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To prevent further infections, and to stop the disease from exploding, the department originally targeted 10,000 people for vaccination—then boosted the number once more in March to 103,000, its estimate of the gay population in New York City—and is giving shots away for free. Daskalakis, an HIV and infectious diseases expert who does HIV outreach testing in gay bars and sex clubs, is the only doctor in New York giving out vaccinations in the field. “The disease has spread beyond social media and gone into the bars and sex clubs,” says Daskalakis, a slender, youthful, and energetic man who has personally given out some 300 vaccinations, including the 44 he will give tonight in a three-hour period.
Several men standing in line at Paddles said their doctors told them that they didn’t have the vaccine, or that it was too expensive to keep in stock (a reported $700 or more for five doses). In addition, some insurance policies won’t cover it. The men said that they heard about Daskalakis by way of social media alerts on Facebook and Twitter. “I think the city can be doing a hell of a lot more to alert people,” says Mark Warfel, a plastic surgeon who had come to the club just for the vaccination. “People are carrying it and don’t know it. Scary.”
In fact, when the disease gained momentum last fall, the city’s efforts to publicize it were drowned out, first by Hurricane Sandy and then by an outbreak of an unrelated fungal meningitis, which was spreading by way of tainted cortisone shots to patients with lumbar spine pain. “A lot of people are still confused by what’s going on,” says Sue Weiss, clinical director for HIV at the Callen-Lorde Community Health Center for people with HIV, who adds that the center has since vaccinated some 5,000 or more of its patients. “Unfortunately, this one kind of got lost in the shuffle.”
As with the emergent HIV crisis in the 1980s, some gay men have been quick to blame themselves, even though the outbreak is not a sexually transmitted disease. When Brooklyn blogger and medical writer Michael Broder first wrote about the topic in early March, his comments section filled with the vitriol of warring camps. “It was like the HIV wars, when Larry Kramer spoke of sex-negative ideas, like, ‘shut down the apps, our promiscuity is killing us,’ and the sex-positive ideas of Richard Berkowitz, who literally wrote the book on condoms and safe sex,” says Broder.
That debate will likely intensify in coming weeks as experts identify more cases or find them elsewhere. Last week, Southern California health officials reported bacterial meningitis deaths among three men (two of whom identified as gay). The most recent death was on April 13—a 33-year-old West Hollywood lawyer who had attended the annual Easter weekend White Party in Palm Springs, which draws gay men from around the country. The Centers for Disease Control and Prevention says the New York City and Los Angeles County health departments have contacted its officials about their cases, but no direct link has been made. The CDC says it is monitoring the outbreaks.
In the meantime, the efforts of groups like Gay Men’s Health Crisis, which has led the charge in educational Twitter and Facebook blasts to the gay community and has given out hundreds of free vaccinations, is proving effective. In March, following its advisory, the NYC health department counted an estimated 1,182 people vaccinated in that month alone, either by the department or by groups and doctors reporting to it, since its recommendations in October. As of April 15, that number totaled 6,668. “Groups like the GMHC have done crazy good promotion,” says Daskalakis, as he cotton-swabs the bare shoulder of a graphic designer swaddled in what looks like a diaper beneath the black lights of the club. “It’s to the point that we have private doctors referring insured people here for the vaccine because it’s free.”
But as an infectious disease expert, he worries about what will happens if a few asymptomatic carriers go unvaccinated. “You look at the social network that we’ve identified that is at risk,” he says, tossing a used needle in a large red sharps box. “We’re all a big dorm here, with no walls and with these anonymous pairings. We need to be careful. This thing could break out into a regional outbreak. That’s why we’re trying to get to as many people as we can. We can’t let it get out of control.”