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Vaccinations in the Setting of HIV Infection |
1. As a general rule, live vaccines should be avoided in persons infected with HIV and particularly in persons with symptomatic HIV or AIDS.
2. Revaccination should be considered in the setting of immune reconstitution (e.g. CD4-lymphocyte increases from less than 200 to over 200.)
3. Due to their transient effects on HIV viral load, delay vaccinations while evaluating new antiretroviral therapy or possible adverse trends in virologic suppression (i.e. rising HIV viral loads)
| Vaccine | Indication | Dose & Frequency | Comment |
| Pneumococcal vaccine | HIV | 1 cc IM every 5-6 years | Revaccinate after immune reconstitution? |
| Influenza vaccine | HIV | 1 cc IM every year in Oct/Nov | Hold vaccination for CD4 < 100 |
| Adult diphtheria/tetanus (dT) | General population | 1 cc IM every 10 years or after high risk exposure and last vaccination > 5 years | |
| Measles, mumps, rubella (MMR) | HIV | Once | Hold vaccination for AIDS |
| Inactivated polio vaccine (IPV) | HIV-infected persons who are
either 1. Travelers to endemic areas 2. Healthcare workers who might treat persons with polio |
Doses at 0, months 1-2, and months 6-12 | Oral polio vaccine contraindicated |
| Hepatitis B vaccine series | HIV | 1 cc IM week 0, week 4, and at 6-12 months or after exposure | Check hepatitis B surface antibody level after series to verify immunity |
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Hepatitis A vaccine series
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Men who have sex with men Travel to endemic area inc Mexico Substance users Recipients of clotting factor concentrates Chronic liver disease |
1 cc IM at 0 and 6 months | |
| Smallpox Vaccine | Contraindicated in HIV | Contraindicated in HIV | Risk of disseminated vaccinia infection |
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Next Page |
Click HERE for Laboratory Evaluation of HIV-Infected Patients |
Updated 6.26.2006
