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Recommended Immunizations for HIV-Positive Adults

June 2009

Immunization NameAssociated DiseaseDosageComments and Warnings
Recommended for All HIV-Positive Adults
Hepatitis B virus (HBV)Hepatitis B3 shots over a 6-month periodRecommended 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.
InfluenzaFlu1 shotMust 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.
Polysaccharide pneumococcalPneumonia1 or 2 shotsShould 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 one time after 5 years.
Tetanus, Diphtheria and Pertussis (Tdap) (Td)
  1. Lockjaw
  2. Diphtheria
  3. Pertussis
1 shotRecommended for adults 64 years of age or younger and should be given in place of next Td booster. Can be given as soon as 2 years after last Td for persons in close contact with babies under 12 months and health care workers.
Recommended for Some HIV-Positive Adults
Hepatitis A virus (HAV)Hepatitis A2 shots over a 1 or 1.5 year periodRecommended 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)
  1. Hepatitis A
  2. Hepatitis B
3 shots over a 6-month period or 4 shots over a 1-year periodCan be used in those who require both HAV and HBV immunization.
Haemophilus influenzae type BBacterial meningitis1 shotHIV-positive adults and their health care providers should discuss whether Haemophilus influenzae immunization is needed.
Human papillomavirus (HPV)Human papillomavirus3 shots over 6 monthsRecommended for females ages 9-26. Not recommended to be given during pregnancy.
Measles, Mumps and Rubella (MMR)
  1. Measles
  2. Mumps
  3. Rubella (German Measles)
1 or 2 shotsPeople 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.
MeningococcalBacterial meningitis1 or 2 shotsRecommended for college students, military recruits people who do not have a spleen, and people traveling to certain parts of the world. Repeat after 5 years if still at risk for infection.
VaricellaChickenpox2 shots over 4-8 weeksPeople born before 1980 do not need to receive this vaccine. Recommended unless there is evidence of immunity or CD4 count is 200 cells/mm3 or below. Not recommended to be given during pregnancy.
Not Recommended for HIV-Positive Adults
AnthraxAnthraxThe currently available smallpox vaccine is a live viral vaccine. Some 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.
SmallpoxSmallpox
Zoster*Shingles

* Immunization for adults 60 years of age and older.

This information is based on:

  1. Recommended Adult Immunization Schedule -- United States, January 9, 2009. Centers for Disease Control Web site. Available at: www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm. Accessed May 12, 2009.
  2. MMWR Quick Guide Recommended Adult Immunization Schedule -- United States, January 2009. Centers for Disease Control Web site. Available at: www.cdc.gov/mmwr/PDF/wk/mm5753-Immunization.pdf. Accessed May 12, 2009.
  3. MMWR General Recommendations on Immunization December 1, 2006 / Vol.55 / No. RR-15. Centers for Disease Control Web site. Available at: www.cdc.gov/mmwr/preview/mmwrhtml/rr5515a1.htm. Accessed May 12, 2009.


  
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This article was provided by AIDSinfo. Visit the AIDSinfo website to find out more about their activities and publications.
 
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