SF Hep B Free Campaign: a Proactive Approach to Promoting Hepatitis B Immunization in Conjunction with Screening and Care

Background:
The population of San Francisco is 34% Asian; over 60% were born in countries endemic for chronic hepatitis B (CHB). Recently, the CDC issued recommendations (Sept. 19, 2008 MMWR) calling for routine testing of all persons born or who have a parent born in endemic regions to identify infected individuals, refer them into care, and vaccinate the unprotected. Hepatitis B vaccination is the only immunization where testing of certain populations prior to immunization is recommended in order to engage in best care practice to eliminate transmission risk and to reduce disease morbidity and mortality.

Setting:
Various public and private healthcare settings within the City and County of San Francisco

Population:
Adult residents who were born in, or whose parents were born in, or whose parents were born in areas with endemic rates of CHB infection, in particular API.

Project Description:
The San Francisco Hep B Free campaign is the largest coordinated effort in the nation working toward eliminating the threat of hepatitis B in its API population. Without designated funding, this campaign has galvanized dozens of public and private organizations including hospitals, HMOs, universities, community health centers, news agencies, foundations, pharmaceutical companies, and elected officials. A key strategy developed to address this population's specific need is the establishment of community based testing sites which link vaccination and referral into care with the testing component. Over 4500 people have been directly served in this manner in the first year alone.

Results/Lessons Learned:
Addressing the need to screen prior to vaccination adds additional barriers to promoting hepatitis B vaccination. Coordinated citywide collaboration across disciplines overcomes resource barriers, builds workable infrastructures, and enhances outreach for promotion of hepatitis B immunization.