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Yellow Fever Vaccine
Dec 31, 2004

I have searched the forums for an answer to this question and there seem to be conflicting viewpoints. I wanted to know how safe yellow fever vaccines and malaria prophylaxis are for asymptomatic people. Some experts on here say the yellow fever vaccine is not safe at all and some say its OK if you're asymptomatic. My viral load has been undetectable, my count above 600, and my ratios above 30 for about 8 years now. I am currently taking Epivir, Ziagen, and Viramune. The only side effects I've had from any meds I've been on are mild cases of facial wasting and neuropathy, both of which stopped after I stopped taking Videx. I feel great and take very good care of myself. The reason I'm asking is because my work might take me to Sub-Saharan Africa in the near future. I would quit my job if I knew that it could put my health at serious risk. I would just like some kind of a clear answer so that I can discuss this further with my doctor. Thanks.

Response from Dr. Henry

There is some confusion partly due to lack of comprehensive data on the long term effectiveness and safety of the live yellow fever vaccine in various populations of HIV infected persons. Generally it is believed to be OK to vaccinate asymptomatic HIV+ persons with yellow fever vaccine but not to use the vaccine in AIDS patients or symptomatic patients. What is unclear to me is what to recommend for lets say an AIDS patient (formerly with CD4 < 200) now doing well with a good CD4 count (i.e. > 350) and well supppressed HIV. When potential exposure to yellow fever is high and/or unavoidable I usually have given the yellow fever vaccine to patients in the latter category (AIDS but doing well now). Your HIV status (also assuming you are asymptomatic) would generally lead me to OK the use of the vaccine. Your HIV specialist would be the best person to assess whether there are circumstancs in your case which might influence that decision. KH



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