Recently there has been an outbreak of Meningitis as well as Hepatitis A in Melbourne Australia. Today I thought it was important to review vaccinations gay men should consider with these outbreaks in mind.
Vaccinations All Gay Men Should Consider
Hepatitis A is a viral illness that is spread from faecal matter being ingested. Due to the nature of gay sex there is an increased risk of faecal oral contact from rimming or contamination of hands and other body parts. A course of Hep A vaccines, usually 2-3 injections, can offer life long immunity to this virus.
Hepatitis B is viral illness that spreads via blood, semen and vaginal secretions. Common transmission routes include sharing of contaminated implements that pierce the skin such as razors, needles, tattoo guns, acupuncture and body piercing needles. Sex and contact between body fluids and mucous membranes, ie semen in the eye can also lead to infection. There have been a few cases of transmission via biting from an infected person.
Hep B vaccination is a 3-4 injections spread over six months.
ADT: Diphtheria & Tetanus
Tetanus and Diphtheria are bacterial infections that, while quite rare, can be fatal. Diphtheria is spread via coughing and sneezing while Tetanus is spread from soil, dust or manure contaminating wounds or even small pin pricks of the skin.
Vaccination should be given every ten years up to the age of 50 when a final booster is given. If you have been exposed to a potential Tetanus prone wound, ie stepping on a rusty nail, your doctors will consider giving you a booster or additional treatment.
With the recent Meningococcal outbreaks it is worth considering having this vaccination. Meningococcal disease is spread via intimate contact such as kissing as well as regular close contact with an infected person, coughing and sneezing. An example may be people sharing a house with an infected person or attending a big event where a person in their early infection may be attending.
Normally a single dose given as an adult will offer life long immunity however some may consider a second vaccination after 3-4 years if a person is still at a high risk of infection, ie health care workers.
It is recommended to consider the multi strain vaccine ie Menactra that protects against the A, C, W and Y strains.
People living with HIV are recommended to have 2 doses of the vaccine separated by 6 months.
Human Papillomavirus Vaccine (HPV)
HPV is a common virus associated with cervical cancer, anal warts as well as mouth and throat cancers. Gay men are at a higher risk of HPV anal, mouth and throat cancers due to the nature of the way we have sex. HPV vaccination is highly worth considering.
Current HPV vaccines like Gardasil™ vaccinate against 4 strains of the virus associated with cancer development. Over life we can become exposed to each of these strains so the younger you are at time of vaccination the higher the protection offered. There is some emerging evidence that even if you have been exposed to strains before becoming vaccinated the vaccine may offer some protection with lower severity of disease.
HPV vaccination is given via three shots over a six month period.
Annual Flu Vaccine
The annual flu vaccine is highly recommended as influenza is easily spread via coughs, sneezes and casual contact. If you are a health care worker or have lots of travel it may be recommended to get 2 vaccinations per year.
Talk To Your Doctors & Get Vaccinated
For all gay men I recommend having a gay friendly doctor you are able to have open and frank discussion with. For your ongoing health I highly recommend having a regular doctor and to have a careful discussion about having the some or all of the vaccines mentioned above.
I recommend printing, sharing and discussing this article with your family doctor.
Yours in great health.
Dr George Forgan-Smith