A Viral Hepatitis Immunization Initiative in Massachusetts Correctional Facilities

Background:
Incarcerated populations remain among the highest risk for hepatitis B and C infection. Vaccination against hepatitis A and B has shown to be a successful health intervention in correctional settings.

Setting:
State and county correctional facilities in Massachusetts.

Population:
Currently incarcerated adults.

Project Description:
Through funding provided by the Centers for Disease Control and Prevention (CDC), the Massachusetts Department of Public Health (MDPH) is providing hepatitis A and B vaccine to Massachusetts correctional facilities. CDC recommends vaccinating adults who are at high-risk for hepatitis C infection, including incarcerated populations. To accomplish this, combination HAV/HBV vaccine is being distributed to correctional facilities based on average population size. Currently incarcerated individuals are being vaccinated at large-scale clinics run by correctional staff, local health departments and MDPH. At MDPH-run clinics, a team including health educators, epidemiologists and nurses has gone to three facilities to offer, screen, receive written permission (if needed) and administer vaccine. We also provide vaccine to facilities wanting to vaccinate inmates using their own staff. At these sites, technical assistance and educational materials are provided. Going forward, correctional facility health units will provide new inmates with risk assessment and hepatitis vaccination upon intake.

Results/Lessons Learned:
Reports received to date indicate that 7,024 doses of monovalent and combination HAV/HBV vaccine have been administered. This program demonstrates success partnering with a range of public health and correctional agencies to provide educational and logistical support to prevent hepatitis. It demonstrates a successful strategy for disease prevention among a population at higher risk for complications from HAV/HBV infection. In addition, planning and organizing clinics provide MDPH staff an opportunity to exercise Emergency Dispensing Site plans utilizing medical reserve corps volunteers. This project identified that substantial organizational and staffing resources are needed to carry out such initiatives.