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May 2014 VA Hep C Treatment Guidelines
UPDATE: Feb 26, 2016-
Funding and Prioritization Status Update

UPDATE: March 2016
VA Hep C Treatment Guidelines
VA to treat all vets in system

By Judith Graham
VA Extends New Hepatitis C Drugs to All Veterans in Its Health System

Orange Count Registry
Vietnam vets blame 'jet guns' for their hepatitis C
By Lily Leung Feb. 14, 2016 
CBS News Investigates
Congress outraged over hepatitis C treatment VA can't afford
Dr. Raymond Schinazi played a leading role developing a drug that cures hepatitis C while working seven-eighths of his time for the VA| By amynordrum

Hepatitis C drug costing VA, DoD millions
By Patricia Kime, Staff writer
We're looking at a company who is milking a cash cow for everything it's worth," Sanders said. 

VA to outsource care for 180,000 vets with hepatitis C
Dennis Wagner, The Arizona Republic 12:27 a.m. EDT June 21, 2015

VA to outsource care for 180,000 vets with hepatitis C
, The Republic | 11:51 a.m. MST June 19, 2015
Dr. David Ross, the VA's director public-health pathogens programs, resigned from the working group. "I cannot in good conscience continue to work on a plan for rationing care to veterans," he wrote.

VA Region Stops Referring Patients To Outside Hospitals Thanks To Budget Shortfall
Michael Volpe Contributor ...According to a memo — the entire region has been forced to stop all “non-VA care” referrals due to a budget shortfall.
Sen. Mark Kirk admitted the VA Choice Program is a failed joke in a letter to Secretary Bob McDonald despite attempts to fix it.

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Dried Hepatitis C Blood Exposure 11/23/2013 Weeks later inconspicuous blood transmits virus and more likely to cause accidental exposures to Hep C

Lack of Standards for
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1970 Jetgun Nursing Instructions

2014 AASLD Study Hepatitis C not an STD

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This potential risk for disease transmission would exist if the jet injector nozzle became contaminated with blood during an injection and was not properly cleaned and disinfected before subsequent injections.

CDC- MMWR Recommendations and Reports

January 28, 1994 / 43(RR01);1-38

General Recommendations on Immunization Recommendations of the Advisory Committee on Immunization Practices (ACIP)

The following CDC staff members prepared this report:* John C. Watson, MD, MPH Charles W. LeBaron, MD Sonja S. Hutchins, MD, MPH Stephen C. Hadler, MD Walter W. Williams, MD, MPH National Immunization Program, CDC

Jet Injectors

Jet injectors that use the same nozzle tip to vaccinate more than one person (multiple-use nozzle jet injectors) have been used worldwide since 1952 to administer vaccines when many persons must be vaccinated with the same vaccine within a short time period. These jet injectors have been generally considered safe and effective for delivering vaccine if used properly by trained personnel; the safety and efficacy of vaccine administered by these jet injectors are considered comparable to vaccine administered by needle and syringe.

The multiple-use nozzle jet injector most widely used in the United States (Ped-o-Jet) has never been implicated in transmission of bloodborne diseases. However, the report of an outbreak of hepatitis B virus (HBV) transmission following use of one type of multiple-use nozzle jet injector in a weight loss clinic and laboratory studies in which blood contamination of jet injectors has been simulated have caused concern that the use of multiple-use nozzle jet injectors may pose a potential hazard of bloodborne-disease transmission to vaccine recipients (10). This potential risk for disease transmission would exist if the jet injector nozzle became contaminated with blood during an injection and was not properly cleaned and disinfected before subsequent injections. The potential risk of bloodborne-disease transmission would be greater when vaccinating persons at increased risk for bloodborne diseases such as HBV or human immunodeficiency virus (HIV) infection because of behavioral or other risk factors (11,12).

Multiple-use nozzle jet injectors can be used in certain situations in which large numbers of persons must be rapidly vaccinated with the same vaccine, the use of needles and syringes is not practical, and state and/or local health authorities judge that the public health benefit from the use of the jet injector outweighs the small potential risk of bloodborne-disease transmission. This potential risk can be minimized by training health-care workers before the vaccine campaign on the proper use of jet injectors and by changing the injector tip or removing the jet injector from use if there is evidence of contamination with blood or other body fluid. In addition, mathematical and animal models suggest that the potential risk for bloodborne-disease transmission can be substantially reduced by swabbing the stationary injector tip with alcohol or acetone after each injection. It is advisable to consult sources experienced in the use of jet injectors (e.g., state or local health departments) before beginning a vaccination program in which these injectors will be used. Manufacturer's directions for use and maintenance of the jet injector devices should be followed closely. Newer models of jet injectors that employ single-use disposable nozzle tips should not pose a potential risk of bloodborne disease transmission if used appropriately.


UPDATE: Jetgun- New PCNIF Fail Safety Test -The study ended early because the protector cap needle-free injector (PCNFI) failed to prevent contamination in the first batch tested (8.2% failure rate). Vaccine. 2008 Mar 4;26(10):1344-52. Epub 2008 Jan 18.