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Outcomes, Approaches, and Challenges to Developing and Passing a Countywide Mandatory Vaccination Policy: St. Louis County's Experience with Hepatitis A Vaccine for Food Service Personnel
Journal article   Open access   Peer reviewed

Outcomes, Approaches, and Challenges to Developing and Passing a Countywide Mandatory Vaccination Policy: St. Louis County's Experience with Hepatitis A Vaccine for Food Service Personnel

Terri Rebmann, Kristin D Wilson, Travis Loux, Ayesha Z Iqbal, Eleanor B Peters and Olivia Peavler
AIMS public health, Vol.3(1), pp.116-130
2016
DOI: 10.3934/publichealth.2016.1.116
PMCID: PMC5690268
PMID: 29546151
url
https://doi.org/10.3934/publichealth.2016.1.116View
Published (Version of record) Open Access

Abstract

In the early 1990s, St. Louis County had multiple foodservice worker-related hepatitis A outbreaks uncontrolled by standard outbreak interventions. Restaurant interest groups and the general public applied political pressure to local public health officials for more stringent interventions, including a mandatory vaccination policy. Local health departments can enact mandatory vaccination policies, but this has rarely been done. The study objectives were to describe the approach used to pass a mandatory vaccination policy at the local jurisdiction level and illustrate the outcome from this ordinance 15 years later. A case study design was used. In-depth, semi-structured interviews using guided questions were conducted in spring, 2015, with six key informants who had direct knowledge of the mandatory vaccination policy process. Meeting minutes and/or reports were also analyzed. A Poisson distribution analysis was used to calculate the rate of outbreaks before and after mandatory vaccination policy implementation. The policy appears to have reduced the number of hepatitis A outbreaks, lowering the morbidity and economic burden in St. Louis County. The lessons learned by local public health officials in passing a mandatory hepatitis A vaccination policy are important and relevant in today's environment. The experience and lessons learned may assist other local health departments when faced with the potential need for mandatory policies for any vaccine preventable disease.
Immunization Outbreak control Public Health Policy Mandatory Vaccination

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