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National Clearinghouse on Homeless Youth and Families

Hepatitis A: Vigilance Needed for a Growing Problem

A gloved hand swabs the arm of a shot recipient

In late March 2019, the Centers for Disease Control and Prevention (CDC) reported continuing, widespread outbreaks of hepatitis A with more than 15,000 cases, 8,500 hospitalizations, and 140 deaths since 2016. These outbreaks have occurred primarily among people experiencing homelessness and people who use drugs.

Because people experiencing homelessness are at increased risk of becoming infected with the hepatitis A virus, the Advisory Committee on Immunization Practices (ACIP) is now recommending that all persons aged 1 year and older experiencing homelessness receive the hepatitis A vaccine.  ACIP also notes that, although routine vaccination consists of a two-dose schedule, one dose is enough to provide personal protection and contribute to herd immunity (which means that getting vaccinated helps prevent the spread of disease through the community). People experiencing homelessness may find it hard to otherwise protect themselves from exposure to the virus because they may not have regular access to clean toilet facilities or be able to avoid crowded living conditions.

Hepatitis A is highly contagious and is usually spread from person to person or through contaminated food or water. Symptoms include:

  • Fever
  • Tiredness
  • Loss of appetite
  • Nausea and vomiting
  • Pain in the abdomen
  • Dark urine
  • Diarrhea
  • Clay-colored stools
  • Joint pain
  • Itching
  • Yellowing of the skin and eyes (jaundice)

Individuals who want to be immunized against hepatitis A or believe they may have been exposed to the virus can contact their health professional, local or state health department, or the clinic or facility where they receive health care.

Extensive information and resources on hepatitis A are available, including resources appropriate for health professionals, the public, and programs that provide shelter and other services to people experiencing homelessness.