II. Precautions

  1. Do not give Live Vaccines (e.g. oral polio, Varicella Vaccine, Flumist) if CD4 Count <200
  2. Defer non-urgent Vaccinations until after Antiretroviral therapy initiated to boost immune response

IV. Preparations: Indicated Non-Live Vaccines

  1. Consider delayed Vaccination until CD4 Count>200 and after Antiretroviral therapy initiated
  2. Pneumococcal Vaccine
    1. Prevnar 13 followed by Pneumovax at least 8 weeks later
    2. Give after diagnosis and then every 6 years
    3. Immunogenicity is better if higher CD4 Count >200
  3. Conjugated H Influenza type b capsular Vaccine
    1. Highly immunogenic in HIV without advanced disease
  4. Influenza Vaccine yearly (inactivated form)
  5. Hepatitis A Vaccine
  6. Hepatitis B Vaccine (if HBsAg negative)
  7. Routine Tetanus Vaccine (Tdap or Td)
  8. Human Papilloma Virus Vaccine (Gardasil)
  9. Meningococcal Vaccine (if indicated)
  10. Consider Hib Vaccine

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