Book contents
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- 7 Diagnosis of HIV-1 infection in children
- 8 Prevention of mother-to-child transmission of HIV
- 9 Routine pediatric care
- 10 Immunizations
- 11 Prevention of opportunistic infections and other infectious complications of HIV in children
- 12 Emergency evaluation and care
- 13 Adherence to antiretroviral therapy in children and youth
- 14 Adolescents and HIV
- 15 Adolescent reproductive health and HIV
- 16 Growth, nutrition, and metabolism
- 17 Neurobehavioral function and assessment of children and adolescents with HIV-1 infection
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- Appendices
- Index
- Plate section
- References
10 - Immunizations
from Part II - General issues in the care of pediatric HIV patients
Published online by Cambridge University Press: 03 February 2010
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- 7 Diagnosis of HIV-1 infection in children
- 8 Prevention of mother-to-child transmission of HIV
- 9 Routine pediatric care
- 10 Immunizations
- 11 Prevention of opportunistic infections and other infectious complications of HIV in children
- 12 Emergency evaluation and care
- 13 Adherence to antiretroviral therapy in children and youth
- 14 Adolescents and HIV
- 15 Adolescent reproductive health and HIV
- 16 Growth, nutrition, and metabolism
- 17 Neurobehavioral function and assessment of children and adolescents with HIV-1 infection
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- Appendices
- Index
- Plate section
- References
Summary
General principles for immunizations in HIV-exposed and HIV-infected patients
Routine pediatric immunizations should be given to all HIV-exposed infants and HIV-infected children according to the schedule recommended by the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP) [1]. Additional vaccines, such as the polyvalent pneumococcal vaccine, may be indicated because of the patient's immunocompromised state. Please note that the recommendations in this chapter are US recommendations; guidelines in other countries and localities may vary.
In the USA, HIV-exposed and -infected children should not receive live-virus or live-bacteria vaccines, with the exception of measles, mumps, rubella (MMR), and varicella vaccine. The inactivated polio vaccine (IPV) should be given instead of the live oral polio vaccine (OPV). Varicella vaccine should be considered in HIV-infected children who are in CDC clinical class N1 or A1 with adequate CD4 counts (see below) [2]. MMR should be given to all HIV-exposed and -infected children unless they are severely immunocompromised (see below) [3]. Although Bacille Calmette—Guerin (BCG) is not recommended for HIV-exposed and -infected children in the USA [4, 5], the World Health Organization recommends BCG in HIV-infected children in countries with high HIV prevalence [6, 7]. However, testing for HIV infection in asymptomatic children without risk factors for HIV is not indicated before administering live virus vaccines.
In general, children with symptomatic HIV infection tend to have poor immunologic responses to vaccines, with decreasing responses as the infection progresses.
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- Textbook of Pediatric HIV Care , pp. 145 - 152Publisher: Cambridge University PressPrint publication year: 2005