Q and A

Question

If I am HIV positive which vaccines can I have?

Hi

I travel frequently to developing countries and often to rural areas. I have some questions on vaccinations. I read that people with HIV may not mount a full immune response when they are vaccinated. My CD4 count is 400 and I’m not yet on medication.

I had the inactivated polio/diptheria/tetanus jab in Dec 06 when I was HIV negative and it expires Dec 2016. Do I need to get re-vaccinated? Also the Typhim Vi jab expired last Dec – is it possible to get an inactivated typhoid jab? And finally, is it safe to have the Dukoral vaccine – is it something you’d recommend?

Many thanks in advance and best wishes to everyone at i-Base.

Answer

Thank you for your question.

Vaccinations in HIV positive people are similar to those in HIV negative people. There are some things to consider when using certain live vaccines but the most important thing is to weigh up the risk versus benefits of having a vaccine. For example, many positive people are afraid of getting the live attenuated yellow fever vaccine. The chance of catching yellow fever from this vaccine and less than 1 in a million whereas the chance of catching yellow fever if you don’t have the vaccine is much higher. Not having the vaccine is far more dangerous than having it.

For detailed guidelines on all vaccines for HIV positive people, please see the excellent guidelines produced by the British HIV Association (BHIVA), updated in 2015.

http://www.bhiva.org/vaccination-guidelines.aspx

With regards to the specific vaccines you mentioned, the polio, diptheria and tetanus jab is not a live vaccine and so is very safe. If you are worried about your level of coverage you should speak to your doctor about testing your antibodies to these infections so that you can gauge when you would need a booster.

The typhoid vaccine is an inactivated vaccine and is not a live vaccine. This means it is safe for you to have. If your vaccine expired then you should try and get a booster before your next trip to a typhoid endemic region.

For more information on the typhoid vaccine please see the BHIVA guidelines above.

Similar recommendations are given for the Dukoral vaccine against cholera. It is safe to have and if you are travelling in cholera endemic areas then you should speak to your GP or nearest travel clinic about this vaccine.

For more information on Dukoral vaccine please see this link.

You may find that having a vaccine can increase your HIV viral load and this should be monitored soon after having the vaccine. If you have advanced HIV with a very low CD4 count (less than 200), then you should speak to your HIV doctor about the risks involved with having vaccines.

You should check with your GP or local travel clinic about any vaccines you are wanting to take because they are best placed to say whether or not it is recommended for each country.

For another site with general information about vaccinations in positive people please see this link.

3 comments

  1. Roy Trevelion

    Hi Musa,

    As Rebecca says above, not having the vaccine is far more dangerous than having it. However, the yellow fever vaccine is not recommended if you have a low CD4 count of under 200, or if you are older than 60 years.

    It’s great news that your blood results are very good. A CD4 count of 1,987 is strong, and your viral load is undetectable. It looks like your HIV treatment is working very well indeed.

    But please speak to your HIV doctor to check first.

  2. Musa

    Im nelly from Nigéria i saw where they are giving yellow fever vaccine and i colleted it but on reaching home my friend told me that the area he colleted his own they said anybody HIV positive should not collect,im worried would the vaccine affect my medication?my CD4 is 1,987 and vl load is 20copies.

  3. Jim

    Many thanks Charlotte. I wasn’t aware I could check I”m still covered by the vaccinations I had though reading this it totally makes sense. It’s very useful to know about the potential effect on viral load so I’ll let my doctor know about the vaccinations I’m having.

    Very much appreciated!

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