Meningococcal Disease Outbreak among Gay, Bisexual Men in Florida, 2021–23

Meningococcal disease: Very serious, often deadly

The two most common types of meningococcal infections are meningitis (an infection of the lining of the brain and spinal cord) and bloodstream infection, both of which can quickly become deadly. People spread meningococcal bacteria to other people by sharing respiratory and throat secretions (saliva or spit). Generally, it takes close (for example, kissing) or lengthy contact to spread these bacteria.

Outbreak primarily affecting gay, bisexual men

Anyone can get meningococcal disease, no matter their gender, age, race, ethnicity, or sexual orientation. Since December 2021, meningococcal disease cases have spanned much of Florida, and affected a wide range of people. Included in these cases is a large, ongoing outbreak, primarily among gay and bisexual men. Recent data show that

• About half of the cases associated with this outbreak are among Hispanic men
• Some of the people affected are living with HIV
• Most people affected live in Florida but some people who have traveled to Florida have also become ill

MenACWY vaccination offers the best protection

Vaccination before traveling

Ideally, people would get vaccinated with one dose (or the 2-dose series for people with HIV) at least 2 weeks before traveling.

Vaccination for people living with HIV

CDC is also emphasizing the importance of routine MenACWY vaccination for people with HIV. For the best protection, people with HIV should make sure they have gotten their 2-dose primary series of a MenACWY vaccine and are up to date with booster doses. Learn more about what people living with HIV need to know about meningococcal disease.

Finding and paying for meningococcal vaccination

For those recommended meningococcal vaccination during this outbreak who have health insurance, it should be covered by their insurance provider. Those recommended vaccination who do not have insurance can get vaccinated for free at any Florida county health department during the outbreak.

Information for clinicians and vaccine providers

Available vaccines

MenACWY vaccines include Menactra®, Menveo®, and MenQuadfi®. Any of these vaccines can be used to vaccinate people during this outbreak.

• Although Menactra® and Menveo® are licensed for people through 55 years of age, they may be administered to people 56 years of age or older.
• MenQuadfi® is licensed for people 2 years of age or older.

Coadministration

You can administer MenACWY and other indicated vaccines, including monkeypox vaccine, during the same visit. Provide the vaccines at a different injection site, if feasible, and with a separate syringe.

Reimbursement

Insurance providers should pay for meningococcal vaccination for those recommended to receive it during this outbreak. If someone does not have insurance, refer them to a county health department as they should be able to provide vaccination free of charge. In Florida, anyone can get a MenACWY vaccine at no cost at any county health department during this outbreak.

Urge people with symptoms to seek medical care

Refer people for immediate medical care if they have symptoms of meningococcal disease (e.g., fever, headache, stiff neck, dark purple rash).

Footnotes

1. CDC routinely recommends MenACWY vaccine for children and adults at increased risk for meningococcal disease during an outbreak involving serogroups A, C, W, or Y. CDC also recommends a booster shot for those at increased risk due to an outbreak who received the vaccine more than 5 years ago.
2. CDC routinely recommends MenACWY vaccine for children and adults at increased risk for meningococcal disease, including those with HIV. People with HIV should get a 2-dose primary series of MenACWY vaccine, with the second dose given at least 8 weeks after the first, followed by a booster dose every 5 years. If someone completed their primary series before the age of 7 years, they should get their first booster dose 3 years later and then get a booster dose every 5 years.