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Antiretroviral TherapyAIDSinfo
Recommended Immunizations for HIV-Positive Adults
June 2006
| Immunization Name | Associated Disease | Dosage | Comments and Warnings |
| Recommended for All HIV-Positive Adults | |||
| Hepatitis B virus (HBV) | Hepatitis B | 3 shots over a 6-month period | Recommended unless there is evidence of immunity or active hepatitis. Blood test to check for HBV antibody levels should be done after completion of immunization series. Additional shots may be necessary if antibody levels are too low. |
| Influenza | Flu | 1 shot | Must be given every year. Only injectable flu vaccine should be given to those who are HIV positive. The nasal spray vaccine (FluMist/LAIV) should not be used in this population. |
| Measles, Mumps, and Rubella (MMR) |
| 1 or 2 shots | The only live vaccine recommended for HIV-positive adults. People born before 1957 do not need to receive this vaccine. HIV-positive adults with CD4 counts <200 cells/mm3, a history of AIDS-defining illness, or clinical symptoms of HIV should not get the MMR vaccine. Each component can be given separately if needed to achieve adequate antibody levels. |
| Polysaccharide pneumococcal | Pneumonia | 1 or 2 shots | Should be given soon after HIV diagnosis, unless vaccinated within the previous 5 years. If CD4 count is <200 cells/mm3 when the vaccine is given, immunization should be repeated when CD4 count is >200 cells/mm3. Repeat every 5 years. |
| Tetanus and Diphtheria Toxoid (Td) |
| 1 shot | Repeat every 10 years. |
| Recommended for Some HIV-Positive Adults | |||
| Hepatitis A virus (HAV) | Hepatitis A | 2 shots over a 1 or 1.5 year period | Recommended for health care workers, men who have sex with men, injection drug users, people with chronic liver disease (including chronic hepatitis B or C), hemophiliacs, and people traveling to certain parts of the world. |
| Hepatitis A/Hepatitis B combined vaccine (Twinrix) |
| 3 shots over a 1-year period | Can be used in those who require both HAV and HBV immunization. |
| Haemophilus influenzae type B | Bacterial meningitis | 1 shot | HIV-positive adults and their health care providers should discuss whether Haemophilus influenzae immunization is needed. |
| Meningococcal | Bacterial meningitis | 1 shot | Recommended for college students, military recruits, and people traveling to certain parts of the world. |
| Not Recommended for HIV-Positive Adults | |||
| Anthrax | Anthrax | The currently available smallpox and varicella vaccines are live viral vaccines. With the exception of the MMR vaccine, live vaccines are not recommended for people with HIV. Although the currently licensed anthrax vaccine is not a live vaccine, the Advisory Committee on Immunization Practices does not recommend routine anthrax vaccination. | |
| Smallpox | Smallpox | ||
| Varicella | Chicken pox | ||
| Varicella-zoster* | Shingles | ||
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* Immunization for adults 60 years of age and older. This information is based on: (1) National Immunization Program Additional Information for Adolescent and Adult Vaccines. Centers for Disease Control Web site. Available at: www.cdc.gov/nip/recs/adult-specinfo.htm. Accessed March 23, 2006 and (2) Recommended Adult Immunization Schedule, by Vaccine and Age Group. Centers for Disease Control Web site. Available at: www.cdc.gov/nip/recs/adult-schedule.pdf. Accessed March 23, 2006. | |||
This article was provided by AIDSinfo.
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