ACROSS FLORIDA — As the number of infected Floridians continues to mount, state health officials are pulling out all stops to convince residents to get vaccinated against hepatitis A. However, the state has yet to clear the single hurdle preventing everyone from getting vaccinated - the cost.
Since Jan. 1, 2018, 3,223 Floridians have tested positive for hepatitis A. Of those who tested positive, 71 percent, or 2,071 people, have been hospitalized and 39 have died.
The Centers for Disease Control and Prevention called this the largest outbreak of the virus since the hepatitis A vaccine became available in 1995. In addition to Florida, the CDC is monitoring outbreaks in 29 other states.
The unprecedented number of cases prompted Florida Surgeon General Dr. Scott Rivkees to declare a statewide public health emergency on Aug. 1.
Additionally, Florida Gov. Ron DeSantis asked the CDC to assist the Department of Health in helping to control the unparalleled rise in the disease in the Sunshine State.
Speaking before the Senate Health Policy Committee last week, Rivkees said he doesn't see an end to the epidemic unless a majority of Floridians get vaccinated.
"According to the CDC, we need to vaccinate 80 percent of the high-risk population before we are going to be able to control this outbreak," he said. "The fact remains that while we continue to investigate the causes as to why this outbreak is happening and find ways to mitigate the effects of this disease, vaccination and education remain key components to prevention and these efforts must continue."
So far this year, county health departments have administered 90,982 hepatitis A vaccinations while private doctors, drugstores and public clinics administered another 129,202 doses for a total of 220,184 vaccinated against the disease.
Hepatitis A is a highly contagious liver infection that is spread through the feces of an infected person. This is why thorough hand-washing after using the bathroom or changing a diaper is essential to preventing the disease. However, soap and water are no guarantee.
The only full-proof defense is vaccination, said Rivkees.
To that end, county health departments have been offering free vaccination clinics and taking vaccinations out to high-risk populations in the community including soup kitchens, homeless camps and clinics for drug users.
The CDC said it's imperative to reach high-risk populations like the homeless, intravenous drug users and men who have sex with other men to battle the outbreak. In addition, the Centers for Disease Control and Prevention recommends that people be vaccinated if they:
- Have adopted or care for a child who comes from a country where hepatitis A is common.
- Are 60 or older and have a serious underlying medical condition.
- Have chronic or long-term liver disease, including hepatitis B or C.
- Have a clotting-factor disorder.
- Have traveled to or will travel to countries where the virus is common.
- Have direct contact with people confirmed to have hepatitis A
Moreover, the National Institute of Health recommends that all children over age 1 be vaccinated.
County health departments routinely offer free vaccinations for those in the high-risk categories as well as those who have been recently exposed to the disease through restaurant, healthcare workers or other people confirmed by the DOH to have contracted the hepatitis A virus.
Those with health insurance can obtain the vaccine from county health departments for $25 although they might want to check with their doctors first. They may be able to get the vaccination through their personal physician at no cost or just a co-pay. Medicare and Medicaid also covers the vaccine at little to no cost.
However, residents who don't meet the high-risk parameters and don't have health insurance are at a disadvantage. Depending on the county, the vaccine can cost residents with no health insurance up to $130 out of pocket.
Nine Florida counties have been identified as high-risk counties. That means 32 to 87 residents per 100,000 people have contracted hepatitis A.
Pasco and Pinellas counties lead the way with 394 and 368 cases, respectively, followed by Volusia (242 cases), Orange (166), Hillsborough (144), Marion (136), Manatee (122), Brevard (109) and Hernando (107).
According to the Department of Health, without health insurance, health departments charge the following fees for hepatitis A vaccinations:
- Pasco $49
- Pinellas $85.66
- Volusia $62.50
- Orange $81.61
- Hillsborough $69
- Marion $62.29
- Brevard $79
- Hernando $58
- Manatee $57
Other counties charge more. In Baker County, the cost of the vaccine is $130. Seminole County charges $120.22. Glades County charges $106.70. The vaccine costs $103 in Santa Rosa County. It's $102.50 in Taylor County. And Hendry County charges $101.70.
By contrast, residents in Hamilton County pay only $10.
Patch contacted the DOH to ask about the price discrepancy but received no response.
In some cases, it's cheaper for uninsured people to get the vaccine at their local drugstore. It costs $112.21 at Publix; $115.19 at CVS Pharmacy; $116.24 at Walmart; and $119.79 at Walgreens.
Still, that's three times more than it costs to receive the medication through the CDC, which offers two approved versions of the vaccine.
One version, HAVRIX®, is manufactured by GlaxoSmithKline and VAQTA® is produced b by Merck & Co. Inc. GlaxoSmithKline also offers a combination hepatitis A and B vaccine called TWINRIX®.
According to the CDC, the base price for HAVRIX® is $30.75 (or $20.52 for children); VAQTA® is also $30.75. The CDC price for the combination TWINRIX® is $61.85.
But before skipping the hepatitis A vaccination due budget constraints, the DOH urges residents to contact their county health department to see if there may be programs available to reduce the price in light of the public health emergency declaration.
Click here for the numbers of all the county health departments in Florida.
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