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Old 07-17-2012
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Default Pneumococcal vaccination in HIV

Is there a particular CD4 count threshold that we need to start pneumococcal vaccination in HIV + pt? Or do we vaccinate at any CD 4 count?
UW mentions in a table to revaccinate in 5 years if the CD4 is <200. My understanding of this is the following... If the initial cd 4 count before starting vaccination is under 200.... Then you must revaccinate after 5 years....which means that I can start the vaccination at any cd 4 even below 200..do I have this right?
If the cd 4 was initially above 200....then no need for a booster after 5 years, unless pt is under 65 years when they got their first shot. Does this sound correct ?
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Last edited by usmledee; 07-17-2012 at 03:49 PM.
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Old 07-17-2012
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Originally Posted by Novobiocin View Post
My question was though, about the CD4 count in HIV pts. It's clear that ICPs like HIV must receive the vaccine, my question was .. should there be a certain CD4 count they must have to be eligible to get the vaccine or do we administer at any CD4 count?
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Originally Posted by usmledee View Post
My question was though, about the CD4 count in HIV pts. It's clear that ICPs like HIV must receive the vaccine, my question was .. should there be a certain CD4 count they must have to be eligible to get the vaccine or do we administer at any CD4 count?
Since CDC does not mention any particular CD4 count then it must be at any CD4 count i.e. whenever they are diagnosed with HIV AIDS.
Everyone has to follow CDC recommendations.
My understanding is that one person can get maximum 2 vaccinations --second one if they were immunized before age 65 and five years have passed since then.

Quote:
A second dose of PPSV23 is recommended 5 years after the first dose for persons aged 19 through 64 years with functional or anatomic asplenia and for persons with immunocompromising conditions.
Quote:
No one should receive more than two doses of PPSV23.

Last edited by Novobiocin; 07-17-2012 at 06:53 PM.
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