The Czech hepatitis A outbreak: a developing public health challenge
The hepatitis A outbreak in the Czech Republic, which began last April in isolated pockets of Ostrava, has grown into a nationwide concern. With 2,141 confirmed cases and 26 deaths—ten of them in Prague—the situation exceeds last year’s toll, when 676 people fell ill and two died. Public health officials describe this as the largest hepatitis A outbreak in decades, prompting urgent discussions about who should receive free vaccines and how best to protect vulnerable groups.
Who should be vaccinated: policymakers and experts weigh the options
A key question facing the Health Ministry and public health authorities is eligibility for vaccination. The State Institute of Health has proposed vaccinating preschool children, a measure that could reduce transmission among future generations. Yet epidemiologists argue that the most at-risk segment includes adults with chronic liver diseases, who are disproportionately likely to suffer severe outcomes from hepatitis A. Matyáš Fošum, deputy chief hygienist and director of the Public Health Protection Department at the Ministry of Health, notes that it is possible to address both groups in vaccination policy.
“There are more proposals; we will see what the expert groups agree on,” Fošum said, adding that if the program expands to include children, the ministry would need to issue a new decree and secure higher vaccine supplies from manufacturers. This echoes the broader policy debate: should vaccination be universal for children, or targeted at high-risk adults as a more cost-effective public health measure?
Balancing supply, cost, and protection
As of this year, more than 112,000 people have been vaccinated—more than double last year’s figure, according to Fošum. Experts emphasize the need for clear criteria to ensure vaccines reach those most at risk. The debate also touches on the financial side: while insurance funds contribute to prevention vaccines, many seniors or families with multiple children find the price a barrier. Advocates for targeted vaccination argue that individuals with chronic liver disease should be prioritized, given their higher risk of severe illness and complications.
The epidemiology: why hepatitis A spreads in the Czech Republic
Epidemiologists say the country remains highly susceptible to hepatitis A because most residents lack antibodies. The last major epidemic occurred in 1979, linked to contaminated Polish strawberries, which left about 30,000 people ill. A later surge in 1989 infected over 2,600 people. Though the current outbreak has different drivers, experts warn it could last longer than typical seasonal peaks. Kateřina Fabiánová, an epidemiologist, highlights that about a quarter of current infections involve children. While children often experience milder symptoms or none at all, they can transmit the virus to others in households and communities, underscoring the case for broader vaccination in pediatric populations.
At-risk groups and social determinants
The most affected populations include socially disadvantaged individuals living in areas with substandard hygiene. Homeless people, alcohol abusers, and drug users figure prominently among the infected, and many face financial barriers to vaccination. Pavel Dlouhý, head of the infectious diseases department in Ústí nad Labem and chair of the Czech Society of Infectious Medicine, argues for paid vaccination for selected high-risk groups when public subsidies are constrained. Insurance and prevention funds can help, but tangible access remains a concern for families and seniors facing vaccination costs.
Looking ahead: timeline, policy, and public health priorities
According to Fabiánová, the hepatitis A epidemic is not over. Past experience in the region suggests it could endure for another year or two, depending on vaccination uptake, public awareness, and adherence to hygiene practices. Health officials are weighing immediate deployment of vaccines to high-risk groups against longer-term strategies that could include childhood vaccination as part of the national immunization calendar. The coming months will be crucial as expert panels finalize recommendations and the ministry negotiates with manufacturers to ensure a stable vaccine supply that can meet demand across all eligible populations.
