Question
Do I need one or two since-flu injections?
27 November 2009. Related: All topics, Children, Opportunistic infections.
I have had one dose of the swine flu jab, and am due to have a second dose next week. Why do I need 2 lots? also should my wife and child (under 2 years old and older than 12 months) be vaccinated against swine flu also because they live with me, but are both HIV-negative.
As always I am in awe of your kindness and passion for creating/maintaining/developing such a wonderful web site and phone line. Its good to know that someone cares as much as you guys do.
Answer
Hi
The reason that HIV-positive people are recommended to have a course of two injections is to improve the chance that it will be effective.
Most vaccine responses vary depending on the strength of your immune system. The lower your CD4 count, the lower the chance that you will generate an immune response that will protect you in the future. With seasonal flu vaccinations, this drops quite considerably if your CD4 count is below 200 cells/mm3.
Because most HIV-positive people have some reduced CD4 function, the double vaccination is hoped to overcome this.
The two main vaccines used for swine flu in the UK are Pandemrix (made by GSK) and Celvapan (made by Baxter).
For HIV-positive people, both are given in two doses, three weeks apart. Celvapan is given in two doses for everyone, regardless of HIV-status.
It is best to contact your GP about whether your wife should have the vaccination. The government leaflet suggest that this may be a good idea, if your own immune system is significantly reduced due to HIV:
“If you have a severely compromised immune system, ask the people you live with to think about getting vaccinated to help protect you against catching swine flu. If you are unsure about whether you should be vaccinated, speak to your GP or practice nurse”.
In practice, the benefit is probably related to your current CD4 count. If it is above 500 it is less important as you will probably be protected by the vaccine. If it is currently less than 200, it is more important as the vaccine may not work for you. Anywhere between 200 and 500, then probably it is also a good idea.
You should discuss the use of vaccinations in children with your GP as vaccination in children is a specialised area.
Thanks also for your comments which are appreciated :)
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