Learning Objectives for this Presentation:
By the end of the presentation participants will be able to use mandates to create sustainable workplace vaccination programs.

Background:
Support for adult vaccines is limited to 317 funding. Cost and access are common barriers for adult vaccinations. Federal law mandates employers to offer hepatitis B vaccine (HBV) to employees at risk for exposure to Hepatitis B. Southern Nevada (SN) mandates hepatitis A vaccine (HAV) for high risk workers, including food handlers. Southern Nevada Health District (SNHD) Immunization Program developed two sustainable adult vaccination programs – “Health Cards” (HC) and “Workplace Vaccination” (WPV) Program – to increase mandate compliance.

Setting:
SNHD is one of the largest local public health organizations in the US, serving over 1.8 million residents through eight public health centers (PHCs). Mandated vaccines are offered through the PHCs and/or worksites.

Population:
Approximately 300,000 adults in SN are at risk for Hepatitis A/B. SN has a large hospitality industry (37 million annual visitors, 433 hotels and 15,181 permitted food establishments); a growing health and childcare industry; and a transient population (over 6,000 monthly new residents and 50,000 undocumented immigrants).

Project Description:
The HC and WPV Programs increase adult access to HAV/HBV and develop sustainable systems to administer HAV/HBV. The HC Program helps adults meet the HAV mandate by giving vaccines and photo id ‘health cards,' for a minimal fee (vouchers available). Cards are renewed bi-annually. The WPV Program helps adults meet the HBV mandate. SNHD developed liaisons with organizations, inspectors, and licensing bureaus to educate local businesses. Information was disseminated using social marketing strategies and liaisons. Employers cover costs to have employees vaccinated at PHCs or at worksites.

Results/Lessons Learned:
SNHD administers approximately 8,000 doses of HAV and 400 doses of HBV monthly. Successful implementation relied on strong mandates, support from community partners/businesses, improved access for patients, a cost recovery system, and immunization tracking through the registry.