Background:
Community partners in Iowa have asked for assistance in providing hepatitis A & B vaccinations for at-risk populations. With no federal funding devoted to adult immunization activities, state health departments are challenged with providing this important and needed service. Through a collaborative partnership, the Immunization, Hepatitis, HIV and STD programs of the Iowa Department of Public Health initiated an integration project which provides infrastructure funds and hepatitis A & B vaccine to local public health agencies offering HIV/STD counseling, testing and referral services.

Objective:
To collaborate to offer hepatitis A & B vaccinations for at risk adults by providing the vaccinations in conjunction with Hepatitis C, HIV and other STD testing.

Method:
Utilizing Federal 317 funds, the Immunization program provides grants to six agencies to target hepatitis prevention services, including vaccination, to adults at risk. Agencies screen all clients for hepatitis risk, vaccinate susceptible patients, conduct reminder/recall activities, and enter vaccination information into the state's immunization registry. Clients at risk are also counseled and tested for hepatitis C virus, HIV and other STDs. At risk individuals eligible for vaccination include Hepatitis C positive individuals, Injection Drug Users (IDU), Men who have sex with men (MSM), and clients with a current STD diagnosis.

Result:
The program began in October of 2003 with 609 vaccinations offered through December 31 of 2003. A total of 2,954 vaccinations were offered throughout the year of 2004. Numbers for 2005 are forthcoming. Feedback from local providers and consumers indicate education and incentives will likely bolster the program further.

Conclusion:
Continued collaboration within public health programs is imperative to comprehensively serve adults at risk for hepatitis A and B infection. Offering holistic services is proving necessary and successful in reaching target populations.

Implications:
Rural states facing public health issues can effectively collaborate to create workable wrap-around services.