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Live virus vaccines in human immunodeficiency virus-infected children: a retrospective survey
M McLaughlin1, P Thomas, I Onorato
1New York City Department of Health, Division of Medical Affairs, NY 10013.
Insights
Live virus vaccines pose risks for immunocompromised children. This study found no serious adverse events in children with human immunodeficiency virus (HIV) after receiving oral polio or measles, mumps, and rubella vaccines.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Vaccinology
Background:
- Live virus vaccines can cause severe reactions in immunocompromised individuals.
- Children with human immunodeficiency virus (HIV) may have compromised immune systems, raising concerns about live vaccine safety.
Purpose of the Study:
- To evaluate the frequency of serious adverse events following live vaccine administration in children with HIV infection.
- To assess the safety of oral polio vaccine (OPV) and measles, mumps, and rubella (MMR) vaccine in pediatric HIV patients.
Main Methods:
- Retrospective survey of outpatient records for 319 children with HIV infection in New York City and New Jersey.
- Review of vaccination histories and temporal relationship between immunization and onset of immunodeficiency symptoms.
Main Results:
- Vaccination histories were available for 221 children; 81% received OPV and 32% received MMR vaccine.
- 120 children had a temporal link between immunization and symptom onset; 46 received OPV and 23 received MMR post-symptom onset.
- No serious adverse events (e.g., measles, polio, meningitis) were reported within one month of vaccination.
Conclusions:
- Live oral polio vaccine and measles, mumps, and rubella vaccine appear to be safe in children with HIV infection.
- Further follow-up is needed, but initial findings suggest no increased risk of severe adverse events.
Abstract:
Live virus vaccines can cause serious adverse reactions when administered to immunocompromised patients. Because children infected with human immunodeficiency virus (HIV) may be immunosuppressed, immunization of these children with live virus vaccines is a potential problem. A retrospective survey was conducted by the New York City Department of Health, with consultation from the Centers for Disease Control, to evaluate the frequency of serious adverse events following receipt of live vaccines among children with HIV infection receiving pediatric care in New York City and New Jersey. Outpatient records of 319 children being cared for by 16 participating physicians were reviewed. Of the 319 charts, 221 (69%) contained vaccination histories. Perinatal transmission of HIV infection was suspected for 208 (94%) of the 221 cases and infection via transfusion for the remaining 13 (6%). Of the 221 for whom immunization histories were available, 180 (81%) had received at least one dose of live oral polio vaccine and 70 (32%) had received measles, mumps, and rubella vaccine. There were 120 children for whom a temporal relationship between immunization and onset of symptoms of immunodeficiency could be seen; 46/120 had received at least one dose of oral polio vaccine and 23/45 had received measles, mumps, and rubella vaccine after onset of symptoms. Although follow-up of this population has been limited, there were no reports of serious adverse events such as typical or atypical measles, paralytic poliomyelitis, or aseptic meningitis in the month following vaccination.(ABSTRACT TRUNCATED AT 250 WORDS)