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would like yellow fever vaccine

Apr 5, 2004

Hello I would like to travel to Ghana this winter for a study abroad program with school. If it weren't for my low t-cell count of 190, I would have no problem getting the yellow fever vaccine. I am in great shape, go the gym every other day, feel great, and have been undetectable for 2 years. I do not have the same fears as getting the vaccine as I'm told I should. My doctor wants me to get a waiver or not to go. I could get a waiver as I will mostly be in the more developed capital city and in modern housing well equipped to deal with mosquitos, etc. Nevertheless, I can avoid it 100% and I really do not feel that getting the vaccine will put me at too much risk. For some reason I just feel very confident that I will be fine. Nevertheless, I would like to know just how much do you think I am ignoring risks? I would very much appreciate your advice, as everyone seems to give me a very black & white CDC-style answer such as "you can not get it given your cd4 count." Isn't there some grey area here?

much thanks

Response from Dr. Holodniy

It is a live attenuated vaccine. There is little published data on the risks in HIV infected patients. However, it has been reported to have been successfully given in patients with asymptomatic infection and high CD4 counts, and was associated with one fatal case of vaccine associated encephalitis. Thus, the CDC recommendations to use extreme caution, or for the vaccine to be contraindicated in patients with AIDS is not unreasonable.

How much does psychological stress affect CD4 count?
RE. CD4 and viral load both climbing? of Mar 28.

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