Within days of the city’s health department announcing it had seen a dozen meningitis cases among gay men since 2010, the Callen-Lorde Community Health Center purchased 620 doses of vaccine, put up posters and flyers in its West 18th Street clinic urging men to get vaccinated, and sent mailers to 3,000 clients who would benefit from vaccination.
“We try and take really good care of the patients who trust us with their health,” said Dr. Gal Mayer, Callen-Lorde’s managing director of clinical services, during an October 16 interview.
On September 27, the city’s Department of Health and Mental Hygiene sent a press release to the media that said the agency had seen four cases with one death in the prior four weeks. Separately, DOHMH sent healthcare providers an alert that said the city had seen 12 cases since 2010. One occurred in 2010, three in 2011, and eight this year. The men ranged in age from 21 to 59 and eight were HIV-positive. Four of the 12 men died from their meningitis infection.
The city did not initially recommend vaccination for gay men, but on October 4, DOHMH issued a statement saying that “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” should get the vaccine.
The city is offering the vaccine at nine facilities run by its Health and Hospitals Corporation and at ten DOHMH clinics. New Yorkers can also call the city’s 311 system for a referral to a private clinic.
While Callen-Lorde is preparing for an increased demand for the meningitis vaccine, the agency has not yet seen a significant uptick in patients seeking the vaccination.
“I don’t think that this outbreak has gotten a lot of attention outside of the alternative press,” Mayer said, though the clinic has already used about one third of the doses it purchased and it continues to buy more in small batches. The mailing should bring in additional clients.
“I think that when people get that and read it, they should be calling for an appointment,” Mayer said. “We’ll continue to capture them as they come in.”
Callen-Lorde’s annual budget is currently $37 million, and it employs nearly 210 people. Founded in 1971 as the Gay Men’s Health Project Clinic by three early gay rights activists, the clinic moved into its Chelsea location in 1998.
With 15,500 dedicated clients, including 3,600 HIV-positive gay men, Callen-Lorde manages 80,000 appointments a year for a variety of services. It has outgrown its offices. On a recent visit, Jay Laudato, Callen-Lorde’s executive director, was found working in his basement office, which is about the size of a hall closet.
Giving out some 200 doses of meningitis vaccine has added work for staff. The vaccine is administered in two shots spaced six to eight weeks apart.
“There’s a lot of extra visits that we have to squeeze in,” Mayer said. So far, patients have shown a range of reactions.
“People are reacting in the typical way that people react,” Mayer said. “Some people are taking it in stride, some people are getting worried.”
The mixed reaction is due, in part, to people not understanding how meningitis is spread. The bacteria that causes the infection of membranes in the spine and brain “colonizes the back of the throat and it’s just sitting there,” Mayer said.
“Usually, some illness that causes weakness in the mucus membranes allows the bacteria to get into the bloodstream,” he said.
A larger meningitis outbreak currently in 16 states was caused by a fungus in a contaminated steroid product that doctors used to treat chronic pain by injecting the drug directly into the spinal chord. The outbreak among gay men and the larger outbreak are unrelated.
A higher profile media campaign deployed on Grindr and similar sites might also bring in more men who should get vaccinated, though it is not clear the city will launch such a campaign.
“Presumably, you’re going to get a lot of bang for your buck on those websites,” Mayer said.