Say there was a disease out there that was mostly fatal, often debilitating, and could cost you your arms and legs — but there was also a vaccine available to help make sure you get it. You’d want the vaccine, right?
Well, meningitis is that disease. And there is a vaccine for it. Yet, despite an ongoing outbreak among men who have sex with men (MSM) in Southern California, only 27 percent of MSM in Los Angeles County report getting the vaccine, and an additional 29 percent don’t know if they have been vaccinated.
Those are just a couple of the facts we discovered in a study published by our Southern California HIV/AIDS Policy Research Center the week of March 27. The information is both troubling and telling—and prompt us to urge all gay and bisexual men, as well as any individual living with HIV, to get vaccinated—and do it now.
The California Department of Public Health declared an outbreak of invasive meningococcal disease (the “official” name of meningitis) in Southern California in March 2016 that has primarily affected MSM. Since then, 27 individuals have been infected in Los Angeles, San Diego, Orange, and Ventura counties—most of them gay and bisexual men. Two men have died. The outbreak is ongoing. And this isn’t the only outbreak we’ve seen in recent years. In a 2014 outbreak in Los Angeles, three gay men in their 20s died as a result of being infected.
Meningitis is a particularly nasty illness. Depending on the strain, up to 70 percent of those who are infected can die. In addition, meningitis can lead to loss of limbs, hearing impairment, and central nervous system and kidney failure. One in five survivors of meningitis experience serious lifelong health issues.
The good news is that we have a vaccine that is 85 percent to 100 percent effective in preventing four strains of meningitis; it is known as “quadrivalent meningococcal conjugate vaccine,” or MCV4. It is available for free at Los Angeles County Public Health Department clinics and from community-based health care organizations such as APLA Health, the Los Angeles LGBT Center, and AIDS Healthcare Foundation.
So why aren’t more gay and bisexual men getting vaccinated? Our research shows that many men want to learn more about the disease and the vaccine or they don’t think they are susceptible to infection. While 27 cases over the course of a year may not seem like many, meningitis can spread quickly in small, close-knit communities.
Meningitis is transmitted through intimate contact—but not as intimate as you may think. Coughs and sneezes from an infected person carry the pathogen. Gay men are vulnerable in the places we socialize, such as bars, clubs, parties, gyms. And it is not necessarily about sexual behavior. You can get meningitis simply by sharing a drink or a cigarette.
For people living with HIV, meningitis can be especially dangerous. For this reason, experts recommend two doses at least eight weeks apart for people living with HIV. In our study, only 26 percent of men who were HIV-positive had received two doses.
In the course of our research, we also learned that 12 percent of the men we surveyed who had not been vaccinated were concerned about side effects. The most common side effect from the MCV4 vaccine is redness or soreness where the shot was given, which usually subsides in one to two days. A small percentage of people who get vaccinated develop a mild fever.
Which brings us to the role medical providers play in helping educate their patients and getting the word out to the community. We need to talk to our own doctors about meningitis and request the vaccine. Most physicians receive little or no training on the unique health needs of the LGBT community at large, and it is in our own best interest to advocate for ourselves. Give your doctor the Centers for Disease Control and Prevention fact sheet and ask them to talk to their other patients who may be at risk about the disease.
And there’s more we can do. Many of the men we surveyed cited a desire to protect themselves and their communities as primary motivations for getting vaccinated. These guys understand what epidemiologists call “herd immunity.” The more of us who are vaccinated, the less likely meningitis will spread. Talk to your friends. Post to social media. Help raise awareness in your networks.
Vaccines are safe and effective—and in the case of a disease as serious as meningitis, they are necessary. Many gay and bisexual men understand all too well what it’s like to worry about contracting a disease through intimate contact. And while it may seem that meningitis is only affecting a few of us, it’s easy—and free—to protect ourselves. Please get vaccinated. Your life may depend on it.
Ian Holloway and Phil Curtis direct the Southern California HIV/AIDS Policy Research Center, a collaboration between UCLA, APLA Health, and the Los Angeles LGBT Center. Holloway is an assistant professor in the Department of Social Welfare at UCLA’s Luskin School of Public Affairs. Curtis is the director of government affairs at APLA Health.
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