March 3, 1998 in City

Jail Vaccinations Unlikely Officials Say Vaccinating Inmates Against Hepatitis A Too Costly, Without Guarantees

By The Spokesman-Review
 
Tags:disease

Spokane’s health district appears to be losing a battle to get state money to vaccinate jail inmates against hepatitis A - in part because state health workers are lobbying against it.

Officials from the state Department of Health say there’s no guarantee that giving inmates shots will stem the hepatitis A epidemic, and they contend the $150,000 cost is too high to justify an experiment.

“This is an interesting idea, but there’s no research to show it’s been effective,” said Patty Hays, a legislative liaison with the state Department of Health.

The request for money came from Dr. Kim Thorburn of the Spokane Regional Health District. Thorburn said she recognizes the program is a shot in the dark, but she insists that without it, the number of hepatitis A cases in Spokane could climb to 600 by year’s end.

There have been more than 100 cases since the start of the year, Thorburn said.

“I feel responsible to think of what I can to try to stop this,” Thorburn said. “I now have a vaccine as a weapon, and I want to try something different.”

The number of new hepatitis A cases in the county appears to have plateaued at about 50 per month, but that’s not likely to decline any time soon, Thorburn said. The result is costly to the health district and grocers and restaurant owners who’ve spent thousands of dollars on vaccines and immunizations.

Thorburn wants to vaccinate all jail inmates for three to six months as a way of getting to members of a susceptible demographic group - male intravenous drug users under age 40.

Her efforts suffered a blow Monday when the House Appropriations Committee released its proposed supplemental budget without including the money. Money still could be added during the next 10 days of the legislative session, but “I’m not thinking I have a huge chance,” Thorburn said.

The problem, state health officials said, is hepatitis A is a fickle virus, and the vaccine is only a few years old. As a result, there’s little research to show the most effective way to prevent it.

In addition, Thorburn’s idea is something of a gamble because there’s no way of telling which inmates are more susceptible to contracting the virus, state officials said.

“Research from other states doesn’t support the jail pilot idea unless you have an extremely stable population,” Hays said. “Certainly in Spokane they have inmates coming in and going out all the time.”

Since hepatitis A outbreaks are cyclical, the health department prefers to develop a statewide “public education” program to fight future outbreaks.

But Thorburn says public education alone also doesn’t work.

“We’ve done bus signs, pamphlets - it doesn’t work,” she said. “It has to be two-pronged. Education has to be there” along with something else.

But the question quickly becomes one of economics.

“Since hepatitis A doesn’t fit any neat answers, we have to ask ‘What can we do that’s both experimental and productive?”’ said Marsha Goldoft, a state epidemiologist in Seattle. “There’s no consensus on that.”

The Spokane Convention and Visitors Bureau, which is concerned about the epidemic’s impact on tourism, isn’t committed to inmate vaccinations.

But a spokeswoman was relieved by the idea of associating the disease with something other than food handlers.

“This is definitely a hygiene and needle-user problem, so it certainly seems like a good idea to me,” spokeswoman Linda Miller said.

Thorburn has sent letters requesting the money to the governor, Republican budget writers and other legislators. The money could be added to the budget anytime during the next 10 days or not at all.

She also is seeking grants to cover the cost.

, DataTimes MEMO: This sidebar appeared with the story: OUTBREAK PLATEAUS The number of new hepatitis A cases in Spokane County appears to have plateaued at about 50 per month, says Dr. Kim Thorburn of the Spokane Regional Health District. That number is not likely to decline any time soon.

This sidebar appeared with the story: OUTBREAK PLATEAUS The number of new hepatitis A cases in Spokane County appears to have plateaued at about 50 per month, says Dr. Kim Thorburn of the Spokane Regional Health District. That number is not likely to decline any time soon.


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