|VACCINATION SCHEDULE: HIV-INFECTED ADULTS|
|This schedule summarizes recommendations for routine administration of vaccines for HIV-infected adults based on CD4 count. For more information on the following immunizations, refer to the vaccination schedule of the Advisory Committee on Immunization Practices (ACIP) and the Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents.|
|Recommended for all persons who meet the age requirement, lack documentation of vaccination, or lack evidence of past infection||Recommended for persons with a risk factor (medical, occupational, lifestyle, or other indication)|
|CD4 T-lymphocyte count|
|Vaccine||<200 cells/µL||≥200 cells/µL|
|Influenza1||1 dose annually|
|Tetanus, diphtheria, pertussis (Td/Tdap)||Substitute Tdap for Td once, then Td booster every 10yrs|
|Measles, mumps, rubella (MMR)2||Contraindicated||2 doses|
|Varicella (VAR)3||Contraindicated||2 doses|
|Herpes Zoster (HZV)||Contraindicated|
|Human papillomavirus (HPV) Female4||3 doses through age 26yrs|
|Human papillomavirus (HPV) Male4||3 doses through age 26yrs|
|Pneumococcal 13-valent conjugate (PCV13)5||1 dose|
|Pneumococcal polysaccharide (PPSV23)5||2 or 3 doses|
|Hepatitis A6||2 or 3 doses|
|Hepatitis B7||3 doses|
|Meningococcal 4-valent conjugate (MenACWY) or polysaccharide (MPSV4)8||2 doses, then every 5yrs|
|Meningococcal B (MenB)9|
|Haemophilus influenzae type b (Hib)10|
1 Inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV). Live attenuated influenza vaccine (LAIV) is not recommended for HIV-infected persons.
2 Two doses should be at least 28 days apart.
3 Two doses should be given 3 months apart.
4 Give 3-dose series at 0, 1–2, and 6mos.
5 Give 1 dose of PCV13, followed by 1 dose of PPSV23 at least 8wks later. The second dose of PPSV23 should be given at least 5yrs after the first PPSV23 dose. If the last PPSV23 was given at <65yrs, at age 65, give another PPSV23 dose at least 8wks after PCV13 and at least 5yrs after the last PPSV23 dose. Pneumococcal vaccines should be given as soon as possible after HIV diagnosis.
6 2-dose series (single-antigen HepB vaccine): Havrix at 0 and 6–12mos or Vaqta at 0 and 6–18mos. 3-dose series (combined HepA-HepB vaccine): Twinrix at 0, 1, and 6mos.
7 3-dose series of single-antigen HepB vaccine (Engerix-B, Recombivax HB) or combined HepA-HepB vaccine (Twinrix) at 0, 1, and 6 mos.
8 Previously unvaccinated persons should receive a 2-dose series at least 2mos apart. If previously vaccinated, give second dose at least 2mos after the first dose. Revaccinate every 5yrs.
9 Not routinely recommended. Meningococcal disease in HIV is caused primarily by serogroups C, W, and Y.
10 Not routinely recommended. Risk for Hib infection in HIV is low.
For information on individual vaccines, please see product monographs at www.eMPR.com, contact company for full labeling, or call the National Immunization Hotline at (800) 232-4636.
Source: Advisory Committee on Immunization Practices (ACIP). Recommended Immunization Schedule for Adults Aged 19 Years or Older by Medical Conditions and Other Indications—United States, 2017. https://www.cdc.gov/vaccines/schedules/hcp/imz/adult-conditions.html
Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents. 2013 May. http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf