Thanks to the dedication of 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. Hepatitis vaccine made available through this program should be used only for low-income uninsured and underinsured adults in San Francisco.
For information on eligibility and program requirements, please review the program guidelines.
How to Apply:
New organizations interested in enrolling in the Hepatitis Vaccine Program should email the SFDPH Immunization Program at email@example.com or call us at (415) 554-2955 to inquire about eligibility and to receive notice (via email) when our annual application is open – typically in early January.
Open enrollment for the Hepatitis Vaccine Program is limited to once per year. Occasionally, special circumstances may allow for entry into the program outside of the normal open enrollment period. Participating providers must commit to accurate and timely documentation and reporting of vaccine usage, serving patients who are eligible for free or low-cost health care services, and fulfilling vaccine storage and handling requirements. Vaccines need to be stored at the right temperature (36 to 46°F) to protect your patients from disease. Adhering to vaccine storage and handling protocol is critical to the success and effectiveness of your vaccination efforts. Continuation of the program depends on availability of vaccine.
Resources and Forms for Existing Partners
Vaccine Storage and Handling
SFDPH Vaccine Management Plan – Must be reviewed annually by the Vaccine Coordinator and Backup Coordinator
Key Staff Contacts Form – Post a copy of this on your storage unit and update it with any staffing change
Emergency Vaccine Management Plan – Post a copy of this on your storage unit and update annually or with any staffing change
EZIZ Trainings – Both Storage and Handling trainings must be completed annually by Vaccine Coordinator, Backup, and any other staff monitoring temperatures
SFDPH Vaccine Storage and Handling Incident Summary Form – Complete this form if your vaccine storage unit temperatures go out of range
Vaccine Requests and Transport
Adult Vaccine Request Form – To be submitted by current program members when vaccine is needed throughout the year
SFDPH Vaccine Transport Guide – Please follow this guidance when picking up or transporting vaccine
Hepatitis Vaccine Authorization Record Forms 2020 – An optional resource for our partners to document vaccine doses administered
Hepatitis vaccine usage reports are due twice yearly. Please complete the Semi-Annual Hepatitis Usage Report and submit to the Immunization Program by the following dates:
- Usage report for the period from January 1 – June 30, 2020: Friday, July 3, 2020
- Usage report for the period from July 1 – December 31, 2020: Friday, January 8, 2021