The focus of the program is vaccination against hepatitis and hepatitis B. Educational brochures are provided to the clinics. We feel that the program is very successful with high clinic participation.

Through Michigan's Vaccine Replacement Program (MI-VRP), we also offer hepatitis A and B vaccines to clients 19 years of age and older seen at a local health department, Federally Qualified Health Center, or migrant health center who are uninsured or underinsured. The eligibility criteria for hepatitis A vaccination are: a household and/or sexual contact of a hepatitis A virus infected person; a man who has sex with other men; a person with an acute or chronic liver disease; an injecting drug user or a non-injecting methamphetamine user. The eligibility criteria for hepatitis B vaccination are: a household and/or sexual contact of a hepatitis B surface antigen positive-person; a sexually active person who is not in a long-term monogamous relationship (e.g., a person with more than one sex partner during the previous six months); a person seeking evaluation or treatment for a sexually transmitted disease, a man who has sex with other men; a current or recent injection drug user, a person with end-stage renal disease, predialysis, hemodialysis, peritoneal dialysis, or home dialysis; a person with acute or chronic liver disease, or a person with HIV infection.

The primary barrier for clinic staff is "time." The primary reason for why respondents would not accept the vaccines was that the individual did not have enough information about the disease or vaccine. Barriers appeared to become irrelevant when information was provided. Secondary reasons for not accepting the vaccine related to fear including fear of needles/shots, fear of the vaccine itself, and fear of discovering they already had the disease and the time and inconvenience associated with receiving the vaccine. The most common reason for not returning to complete the series was forgetting.

Michigan also has another website that offers information on viral hepatitis, HIV, STDs, and the Perinatal Hepatitis B Prevention Program Manual. www.michigan.gov/hivstd