Vaccines and HIV

The way a vaccine works is: first, a weak, live or dead, virus or bacteria is injected into the body and the body will make “antibodies”--a white blood cell that can fight the foreign virus or bacteria--against this substance.  These antibodies willprotect the person from getting the virus or bacteria in the future.  

In those with HIV, the body is not able to make antibodies as good as it could without HIV.  However, that doesn’t mean one should not receive the vaccine.  Vaccinating those with HIV is perhaps even more important than vaccinating those without the virus, since any extra infections will place an extra demand on the body in addition to the HIV infection.  Vaccinations should be given as soon as possible after HIV is diagnosed.  

In general, giving vaccinations (immunizations) to those with HIV may cause an increase in the amount of virus in the blood.  This may last for up to 6 weeks and is not important.  Only “dead” virus or “dead” bacteria vaccines should be given; “live” weakened virus or bacteria vaccines are not allowed (the only exception is the measles, mumps, and rubella (MMR) vaccine.  The following table contains the names of the vaccines, when they are given, whether “booster” doses are needed, and any comments about the specific vaccine.  

mims.co.uk

Vaccinations in those with HIV
Name of Vaccine	Abbreviation	When given	Booster	Comments
Tetanus/diphtheria	Td	Infant, childhood, adult	Every ten years; if wounded, give after 5 years	Injection drug users at more risk to get tetanus
Pneumococcal	Pneumovax	Childhood or at first visit to HIV clinic	In adults, give one booster 5-6 years after 1st dose; consider re-vaccinating after CD4 moves above 200.
Influenza	Flu shot	Every flu season	Every year
Hepatitis A	Hep A or HAV	Usualy given in infancy or childhood; if not immune, give at first visit, then 6-12months after 1st shot	Can tell if vaccine worked by checking for the Hepatitis A antibody (Hep A Ab) in blood.	Injection drug users, men who have sex with men, international travelers, hemophiliacs at more risk to get Hepatitis A.
Hepatitis B	Hep B or HBV	If not immune, give vaccine at first visit, then in one month, then 6 months after 1st shot	Booster required only if shot not effective--must check Hepatitis B surface Antibody (HBsAb).	If Hepatitis B surface antibody less than 10, must get one or more doses of vaccine
Optional vaccinations that may be given in those with HIV
Measles, Mumps, and Rubella	MMR	At age 1 year or in an adult with no history of getting vaccine	One booster is given 1 month after 1st shot.	Do not give to those with CD4 count less than 200.
Meningococcal	MCV4 or MPSV4	All children age 11-12 or before high school; Adults less than 55 years old; also, children 2-10 in high risk groups	Consider a booster after 5 years if still at high risk	High risk: College students living in dormitories; no spleen; certain diseases; military; certain travelers
Human Papilloma Virus	HPV	females age 11-12--dose #1; dose #2 two months after first dose, then dose #3 six months after first dose.	No
Polio	eIPV (enhanced potency inactivated polio vaccine	Adults 18 or older--2 doses		Give only to those traveling to developing countries or to those who have been exposed to people who have just receive the oral polio vaccine
Varicella Zoster Virus	VZV or shingles			Do not give in those with CD4 less than 200 or in those with a history of chicken pox. Do not come into contact with someone who has VZV or shingles. Contact your health care provider if you do.)

The following vaccines should not be given to someone with HIV:

1. Oral polio vaccine (OPV)
2. Haemophilus influenzae type b conjugate vaccine (HbCV)
3. Varicella Zoster (shingles); this is a “live” virus vaccine
4. Smallpox (Vaccinia): also a “live” virus vaccine
5. Rotavirus: also a “live” virus vaccine
6. Bacillus Calmette-Guerin Vaccine (BCG): a “live”, weakened vaccine
7. Live, attenuated (weakened) cold-adapted vaccine (LAIV, FluMist)