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Op-Ed

Vacc for PLHIVs

A Filipino living with HIV wants to know what vaccinations he should consider getting, and Dr. Jose Narciso Melchor Sescon responds.

Dr. Jose Narciso Melchor Sescon – president of the AIDS Society of the Philippines and current Chief of Clinics of Sta. Ana Hospital – answers all your HIV-related inquiries. For all your questions, email josescon1@gmail.com or info@outragemag.com.

Dear Doc,

I have been HIV positive for three years now. It has been mentioned to me that because of my status, I should get vaccinated. My question is: What vaccinations are recommended for an HIV-positive person to have?

Vacc Man

Thank you for the question.

Vaccines or immunizations serve as protection for HIV persons from obtaining diseases. We understand the HIV causes damage to the immune system and therefore affects any vaccine’s effectiveness. It is best recommended, in general, that vaccines be given when the CD4 count is above 200 copies/mm3. Upon vaccination/immunization, these stimulate the body’s immune responses so a transient viral load increase may occur.

HIV medicines (anti-retroviral) strengthen the immune system and reduce HIV viral load, so people with HIV may want to start ART before getting vaccination. In some cases, vaccines are given first before ART; for example flu vaccine, when the risk is greatest.

Here are some of the vaccines:

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  1. Influenza (flu) vaccine – yearly given since new strains are added every year
  2. Pneumococcal vaccine – which is given every five years
  3. Hepatitis B vaccines – given three shots at 0, 1, 6 month intervals; before having the Hep B shots, blood tests to determine Hepatitis titers (antibody’s blood levels are checked against hepatitis) is first undertaken
  4. HPV vaccine (quadrivalent type) – given on 0, 2, 6 months for prevention of genital warts (for those up to age 26)
  5. Tetanus, Diphtheria and Pertussis (whooping cough) (TPD vaccine) – if started, given every ten years

These are the basic vaccines one has to take and should be administered by health professional (e.g. nurse, midwife). They are given at different time intervals to allow the body to generate the desired immune system responses.

Prior to administering these vaccines, the health provider would ask some ask some specific questions, and they may even ask for specific laboratory tests prior to the administration of vaccines.

In general, HIV clients should get inactivated vaccines to avoid the remote chance of getting a disease from a live, attenuated vaccine types. However, there are vaccines wherein only live attenuated vaccines are available (for example, chicken pox, shingles). In this case, the protection offered by the live vaccines may outweigh the risks. It is to the discretion of the health provider/HIV specialists to do so.

It is best that at the time of the vaccination, the body is in good health condition and well-nourished, considering that the body sometimes would feel sickly (sore area of injection/arm, fever-like feeling) as part of the vaccine reaction. Please listen carefully to your health provider’s instructions for post-vaccination instructions in case there are any untoward signs and symptoms that develop.

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