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Alyson Books, in partnership with The Advocate, is publishing The Advocate Guide to Gay Men's Health and Wellness by Frank Spinelli, MD, in January. This concise reference manual aims to be a definitive source for all you need to know about your health. The book provides helpful information on how to stay well and what to do if you become ill. In this excerpt Spinelli lays out the five vaccines every gay man should know about.
1 Tetanus vaccine Tetanus is an often-fatal disease caused by the bacteria Clostridium tetani. Contracted through injuries such as lacerations, punctures, and splinters, tetanus is characterized by muscular rigidity rapidly spreading throughout the body, producing pain and stiffness, especially in the neck and jaw -- hence the alternative name lockjaw. The impact on the facial muscles produces a particular characteristic feature called risus sardonicus, or "sardonic grin," in which the angles of the mouth are drawn down, exposing taught clenched teeth. The vaccine for tetanus is co-administered with the diphtheria toxoid called Td, which should be offered to all adults. Administration of a booster dose to all adults who have completed a primary series can be given after ten years. A new onetime single dose of Tdap instead of Td is recommended for those between the ages of nineteen and sixty-four in order to provide protection against the spread of pertussis.
2 Hepatitis A and B vaccine Both hepatitis A and B are viruses that can be avoided through vaccination. By the very nature of their sexual practices, gay men are more predisposed to these diseases, and it is strongly recommended that they all get vaccinated, especially those who are HIV- positive. Prior to taking the vaccination, your doctor should check your blood for the antibodies because you could already have been exposed to hepatitis A or B and not know it. If you have not been exposed, and that is proven by a blood test, then your doctor can administer the series. Hepatitis B is given in three separate injections over six months. Hepatitis A is given twice over six months. The combined hepatitis A and B, or the TWINRX, is given three times over six months. Once you have completed the series, immunity is assessed by checking for the antibodies in your blood. Upon development of the antibodies, you will have immunity against hepatitis for up to seven to ten years. The vaccine has been available in the United States since 1995.
3 Pneumovax This is a preventative vaccine against pneumococcal pneumonia caused by the bacteria streptococcus pneumonia. The indication is for individuals, aged sixty-five and older, or anyone with chronic medical conditions, such as diabetes, liver disease, kidney failure, and especially HIV. A booster shot after five years can be given.
4 Flu vaccine Every fall there is a huge campaign for the flu vaccine. The flu can be debilitating and even deadly for some who contract it. A few years ago there was even a shortage of the flu vaccine. This had everyone in a panic. The CDC reports that each year the flu will affect 5 to 20 percent of the population and more than 200,000 people will be hospitalized from complications of it. In fact, about 35,000 people will die from the flu each year. An allergy to eggs is the only excuse to avoid the flu vaccine because current manufacturers use an egg extract as the basis for the vaccine.
5 Gardasil The vaccine for the human papillomavirus (HPV) types 6, 11, 16, and 18. Currently this vaccine is not indicated in men. Gardasil helps prevent disease and does not treat HPV. It works best when given before you have had any contact with HPV.
