VACCINATION ISSUES IN AIDS


ACIP until mid-1996 recommended MMR for all eligible pts with asymptomatic HIV infection and consideration if symptomatic

After case report of 20yo many with AIDS and CD4 of "too low to count" got MMR and developed measles pneumonia and died, ACIP is re-evaluating reccs; for now reccs witholding MMR from HIV+ pts with "severe immunosuppression" (CD4 < 750 if <12mo; < 500 if 1-5yo; < 200 if >15-MMWR 45:603, 1996-JW)

Influenza vaccine appeared effective c/w placebo and w/o sig. adverse effects in a randomized trial of 102 pts with HIV and CD4 < 500/mm3 (Ann. Int. Med. 131:430, 1999--JW)