prevention and allows for targeting vaccine to the most at-risk populations.

LEARNING OBJECTIVES:
Upon completion of this session participants will be able to identify the steps necessary to establish a vaccination program in an existing public health structure and learn methods to acquire non-federal funding to support the program.