Reframing Hepatitis C Prevention for Vulnerable Communities

The journey of a new vaccination campaign for hepatitis C in vulnerable populations begins with an essential correction: there is currently no approved vaccine that prevents hepatitis C infection. A credible public health campaign must therefore avoid promising immunisation against the virus and focus on prevention, testing, treatment, and protection against related infections.

Hepatitis C is a blood-borne virus that can cause chronic liver disease, cirrhosis, liver cancer, and premature death. Direct-acting antiviral medicines can cure most infections, often within 8 to 12 weeks, yet many people remain undiagnosed or face barriers to care. A campaign that connects people with screening and treatment can deliver the practical benefits communities may expect from a vaccination drive.

This work belongs within a coordinated health translation system. Research evidence, community knowledge, primary care, hospitals, drug and alcohol services, prisons, Aboriginal and Torres Strait Islander health organisations, and peer networks all have a role in turning prevention goals into accessible services.

Start With Accurate Public Health Messaging

The first stage is to explain the difference between hepatitis A, hepatitis B, and hepatitis C. Vaccines are available for hepatitis A and hepatitis B, but not hepatitis C. Hepatitis B vaccination is especially relevant for people at risk of blood exposure, and combined prevention messaging can help the public understand which infections can be prevented through immunisation.

Clear language should also explain how hepatitis C spreads. Sharing injecting equipment is a major route, while tattooing or piercing with unsterile equipment, unprotected exposure to infected blood, and some healthcare procedures can also carry risk. Hepatitis C is not spread through casual contact, shared meals, hugging, or ordinary household interaction.

Campaign materials should avoid language that blames people for infection or assumes a single lifestyle. Vulnerability may be shaped by homelessness, incarceration, poverty, mental illness, disability, limited health literacy, migration experiences, unstable healthcare access, or previous trauma. Messages are more effective when they emphasise confidentiality, cure, respect, and practical support.

Design Services Around Real Barriers

A prevention campaign needs to meet people where healthcare already happens. Mobile clinics, needle and syringe programs, opioid treatment services, community pharmacies, sexual health clinics, Aboriginal Community Controlled Health Services, emergency departments, and custodial health facilities can all provide testing or referrals.

Point-of-care antibody testing followed by confirmatory RNA testing can shorten the path from concern to diagnosis. Dried blood spot testing may help reach people who avoid conventional blood collection. In some settings, nurse-led or peer-supported pathways can reduce delays and help patients start antiviral treatment without navigating several separate appointments.

Trust is a clinical intervention in its own right. People may fear disclosure, child protection consequences, immigration impacts, discrimination, or judgment from healthcare workers. Confidentiality statements, trained staff, interpreters, flexible appointment times, transport assistance, and peer navigation can make the difference between an offered service and a completed course of care.

Build Partnerships From Evidence to Practice

A Queensland-wide approach can benefit from collaboration between researchers, clinicians, consumers, and service leaders. The Brisbane Diamantina network provides a useful model for connecting research institutes, universities, and health services so that evidence can inform everyday care rather than remain in academic publications.

Community members should participate before campaign materials are finalised. Co-design workshops can test whether messages are understandable, whether imagery feels respectful, and whether proposed services fit local routines. Aboriginal and Torres Strait Islander leadership is particularly important when programmes operate in communities with distinct cultural priorities and experiences of healthcare.

The campaign should also learn from successful immunisation and maternal health initiatives. Work on maternal vaccination uptake demonstrates the value of trusted messengers, reminder systems, convenient delivery, and locally adapted communication. These principles can be applied to hepatitis C screening and treatment without incorrectly presenting hepatitis C as vaccine-preventable.

Connect Testing With Effective Treatment

Testing has limited value if people receive results without a clear route to treatment. Every campaign site should establish referral protocols, clinical responsibility, and follow-up procedures before advertising screening. Electronic reminders, warm referrals, and case management can reduce the number of people lost between diagnosis and treatment.

Direct-acting antivirals are highly effective, but medical assessment remains important. Clinicians may need to review liver health, medication interactions, pregnancy status, hepatitis B infection, and previous treatment. People who inject drugs should not be excluded from therapy; treating current infection and offering harm reduction together can reduce illness and community transmission.

Follow-up should include a test for sustained virological response after treatment and education about reinfection. A cure removes the existing infection but does not create immunity. People with continuing exposure risk may need regular testing, sterile injecting equipment, and ongoing contact with peer or primary care services.

Make Clinical Environments Safer

Hospitals and acute care services may encounter people with undiagnosed hepatitis C during treatment for unrelated conditions. Staff need practical training in standard precautions, respectful communication, testing pathways, and referral options. Infection control should be based on evidence rather than fear, because ordinary contact with a patient does not transmit hepatitis C.

Health systems should also consider the needs of people who cannot easily describe symptoms or make decisions independently. Trauma-informed communication, supported decision-making, and accessible information are relevant across emergency, intensive care, mental health, and community settings. Guidance on pain care for non-verbal patients illustrates how clinical systems can adapt care to patients whose needs may otherwise be overlooked.

A campaign becomes stronger when it is integrated with broader liver health, blood-borne virus, mental health, and substance use services. Shared records, with appropriate consent and privacy safeguards, can help prevent repeated assessments and support continuity when people move between hospitals, housing services, prison health, and community care.

Measure Equity, Trust, and Health Outcomes

Success should not be judged by the number of posters distributed or tests performed alone. Useful measures include the proportion of people receiving results, time from diagnosis to treatment, treatment completion, cure rates, reinfection, patient experience, and differences in outcomes between population groups.

Data should be separated by location and relevant social factors where safe and ethical. Aggregate results can reveal whether rural communities, people leaving prison, people experiencing homelessness, or Aboriginal and Torres Strait Islander communities are benefiting equally. Privacy protections and community governance are essential when collecting information about small or identifiable groups.

Evaluation should combine statistics with lived experience. Interviews, peer feedback, service observations, and consumer advisory groups can show why a pathway is working or failing. Findings should be shared in accessible formats and used to revise funding, workforce training, outreach locations, and referral processes.

Priorities for a Fair and Effective Campaign

• State clearly that no hepatitis C vaccine is currently available, while promoting hepatitis B vaccination where appropriate.
• Offer low-barrier testing with confirmatory diagnosis, treatment referral, and follow-up in the same service pathway.
• Fund peer workers and community-controlled organisations to guide communication, outreach, and programme governance.
• Combine antiviral treatment with sterile equipment, harm reduction, mental health support, and care for housing or social needs.
• Track patient experience and equity outcomes alongside testing, treatment, and cure statistics.

A well-designed campaign can transform the promise of prevention into measurable action. By linking accurate education with accessible testing, curative treatment, harm reduction, and community leadership, health services can reduce hepatitis C transmission and improve liver health without overstating what vaccination can achieve. Research partners, clinicians, funders, and community organisations can begin by mapping local gaps, agreeing on shared measures, and creating referral pathways that work from the first conversation through cure.