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What Do I Need to Know About Immunizations?

June 2009

I Am HIV Positive. Why Do I Need Immunizations?

Terms Used in This Fact Sheet

Antibody: a protein produced by the body's immune system that recognizes and fights infectious organisms. Each antibody is specific to a particular disease.

CD4 count: CD4 cells, also called CD4+ T cells, are a type of white blood cell that fights infection. HIV destroys CD4 cells, making it harder for your body to fight infections. A CD4 count is the number of CD4 cells in a sample of blood.

Immunization: the introduction of a vaccine into the body to stimulate the formation of antibodies to fight a specific disease. These antibodies will protect the person from getting that disease in the future.

Live vaccine: a vaccine containing live viruses or bacteria that have been weakened to produce an immune response without causing the severe effects of the disease.

Vaccine: a substance that stimulates the body's immune response in order to prevent or control an infection.

Viral load: the amount of HIV in a blood sample.

When you have HIV you are at increased risk for certain infections. Some of these infections can be prevented with vaccines.


Which Immunizations Should I Have?

See Recommended Immunizations for HIV Positive Adults Fact Sheet.


I Am Not Sure Which Immunizations I Have Had. What Should I Do?

Your doctor can help you determine which immunizations you have had. There are several blood tests that may also help determine if you have already had an immunization or the disease itself.

  • Hepatitis A: An antibody test will determine if you have had this immunization series or if you have had hepatitis A.
  • Hepatitis B: An antibody test will help determine if you have received this immunization series and if it was effective or if you have had hepatitis B.
  • Measles: If you were born before 1957 you will not need this immunization. An antibody test will help determine if you have received this immunization or if you have had measles.
  • Mumps: If you were born before 1957 you will not need this immunization. An antibody test will help determine if you have received this immunization or if you have had the mumps.
  • Rubella: If you were born before 1957 you will not need this immunization. An antibody test will help determine if you have received this immunization or if you have had rubella. If the test results are unclear and you are a woman of child-bearing age, you may need to have this immunization.
  • Measles, Mumps, Rubella (MMR): If you were born before 1957 you will not need this immunization. If you weren't previously immunized, have a CD4 count higher than 200, and have no or only mild HIV symptoms, you will need at least one dose of MMR. If you have moderate or severe symptoms from HIV, you should not receive MMR due to the risk of severe complications.
  • Varicella: If you were born before 1980 you will not need this immunization. If you have had chicken pox or shingles, have documentation of 2 doses of varicella vaccine, or have laboratory evidence of immunity you will not need this vaccine. If your CD4 count is below 200 you should not have this immunization.


Are There Side Effects From Immunizations?

Side effects may or may not occur.

  • Swelling, redness, and soreness at the injection site are common with any injection.
  • Moderate side effects such as fever, headache, and muscle aches may also occur.
  • Severe side effects such as an allergic reaction are possible and usually occur immediately or within several hours after the injection.
  • Certain immunizations, such as for pneumonia and influenza, may increase your viral load for several weeks.
  • If any side effects persist or become severe, contact your doctor.


When Should I Get Immunized?

  • It is suggested that you begin getting the recommended immunizations as soon as possible after you are diagnosed with HIV.
  • Some immunizations are more effective if your CD4 count is higher than 200 cells/mm3 when you receive them. Your doctor will decide when you should receive these immunizations.
  • For the influenza vaccine, it is best for your CD4 count to be greater than 100 cells/mm3 and your viral load to be less than 30,000 copies/mL.
  • See Recommended Immunizations for HIV Positive Adults Fact Sheet.


Do Any of the Immunizations Need to Be Given Again?

Some immunizations may need to be repeated.

  • After receiving the hepatitis B series, an antibody test may indicate that you have not developed antibodies in response to the immunization. You should then receive additional doses to be sure the immunization will be effective.
  • Influenza immunization should be repeated in the fall of every year when the vaccine becomes available.
  • Pneumococcal immunization is recommended to be repeated one time after 5 years, or if your CD4 count was lower than 200 cells/mm3 when you received the first dose.
  • Tetanus and diphtheria (Td) immunization should be repeated every 10 years. Tetanus, diphtheria, and pertussis (TDap) immunization should replace your next Td booster. Once you have received one TDap immunization, you will only need to receive the Td booster in the future because there is no need for repeated pertussis immunization.
  • Meningococcal immunization is recommended to be repeated after 5 years if you remain at risk for infection. You are considered at risk for infection if you are a college student, military recruit, do not have a spleen, or travel to certain parts of the world.


Are There Any Other Immunizations I Should Have?

  • If you travel outside of the United States, you may need additional immunizations for some countries.
  • Certain people, such as military personnel and health care workers, are advised to have specific immunizations.
  • Talk with your doctor to determine whether you need other immunizations.


Are There Any Immunizations I Should Not Have?

HIV positive people should usually avoid getting immunized with live vaccines because their immune systems may have been weakened by HIV. A weakened immune system might not be strong enough to fight off the viral/bacterial infection that may result from a live vaccine. MMR and varicella immunizations are an exception to this recommendation.


For More Information

Contact your doctor or an AIDSinfo Health Information Specialist at 1-800-448-0440 or http://aidsinfo.nih.gov.

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.
 
See Also
More on Preventing Other Infections When You Have HIV/AIDS

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