Immunization Guidelines

When we think of immunizations the first thing that comes to mind babies getting their first vaccines. But adult immunization is a very important part of health maintenance, especially in people living with HIV. Adult immunization is an essential part of good HIV care. But which immunizations should the HIV+ person get? In fact, not all vaccines are safe to give a person with a weakened immune system such as people living with HIV. Here are the immunization guidelines for HIV infected adults.

• Pneumococcal Pneumonia (Pneumovax) - All HIV infected people should be vaccinated as part of their initial evaluation when entering HIV care. A second vaccine dose should be given 5 years after the initial dose for a total of two doses in a lifetime.
  • Persons over the age of 64 years should only receive one dose in their lifetime.

    Pneumovax Fact Sheet

• Hepatitis A - All men who have sex with men and those women who practice receptive anal intercourse should be vaccinated for protection against Hepatitis A.
  • Given in 2 doses, the initial dose and the second 6-12 months later.
  • Can be given as part of the combined Hepatitis A and B vaccine called Twinrix.

    Hepatitis A Vaccine

    Twinrix Fact Sheet

• Hepatitis B - Administer to anyone who has no evidence of Hepatitis B antibodies which is determined by a simple blood test.
  • Given in 3 doses, the initial dose, the second 1 month later, and the third 5 months after the second (all 3 doses should be given over a 6 month period).
  • Can be given along with Hepatitis A vaccine as part of the Twinrix vaccine.
  • Approximately one month after the third dose, the patient should be tested for the presence of Hepatitis B antibodies. If there are none, a booster dose or an new double dose series should be done using the same time frame as the single dose series.
  • If after a double dose series or booster dose there are still no Hepatitis B antibodies in the blood, no further Hepatitis B vaccine is given.

    Hepatitis B Vaccine Fact Sheet

    Double Dose Hepatitis B vaccine Guide

• Influenza (flu) - Administer to all HIV infected people once each year. Exceptions are made for those people with a documented sensitivity to the vaccine or an allergy to preservatives or eggs.

  Flu Vaccine Fact Sheet

  Important Warning!
  The nasal flu vaccine FluMist contains live flu virus. Therefore, people with weakened immune systems, including people living with HIV, should NEVER take or be given FluMist.

• Tetanus Vaccine or Tdap - Administer using guidelines for those people not HIV infected.
  • Should be administered every 5-10 years.

    Tetanus Vaccine Fact Sheet

• Human Papilloma Vaccine (HPV) - Ideally should be given to young girls 11 or 12 years of age (ideally before becoming sexually active).
  • Given as a series of 3 doses; the initial dose, the second dose 4-6 weeks after the first; the third 6 months after the initial dose.
  • Currently the HPV vaccine is not approved to be given to men.

    HPV Vaccine Guide

    Everything You Need to Know About HPV

Important Warning!
An HIV infected person should never be given vaccines containing live virus (e.g., the chickenpox vaccine, FluMist influenza vaccine). In people with weakened immune systems like people with HIV, live virus vaccine can cause a severe outbreak of the virus being vaccinated against. Before agreeing to receive any vaccine, confirm with your doctor or theperson administering the vaccine that it's not a live virus vaccine.

What is a vaccine?

Understanding the Immune Response and Immunizations

_{Source: The Centers for Disease Control (CDC); "Recommended Adult Immunization Schedule"; 1 Sept 2007.}