Hepatitis Vaccine Distribution Program 2012

Thanks to dedication and approval from the SF Health Commission, each year, the San Francisco Department of Public Health is able to provide a number of eligible, non-profit health care organizations with limited amounts of hepatitis A and B vaccine to be administered to San Francisco residents who may otherwise be unable to afford vaccination.

Open enrollment for the hepatitis vaccine program is limited to once per year, with all applications usually being due the last week of January. Occasionally special circumstances may allow for entry into the program outside of the normal open enrollment period.

The program guidelines detail the type of provider that is eligible for this program. For more information about the program please call (415) 554-2830 and ask for the Adult Immunization Coordinator or download the application form and usage agreement. Continuation in the program depends on availability of funds, accurate and timely documentation and reporting of usage, and whether or not providers continue to serve patients who are eligible for free or low-cost health care services.

Current Hepatitis Vaccine Program Participants

If you are currently a member of the Hepatitis Vaccine Program, you no longer need to submit the application form. Instead, please complete the annual update form and usage agreement also due on Friday, February 10, 2012. You can also download a copy of the usage report. Usage reports are usually due in January and July of each year.

Due dates for the 2011 Hepatitis Vaccine Program are as follows:

• Application form (for new applicants only): Friday, February 10, 2012
• Annual update form (for current program participants): Friday, February 10, 2012
• Usage agreement (everyone): Friday, February 10, 2012
• Usage report for the period of usage from January 1 - June 30, 2012 (everyone): Friday, July 13, 2012
• Usage report for the period of usage from July 1 - December 31, 2012 (everyone): Friday, January 11, 2013

Additional Resources:

Hepatitis A and B Vaccine Information Statements

Adult Vaccine Request Form - to be submitted by current program members when vaccine is needed througout the year