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Immunizations
Jul 2, 2003

Hi! I have been diagnosed with HIV for about 4 months (March 2003). I am almost sure that I was infected in December 2002. In addition to HIV, I HAD been infected with Gonorrhea (taken care of with antibiotics!!) I've had lab work done twice. initial Viral Load was 16,700 while CD4+ was 589. My second lab results showed a slight raise in Viral Load (18,000) and a raise in CD4+ (700). As of right now I am not on HIV medications, but I do take Vitamins B, E, and A daily. I am also have not experienced anything that I would consider a symptom. I have been going to college for a few years and have been accepted into a Nursing (RN) program this fall. My first question is.... Do you feel it is RISKY or dnagerous (to either myself OR to my future patients) for me to continue and enter the Nursing field? One of the requirements of entering the program is positive titers for several vaccinations (ie. MMR, Chickenpox, etc.). My titer for mumps (or was it measles... I just found out today and can't remember, sorry) came back negative. My ARNP told me that it is NOT recommended that I get revaccinated because it is a live vaccine. My second question is.... How risky is it for me to get such a vaccine? With HIGH CD4 counts am I really at anymore risk of diesease than anyone else not infected with HIV is?? I thought I had to have low CD4 counts to be at risk of sickness. I was not really very afraid, but this advice of NOT getting a vaccine has made me rethink a little. THANK YOU!!! :-) P.S. I'm a 27 year old male.

Response from Dr. Young

Thanks for your question.

In the state of Colorado, HIV status cannot and does not prevent persons from employment in the health care industry. This includes physicians and nurses. With a high CD4 count, your risk of acquiring infection is remote; though I'd always advice good handwashing and universal precautions.

As for vaccines; the conservative view is that even with high CD4s, to avoid any live virus vaccination-- this would include mumps, measles or rubella (as well as yellow fever) vaccinations. Since you were likely vaccinated as a child, you very well might have protective antibody titers for some of these, and would serve as a surrogate to needing a vaccination booster. In general, I write "medically contraindicated" on the request for vaccine documentation. BY


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