Hepatitis A Vaccine Shortage Continues in California and Worldwide

San Diego County announced it is postponing a hepatitis A vaccination awareness campaign, until the vaccine shortage is resolved, the county’s chief public health officer said.

“Our goal is to get that vaccine in as many arms as possible for that first dose,” said Dr. Wilma Wooten, who is leading the fight against the hepatitis A epidemic.

Hepatitis A has been reported to sicken 544 people and killing 20, in the San Diego area, as of November. 6, 2017.

This epidemic lead California Gov. Jerry Brown to declare a state of emergency in an effort to increase the state’s supply of adult hepatitis A vaccine. The declaration allowed the state to immediately purchase additional vaccines directly from manufacturers.

“The first shot is the most important because it protects people 90 to 95 percent of the time against the virus that causes the disease. The second shot raises the protection level to “close to 100 percent,” said Dr. Wooten.

The two hepatitis A vaccinations, considered the best way to control the spread of the virus, should be administered six months apart.

This spike in demand for hepatitis A vaccine has put a squeeze on supplies, according to the US Centers for Disease Control and Prevention (CDC).

Hepatitis A cases have been reported in California, Michigan, Utah, New York, and Florida.

Additionally, the worldwide demand for hepatitis A vaccines has constrained availability in 11 European countries.

But, these manufacturing constraints do not apply to the pediatric Hepatitis A vaccine supply in the US.

Merck and GlaxoSmithKline, are the two companies with approval from the Food and Drug Administration to sell the vaccine in the United States. Both manufacturers sell the hepatitis A vaccine in pre-filled syringes and less costly single-dose vials.

The Hepatitis A vaccine is an inactivated (killed) vaccine, according to the CDC. There are three FDA approved monovalent hepatitis A vaccines:

• Vaqta (Merck) and Havrix (GlaxoSmithKline), are approved for people ≥12 months of age in a 2-dose series
• A combined hepatitis A and hepatitis B Twinrix, (GlaxoSmithKline) vaccine is approved for people ≥18 years of age in the United States.

“The deadly nature of the epidemics in San Diego and Michigan worries public health officials the most,” said Dr. Noele P. Nelson, a CDC specialist in hepatitis vaccine research and policy.

“The number of deaths in the Michigan and San Diego outbreaks are quite high from what we’ve seen in the past,” Dr. Nelson told members of the CDC’s Advisory Committee on Immunization Practices at a October 2017 meeting.

Hepatitis A virus is spread through person to person contact and has occurred primarily among persons who are homeless, persons who use drugs, men who have sex with men (MSM) and their close direct contacts, according to the CDC.

Individuals can obtain hepatitis A immunizations through primary care physicians and most pharmacies.

Pharmacies, such as CVS, have increased their focus on hepatitis vaccinations.

The CDC Vaccine Price List provides current vaccine information.

Vaccine discounts can be found here.