“It’s definitely ‘all hands on deck,'” says Washtenaw County Public Health Department spokeswoman Susan Ringler-Cerniglia. “Or should I say ‘all needles on deck?'”

Alarmed by an outbreak of Hepatitis A, health officials are promoting vaccination for high-risk residents: restaurant workers, gay men, drug users, individuals in homeless shelters and jails, and first responders.

Hep A cases in southeast Michigan counties have increased dramatically over the past sixteen months: in 2017, at least 600 cases were diagnosed, with twenty fatalities. Washtenaw County’s numbers are comparatively low, with just nine cases as of early December. But with seven cases since September, the health department was offering walk-in vaccination days in December. Some restaurant owners are paying for their staffs to get the shots, and the Delonis Center homeless shelter provides them free. That’s multiplied the number of people getting vaccinated from about ninety a week in September to about 400 weekly in December.