The NYC Department of Health has noted a recent increase in reports of hepatitis A among people who use drugs, are homeless or unstably housed, or are in methadone programs in NYC. Hep A can lead to severe illness and death, particularly in people with underlying health conditions such as liver disease.

This alert is for all networks of NYC providers to encourage proactive Hep A vaccination.

Providers are urged to support the following groups to complete Hep A vaccination:

  • People who are unstably housed or experiencing homelessness
  • People who use drugs
  • People in methadone or opioid use treatment programs
  • People with chronic liver disease
  • Men who have sex with men
  • People with HIV infection

Providers who are able to vaccinate their patients should:

  • Check the Citywide Immunization Registry (CIR) for their patients’ vaccination status. If vaccine history is not available, serologic testing is not indicated to evaluate immunity from prior infection or prior vaccination before administering the vaccine. An extra dose of vaccine is safe to administer even if the patient has had a previous infection or has vaccine-induced immunity.
  • Vaccinate people who do not have documentation of complete vaccination, including developing a case management plan to complete the 2-dose series. Providers should give the first dose of the vaccine even if there is concern about loss to follow-up before the second dose can be completed. Although recommended as a 2-dose series, one dose of HAV vaccine provides personal protection, with seroconversion after the first dose estimated at >95% and can contribute to herd immunity.
  • Document each Hep A vaccine dose in the CIR, if the patient consents.

Providers who are unable to vaccinate their patients should refer for Hep A vaccination, and support patients to complete the 2-dose series:

  • Support patients to ask their primary care doctor for the Hep A vaccine.
  • Refer uninsured patients to an NYC immunization clinic for a free Hep A vaccine.
  • Schedule an appointment with a Syringe Service Provider (SSP) for a free Hep A vaccine (click Drug and Alcohol Services, then Syringe Service Provider). SSPs are community-based programs that provide services to people who use or inject drugs. SSPs distribute sterile syringes, safer drug use equipment, and safer sex supplies. SSPs also provide health education and street-based outreach and offer health care services for people who may experience drug-related harm.

Please let us know if we can further support efforts to promote Hep A vaccination at

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