Hi, With the recent news about measles outbreaks around I asked my primary care Dr for an MMR IgG test. All came back negative for immunity (not surprising as I was vaccinated back in the 1960s). Question is, my ID Dr said I shouldn't get a booster shot for MMR even though my CD4 count has been over 400 for the last 9 years. I've read conflicting thoughts about getting one online and wanted to get another opinion. Thank you.
The devil is in the details about what measles vaccine you received in the 1960's and when. If vaccination was between 1963 and 1968, it was likely the inactivated form, and not the live-attenuated form, which provides a much better immune response. Experts would recommend for those who received the killed vaccine and now don't have evidence of immunity, that an additional measles vaccination would be indicated. In those who received the live vaccine, and even if they don't have evidence of IgG antibody against measles, the recommendations are less clear. Most of the published recommendations (including those for HIV infected people) focus on those without evidence of having received the appropriate vaccine and without immunity. Those folks should get a two shot series. Whether a booster is required for people who received the appropriate vaccine the first time, even if they are HIV infected or don't have evidence of antibody is not specifically addressed. Therefore, there is no contraindication for someone with HIV infection and a CD4 count over 200 and on HIV treatment to receive measles vaccine.