Missouri health officials have signed a contract designed to boost the rate of people vaccinated against hepatitis A as the number of cases of the liver disease increases. The Missouri Department of Health and Senior Services awarded a no-bid contract to the Missouri Primary Care Association. The agreement will pay the organization $125,000 a year to focus on getting more adolescents to receive at least five vaccines, including influenza, hepatitis A and HPV. Contract talks began before health officials warned last week that a hepatitis A outbreak in the state could grow worse if it spreads to urban areas. Health officials say the state has recorded 414 cases of the virus since September 2017. In previous years, only about 10 cases were reported annually.