Live vaccines are used for MMR and thus may pose risks in immunocompromised patients. In a study of children with HIV infection, however, no severe reactions were documented in 70 HIV-infected children who received MMR vaccines.(
87) Moreover, reports suggest that severe disease with pneumonitis is common with measles in HIV-infected children, with a mortality rate of about 30%. One review suggests that vaccination may reduce the mortality rate of measles in HIV-infected children.(
88) On that basis, the CDC recommends measles vaccine for all HIV-infected children who are not severely immunosuppressed (with severe immunosuppression defined as a CD4 percentage of <15%) and who lack evidence of measles immunity.(
86)
As with other vaccines, serologic response may be poor in HIV infection, and children with severe HIV-related immunosuppression
should be considered susceptible to measles even if they have received measles vaccine....(
86)
Immunizations and HIV