New York City's health department now urges HIV-positive men who hooked up with new sexual partners since September 1 to get a meningitis vaccine. | WORLD HEALTH ORGANIZATION
Less than a week after saying it had no plans to launch a vaccine campaign to combat an outbreak of invasive meningococcal disease (IMD) among gay and bisexual men in New York City, the city’s health department advised men who are at risk for the infection to get vaccinated and it established a network of city and private clinics to deliver the shots.
“The Department is advising vaccinations for any man who is HIV-positive and has had intimate contact with another man that he met through a website, digital application (‘App’), or at a bar or party since September 1, 2012,” the Department of Health and Mental Hygiene (DOHMH) wrote in an October 4 statement. “Vaccine will be available starting Friday at medical facilities throughout the city for men who meet these criteria but who cannot obtain it from their HIV care providers.”
On September 27, the DOHMH sent a press release to media that described an outbreak of four IMD cases in the prior four weeks, with one death among those four gay men.
Separately, the agency sent an alert to healthcare providers that described 12 cases with four deaths. One occurred in 2010, three occurred in 2011, and eight occurred this year. DOHMH did not recommend vaccination in that alert. Eight of the 12 men were HIV-positive.
After the September 27 press release, Gay City News was told by a person who had knowledge of DOHMH’s internal deliberations that the department would buy 10,000 vaccine doses and launch a campaign to tell gay and bisexual men to get vaccinated against the bug. A DOHMH spokesperson told the newspaper that the agency would buy “some” doses of the vaccine. Another DOHMH spokesperson later denied that the agency had any such plans and demanded that Gay City News correct its earlier reporting.
“We have not purchased 10,000 doses and have not decided to launch a campaign,” Alexandra Waldhorn wrote in a September 28 email. “Both references need to be corrected. If anything changes, we’ll be sure to let you know.”
The October 4 statement said men who were at risk for meningitis could get a shot at nine facilities run by the city’s Health and Hospitals Corporation (HHC), any one of ten DOHMH clinics, or they could call the city’s 311 system for a referral to a private clinic.
Meningitis is a relatively rare infection, and it would be unusual for health facilities to stock large amounts of the vaccine. What is entirely unclear is how widely DOHMH dispersed the message about vaccination and how many doses the city has on hand to vaccinate men who want it.
“We have a dynamic, reliable, and stable supply chain to ensure that enough vaccine is available so that all patients identified as high risk can receive vaccine at their primary medical provider, at an HHC facility, or at a DOHMH clinic,” Chanel Caraway, a DOHMH spokesperson, wrote in an October 4 email when asked how many doses the agency possesses.
“We will be publicizing this alert widely through traditional and non-traditional media, HIV service providers, and community-based organizations that work with the affected community,” Caraway wrote.
Ana Marengo, an HHC spokesperson, said that her agency would rely on DOHMH for its future vaccine needs.
“Our clinical teams have estimated that our supply is sufficient for the near term, with more being ordered and made available by DOHMH,” Marengo wrote in an October 4 email. “We expect to vaccinate anyone who is at risk.”
New York City’s response, undefined as yet in scope and aggressiveness, is in marked contrast to the response mounted by the two other North American cities that have had meningitis outbreaks among gay men.
Two of six gay men infected with meningitis in Toronto died in an outbreak from “early May to mid-July of 2001,” according to a 2003 issue of the Journal of Clinical Microbiology. Toronto health officials administered 3,850 vaccine doses free of charge in 50 locations, including bathhouses and a community center, from July 25 through August 18 of that year. Toronto saw no additional cases after that.
An October 2003 outbreak in Chicago that killed three of six infected gay men led health authorities there to mount an eight-day vaccination campaign that administered 14,267 doses at six sites, according to a 2007 article in the Journal of Clinical Microbiology. There were no new cases there.
Information on city health facilities where vaccinations are available can be found at tinyurl.com/9gkcu. Information on meningitis provided by the state health department can be found at tinyurl.com/95bqp36. The Callen-Lorde Community Health Center, an LGBT-focused facility located at 356 West 18th Street, is among the private facilities mounting a vaccination effort.