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Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents

Figure: Immunization Schedule for Human Immunodeficiency Virus (HIV)-Infected Adults

Last Updated: May 7, 2013; Last Reviewed: May 7, 2013

Immunization Schedule for Human Immunodeficiency Virus (HIV)-Infected Adults
Vaccine ↓  Indication → HIV Infection
CD4+ T lymphocyte count
<200 cells/μL
HIV Infection
CD4+ T lymphocyte count
≥200 cells/μL
Influenza * 1 dose IIV annually
Tetanus, diphtheria, pertussis (Td/Tdap) * Substitute 1-time dose of Tdap for Td booster; then boost with Td every 10 yrs
Varicella * Contraindicated 2 doses
Human papillomavirus (HPV) Female * 3 doses through age 26 yrs
Human papillomavirus (HPV) Male *
3 doses through age 26 yrs
Zoster Contraindicated

Measles, mumps, rubella (MMR) * Contraindicated
1 or 2 doses
Pneumococcal polysaccharide (PPSV23) 1 dose followed by a booster at 5 years
Pneumococcal 13-valent conjugate (PCV13) *
1 dose
Meningococcal * 1 or more doses
Hepatitis A * 2 doses
Hepatitis B * 3 doses
* Covered by the Vaccine Injury Compensation Program
† IIV - Inactivated Influenza Vaccine. LAIV (live attenuated influenza vaccine) is not recommended for HIV-infected persons

For all persons in this category who meet the age requirements and who lack documentation of vaccination or have no evidence of previous infection; zoster vaccine is recommended regardless of prior episode of zoster Adapted from the advisory Committee on Immunization Practices (ACIP) 2013 Adult Immunization Schedule. A summary of the adult immunization schedule vaccines and their primary indications, adverse events and contraindications can be found at: For more detailed information on immunization of persons with HIV infection against influenza, pneumoccocial disease, hepatitis b, human papillomavirus, varicella, and hepatitis a, see disease-specific sections in the text and in Table 1. For additional information on these and other vaccines (tetanus, diptheria, pertussis, measles, mumps, rubella, and meningoccocal disease), refer to the recommendations of the ACIP at:
    Recommended if some other risk factor is present (e.g., on the basis of medical, occupational, lifestyle, or other indications)
    No recommendation

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