Vaccines

Question 1

Vaccines recommended in PLWHIV

Answer 1

1. HBV 4 doses - Engerix
2. Influenza - yearly
3. Pneumococcus
4. MMR
5. VZV
6. Shingrix
7. HPV

Question 2

HBV vaccine in HIV

Answer 2

Engerix double dose 4 doses @ 0,1,2,6

Ab levels measured at 4-8 weeks post last dose

If Ab < 10, 3 further doses at monthly intervals. Consider using Fendrix instead. If still no response, monitor HbsAg yearly and PEP if necessary.

If >10 but <100, boost & test again in 4-8 weeks

Vaccine is recommended in both isolated core Ab pos & ? In occult infections

Question 3

HPV vaccine in HIV

Answer 3

Recommend in All PLHIV up to 26 years

MSM up to 40 years

Women up to 40 years

If ART naive, consider waiting until CD4>200.

Quadrivalent 4vHPV vaccine @ 0,1,6 months.

Question 4

Influenza vaccine in HIV

Answer 4

Annual vaccination between September and November

Quadrivalent vaccine preferred.

LAIV NOT recommended

Question 5

Pneumococcal vaccine in HIV

Answer 5

Single dose PCV-13

Question 6

VZV/shingles vaccine in HIV

Answer 6

If VZV IgG neg & CD4>200, 2 doses 3 months apart.

VZV IgG pos & CD4>200, shingrix if 60+ years.