Flu Season 2016-2017



Preventing Seasonal Flu With Vaccination

September 1st 2016

Schedule your meningitis vaccination

Meningococcal outbreak in Los Angeles and Orange counties - Summer 2016


Update- August 1st:
Meningitis outbreaks among gay men have experts puzzled
| Los Angeles Times


Update - July 27:
Invasive Meningococcal Disease Vaccination Recommendations Expanded
| Department of Public Health


July 15th

This bulletin is from your doctor and goes to all patients of the practice regardless of individual risk group.


Meningitis is a rare but important disease. The current outbreak was first identified in May of this year. Since then, nine men in Los Angeles and Orange counties have fallen ill with a meningococcal infection, according to Dr. Karen Smith, public health officer for the California Department of Public Health. Most of the men were gay or bisexual. One of them has died from the infection.


The Los Angeles County Department of Public Health and The U.S. Advisory Committee on Immunization Practices recommended that all HIV patients routinely receive meningococcal vaccines. It is also recommended for all men who have sex with men with multiple partners and for college going adults.


Please review the information here and determine how this information applies to you. Feel free to share with friend and family. After review, if you have questions as to how this applies to you, please reach out over the portal or make an appointment to come in and discuss with your physician. This information will be updated on an as needed basis but for up to date information from the Los Angeles Public Health Department check the links below.



Meningococcal Vaccine FAQ:


Q: What is meningitis?


A: It is a serious infection of the surface of the brain and spinal cord.  Bacterial meningitis is particularly dangerous. The vaccine we are recommending now protects against one cause of this, Neisseria meningitidis.



Q: Do we recommend getting the meningitis vaccine?


A: Yes, if you are HIV + person: also if you are a male and have multiple male sexual partners, especially using online apps. For more even more precise information look here: http://publichealth.lacounty.gov/acd/docs/IMD2016.pdf



Q: Why is this being recommended now?


A: Since March 2016, there have been 13 cases in Southern California, 9 of them in Los Angeles. Most cases have been in gay men. Even though this is a small number of cases, vaccination is recommended to people at special risk because this organism (bacteria, bug) is easily spread from person to person.



Q: How is the meningococcal organism (bug) spread?


A: This organism is spread by close personal contact with an infected person. This includes sharing straws or joints, and other close contact eg kissing. See http://Dontswap.com for more information about transmission.



Q: Is it OK for HIV+ people to get the vaccine?


A: Yes, in fact it is recommended.



Q: How urgently do I need the vaccine?


A. It is not an emergency but sooner is better.


Q: How often is the vaccine given and what if I already got the vaccine in the last 5 years?


A: What you need depends on your status:


If you never did receive the vaccine before:


If HIV + you should receive 2 shots, one now and a second shot in about 2 months

If HIV negative you should receive just one shot


If you did receive the vaccine before within the last 5 years and ask what you need now:


If HIV + : If you got just one dose in the last 5 years, you should get a second dose (also called a booster).

If HIV + : If you already got two doses in past 5 years, you don't need another dose.

If HIV negative: If you already got one dose in the past 5 years, you don't need another dose



Q: Where is the shot administered?


A: In the arm or shoulder into the muscle.



Q: What are the side effects?


A:  Side effects are usually minimal besides a sore arm. However, please review this FDA approved language from the Menactra package insert to be found at http://www.menactra.com/


Side effects to Menactra vaccine include injection site pain, redness, swelling, headache and tiredness. In infants, irritability, crying, drowsiness, loss of appetite, and diarrhea. Other side effects may occur.


Vaccination should be avoided by persons with known hypersensitivity (severe allergic reaction) to any ingredient of the vaccine. Persons previously diagnosed with Guillain-Barré syndrome (GBS - severe muscle weakness) may have an increased chance of getting GBS following vaccination.


Vaccination with Menactra vaccine may not protect all individuals.



Q: What is the difference between the two brands of meningitis vaccine, Menomune and Menactra?


A: Menactra is the brand preferred for adults under age 55.  Menomune is preferred for adults 55 and older who have not been previously vaccinated. Menomune is currently in short supply.



Q: What if the pharmacy does not have the brand that is recommended for someone my age?


A: In that case we recommend getting whichever is available.



Q: Where can I get the vaccine?


A: Here are some locations we know have it. Please call the pharmacy to ensure in stock.

Olympia Plaza Pharmacy in our building 323 937-2590

AdRx Pharmacy on Wilshire 323 936-8221

Community Walgreens in West Hollywood 310 657-4333

Other specialized pharmacies eg Capitol Drugs and others.


You can also compare prices at www.goodrx.com, typing in Menactra



Q: How much does it cost?


A: It is mostly covered by insurance. The vaccine itself is approximately $150 per dose. Depending on your insurance plan, you may have to pay some or all (or none) of the cost of the vaccine. Most patients with insurance pay very little. Inquire ahead with the pharmacy.


It is good to check pricing but we have found the cost to be about the same in each pharmacy we have checked.


Q: What about administration of the vaccine?


If you bring your vaccine here to the office, we will administer and also document the vial/batch in your chart; there is a “minimal nurse visit” billed to your insurance. You may also combine this with a physician visit, lab work if prescheduled. Please call the office first.


Q: I have heard that some clinics give it for free. Do you have that information?


A: Yes, AIDS Healthcare Foundation (AHF) offers it at no cost on a walk-in basis at its Wellness Centers in Hollywood and the San Fernando Valley. For the locations, days and hours of operation of these clinics see http://aidshealthcare.org.  It is also available at the LA Gay and Lesbian Center - www.lalgbtcenter.org/hiv_care and the county health department.


Q: Where can I learn more?


A: http://publichealth.lacounty.gov/acd/Mening.htm