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Immunizations (Vaccinations) for people with HIV/AIDS

HIV affects the immune system and weakens the body's ability to fight germs. It is therefore very important that people with HIV/AIDS (PHAs) take certain precautions to prevent illnesses and infections.

You can protect yourself from many infections by getting immunizations or vaccinations. Usually, these come in the form of an injection or a series of injections.

Other important ways to prevent infections include the following:

• taking some medications to prevent common AIDS-related infections
• using condoms for sex
• not sharing needles or drug-use equipment

What are immunizations (vaccinations)?

• Immunizations, or vaccinations, are injections that build up your body's defenses or immune system against certain infections. Usually the injections contain a very small amount of weakened or inactive forms of a certain germ. Vaccinations stimulate the immune system to produce proteins called antibodies, which attack certain germs. After vaccination, the next time your body comes into contact with the germ, it will be able to produce more antibodies to fight and prevent the germ from making you sick.
• There are two kinds of vaccines -- live vaccines or inactivated vaccines. A live vaccine is made from a weakened form of the germ. An inactivated vaccine is made from a dead form of the germ.
• Some vaccinations are recommended for everyone, such as the vaccines you received when you were a baby and later in childhood. Some vaccines are only recommended for specific groups of people at risk for certain infections. Vaccines may cause side effects and possibly a mild form of the disease they are designed to protect you from.

What is different for people with HIV/AIDS?

• PHAs may have different responses to vaccinations depending on the health of their immune systems.
• If your immune system is very weak (for example, if you have a very low T-cell [CD4] count), your body may not be able to produce enough antibodies after you have been vaccinated, or the antibodies may not last long. The vaccine may also cause more side effects or a more serious reaction when your T-cell count is very low. In PHAs, however, the risk of getting sick from the disease may be much worse than these short-term side effects or reactions. Discuss the risks and benefits of each vaccination with your doctor or nurse. The risks and benefits will vary, depending on the state of your health.
• In general, guidelines suggest that PHAs should not get live vaccines (such as the smallpox vaccine) because of the greater risk of developing this disease from the vaccine.
• Studies have shown that vaccination may increase your viral load for a short period of time. Do not measure your viral load within four weeks of any vaccination.
  

Which vaccinations are recommended for people with HIV/AIDS?

• pneumonia vaccine (Pneumovax): recommended for all PHAs once every 5 years for protection against common bacterial penumonia.
• flu vaccine (flu shot): recommended for all PHAs except those who are allergic to eggs. It is given once a year, usually around November.
• tetanus and diptheria: recommended for all PHAs once every 10 years for protection against these two common bacteria that can cause serious infections.
• hepatitis vaccines: hepatitis A vaccine is usually given as a series of two shots and will protect you for about 20 years. It is especially recommended for people who travel a lot. Hepatitis B vaccine is usually given as a series of three shots and will protect you for about 10 years. It is especially recommended for men who have sex with men, and people who use street drugs or inject drugs. There is no vaccination for hepatitis C.
• measles, mumps and rubella (MMR): a live vaccine that offers protection against three very common viruses that can be spread by coughing or sneezing. It is considered safe for PHAs whose T-cell (CD4) count is more than 200 but is not recommended for people with a lower T-cell count.

What about vaccinations for travelling?

• Check with your doctor or a travel clinic about the vaccinations you may need for travelling to different countries. Some countries may require specific vaccines for all travellers.
• In general, hepatitis A and B vaccines are recommended for all travellers.
• PHAs should avoid live vaccines such as cholera, typhoid, yellow fever and smallpox (vaccinia). If the country you are going to requires any of these vaccines, you can talk with your doctor and get a letter to explain that you have a medical reason for not getting vaccinated.