The meningococcal vaccine is now being recommended for New York City-residing HIV-positive men who have had intimate contact with other men under certain circumstances, according to a new alert from the NYC Department of Health and Mental Hygiene (DOHMH). The recommendation, issued October 4 by the agency, stems from the recent increase in invasive meningococcal disease cases among men who have sex with men (MSM) and its high fatality rate among those living with HIV.
An investigation into the outbreak was announced September 26, 2012. Since 2010, there have been 13 cases of Neisseria meningitidis—the bacterium responsible for the disease, which causes high fever, headache, stiff neck, and rash and may lead to life-threatening meningitis and pneumonia—among MSM residing in four of the five boroughs of the city. There was one case in 2010, four in 2011 and eight in 2012 (four in the last five weeks).
All cases were men between 21 and 59 years of age and eight are HIV positive. Four patient s have died, three of whom were infected with HIV.
It is important to note that the outbreak of invasive meningococcal disease among MSM in NYC is completely unrelated to the outbreak of fungal-related meningitis in several states that has been tied to the use of an injectable corticosteroid.
Based on the recent invasive meningococcal disease cases in NYC, the DOHMH is recommending the meningococcal vaccine for MSM meeting certain criteria:
1) They are living with HIV, and“Individuals who meet some but not all of these criteria are advised to discuss their need for meningococcal vaccine with their physician or medical provider,” the NYC DOHMH statement clarifies.
2) they’ve had intimate contact with men they met through an website, a smart phone “app” (e.g., Grindr), or at a bar or party since September 1, 2012.
There are several meningococcal vaccines licensed for use in adults. The vaccine may provide protection seven to ten days after vaccination, but not everyone will develop protective levels of antibodies.
MSM living with HIV who do receive one dose of the vaccine should return to their health care providers eight weeks later for a necessary second dose.
Because the vaccine is best given in the context of regular medical care for HIV infection, people should first check with their regular health care provider to ask if they have the vaccine. If the medical provider does not have the vaccine, people should visit an HIV clinic where the vaccine is available.
NYC residents may call “311” to find their nearest HIV clinic providing the vaccine.
To read the NYC DOHMH alert, click here.