Hep A is a waterborne disease. If you live somewhere with proper sanitation and don't have contact with sewage you are at low risk and the funds for the vaccine are better directed elsewhere.
Not sure why you were downvoted. This is absolutely correct and why the city is paying for street cleaning in the areas most affected, in line with the efforts of the City of San Diego in their downtown areas.
Are the street sweepers in SF effective at actually sanitizing the urine and feces or are they really aerating the excrement so any diseases contained within are more easily transmitted to passersby? I'm guessing the latter.
and a lack of public toilets. People are people — we generally would rather go to the bathroom in private if it's an option. Homeless people don't shit in the street because it's their first choice.
HepA is more accurately transmitted via what's called the "oral-fecal route". If you eat food prepared by other people, people who may not be completely diligent in washing their hands, it's worth getting vaccinated. There's a large outbreak in Los Angeles currently.
https://www.cdc.gov/hepatitis/hav/afaq.htm#statistics
I agree that it's a low risk disease but disagree that funds would be better spent elsewhere as it is a cheap vaccine. Most people here probably were already vaccinated as a baby or had it as a child without obvious symptoms. If you get it as an adult it can make you quite sick and put you out of commission for a few days but rarely kills people, unless you have chronic liver disease already for another reason. It's the cirrhotics who suddenly get exposed for the first time as an adult who wind up with fulminant liver failure and die.