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The page has been copied from www.hivwebstudy.org:
Update to HBV Vaccination at Madison (see below) [pdf]
Recommended Adult Immunization Schedule: January 2009
Annals of Internal Medicine - January 2009
Vaccines & Immunizations - CDC web site
Quick Guide - New Adult Immunization Guidelines
Pneumococcal Vaccine - Decision Tree [New - 2012]
2007-2008 Adult Schedule Figures
Recommended Immunizations for HIV-Infected Adults
Currently, we are providing double-dose 40 mcg recombinant HBV vaccine (2 doses of 20 mcg/ml Engerix-HB) to our patients, based on 2006 Guidelines from the Advisory Committee on Immunization Practices. However, 2008 Guidelines from the DHHS/CDC/HIVMA on Opportunistic Infections do not recommend double-dosing up front, arguing that the data in support of this practice is inadequate. We have reviewed the primary literature and agree that there is insufficient evidence to support widespread use of double-dose HB vaccine. There is some data to support its use in revaccination of non-responders. Therefore, Madison Clinic guidelines on hepatitis B immunization will be as follows:
NOTE: Advised to start immediately soon after entry into care, esp if pt has early HIV infection and high CD4 counts. If pt has more advanced disease (esp nadir CD4 <200) and you anticipate starting HAART within next 6 months, advise waiting until viral suppression achieved as this has been shown in several studies to be associated with improved vaccine responses. It is less clear whether waiting for immune reconstitution to CD4>200 is warranted.
No clear data to support annual HBsAb assessment or booster dosing beyond what is described above.
* Varicella vaccination should be considered for HIV-infected children with age-specific CD4+ T-lymphocyte percentage >15% and may be considered for "non-immune" adolescents and adults in with CD4+ T-lymphocyte count >200 cells/L.
From:HIV Web Study <http://www.hivwebstudy.org>
This table has been reproduced and modified from the ACIP recommendations for routine immunizations of adults with medical conditions. Centers for Disease Control and Prevention: The Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2002-2003 and Recommended Immunizations for adults with medical conditions: United States, 2002-2003. MMWR Recomm Rep. 2002;51(40):904-8.
For the full CDC guidelines on vaccinations see: http://www.cdc.gov/mmwr/PDF/rr/rr5102.pdf
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