I read in the Lancet today about the need for universal hepatitis A vaccination for children to prevent what can be a fatal disease. However, under the current U.S. Centers for Disease Control and Prevention (CDC) framework, this safe and effective vaccine has been removed from the recommended childhood immunization list. It’s another move that puts politics ahead of public health.
i have I’ve spent most of my 30 years in court fighting for people sickened by preventable food poisoning. I sat across from families who had lost loved ones. E. coli, salmonellaand Listeria. But few pathogens frustrate me as much as hepatitis A. Because even though we’ve had a safe and effective vaccine against this since 1995, we still can’t seem to get it into the arms of the people who need it most.
Hepatitis A is a liver disease that is mainly spread through contaminated food and water and the fecal-oral route. To put it simply, it is a disease of hygiene and poverty. It thrives in places where hand washing is inadequate, workers cannot afford sick leave, and access to health care is limited. That description fits too many American food service workers.
Consider what happens when one infected restaurant worker handles food before symptoms appear. Hepatitis A is most contagious within two weeks. before People are sick. A single outbreak can expose hundreds, sometimes thousands, of customers. I have litigated cases involving fast food chains, buffet restaurants, catering events, and grocery store delis. The pattern is always the same. One unvaccinated employee, one hand-washing mistake, and suddenly the local health department is rushing to provide post-exposure prophylaxis to the entire community. The human, financial and reputational costs are enormous.
The economic argument alone should be persuasive. A full course of hepatitis A vaccine costs between $100 and $200. A single outbreak investigation, combined with the medical costs of infected customers and the almost certain loss of business for the restaurants involved, can run into the millions of dollars. The ensuing litigation is costly for everyone. I know, because I file the papers.
But this is bigger than the economy. Hepatitis A disproportionately affects the most vulnerable populations: the elderly, people with liver disease, the homeless, and communities with limited sanitation infrastructure. When restaurant workers unknowingly spread the virus, they become an unwitting bridge between the pandemic and the dining public, who have no reason to suspect that guacamole is dangerous.
Some states have mandated hepatitis A vaccination for food handlers. It’s progress, but it’s a patchwork. Consistent national standards are needed. Employers in the food service industry must require workers to be vaccinated and cover the costs associated with doing so. These are the same businesses that profit from the public’s trust. Maintaining that trust is part of the cost of doing business.
I also want to be clear: Restaurant workers are not the villains here. They often work without sick leave, without health insurance, and without anyone explaining to them how a free vaccine can protect them, their families, and every client they serve. Failure is systematic. This falls on the shoulders of dubious employers, legislators who resist mandates, and a chronically under-resourced public health infrastructure.
In the past, we vaccinated children against hepatitis A as part of the standard childhood immunization schedule, and we hope that most people still do so. But the question is, why are we willing to protect our children but not our food workers?
A vaccine exists. Science has settled down. Outbreaks are predictable and preventable. What we lack is the political will to act. I have seen the results of that inaction. They are not abstract. There are names, medical records, and in some cases, headstones.
Vaccinate food service workers. Get everyone vaccinated. This is not a radical position. This is simply the logical conclusion of everything we know about this disease. By the way, fire RFK Jr. and his anti-vaccine mob.
Bill Mahler Food safety attorney and managing partner. Mahler ClarkWe are the nation’s leading law firm representing food poisoning victims. William “Bill” Mahler He has been a food safety lawyer and advocate since the 1993 Jack-in-the-Box E. coli outbreak documented in the book. “poisoning” And at the recent Emmy Awards: netflix documentary With the same name. Bill’s work was featured in the New Yorker; “A bug in the system;” Seattle Times, “30 years since the deadly E. coli outbreak Outbreak, Seattle Lawyers Still Fighting for Food Safety.” washington Post, “He helped make hamburgers safer. Now he’s fighting food poisoning again.” and Many other things.
