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When To Immunize Your HIV-Infected Child?

By Nancy Wongvipat, M.P.H.

July 1999

The information on this page is the recommended immunization schedule for HIV-infected children, adapted from the 1999 USPHS/IDSA Guidelines for the Prevention of Opportunistic Infections in Persons Infected with HIV (updated May 14, 1999). This schedule also applies to children born to HIV-infected mothers, in which the child's HIV infection status has not been determined.


Vaccine recommendations for immunosuppressed children

  • Polio. Inactivated poliovirus vaccine (IPV) is the only polio vaccine recommended for HIV-infected people and their household contacts because it cannot replicate or spread from person to person. Although the third dose of IPV is generally administered at 12 to 18 months, the third dose of IPV has been approved to be administered as early as 6 months of age. Oral poliovirus vaccine (OPV) should not be administered to HIV-infected people or their household contacts because it is a live vaccine and can replicate and spread from person to person.

  • Measles, mumps, rubella (MMR). MMR vaccine should not be given to severely immunocompromised children. HIV-infected children without severe immunosuppression should routinely receive their first dose of MMR vaccine as soon as possible upon reaching the first birthday. The second dose should be given as soon as one month after the first dose, rather than waiting until school entry.

  • Influenza. Influenza vaccine should be given to all HIV-infected children over 6 months old each year up to age 6.

  • Streptococcus pneumoniae. This vaccine should be given to all HIV-infected children at 24 months of age.

  • Varicella. This vaccine should not be given to HIV-infected children.

  • Rotavirus. This vaccine should not be given to HIV-infected children.


Vaccine recommendations for all children
(those immunocompetent and immunocompromised)

  • Hepatitis B (HB). The HB vaccine is different from the HB immune globulin. HB immune globulin is given to those who are already infected with HB, whereas, HB vaccine is given to those who have not yet been exposed to HB.

    HB vaccination consists of three doses. The second dose should be administered at least one month after the first dose, and the third dose should be administered at least four months after the first dose and at least two months after the second dose (Dose 1 at birth; Dose 2 at one month; and Dose 3 at six months).

    Infants born to HB-positive mothers should receive HB immune globulin and be vaccinated within 12 hours after birth. Infants born to mothers whose HB status is unknown should also be vaccinated within 12 hours after birth. If the mother is found to be HB-positive, the infant should receive HB immune globulin no later than one week of age. Infants born to HB-negative mothers should be vaccinated after birth. Children and adolescents who have not been vaccinated against HB in infancy may begin the series during any childhood visit.

  • Diphtheria, Tetanus, Pertussis. DTaP (diphtheria and tetanus toxoids and acellular pertussis vaccine) is given in four doses (Dose 1 at age 2 months; Dose 2 at 4 months; Dose 3 at six months; and Dose 4 at 15 months). The fourth dose of DTaP may be given as early as 12 months of age if six months have passed since the third dose. Td (tetanus and diphtheria toxoids) is recommended at 11 or 12 years of age if at least five years have passed since the last dose of DTP, DTaP or DT. Routine Td boosters are recommended every 10 years.

  • Haemophilus influenza type b (Hib). Three types of Hib vaccine can be given to children under 12 months of age. Your child should get doses at 2 and 4 months, and a booster dose between 12 and 15 months. Depending on which vaccine your doctor or clinic is using, there may also be a dose at 6 months. Children who are late in getting their first dose may follow a different schedule. Your doctor or clinic can give you details. Hib vaccine is usually not recommended for children after their fifth birthday, since not many children over five get the disease.


This article has been reprinted at The Body with the permission of AIDS Project Los Angeles (APLA).




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