Adverse events after vaccination among HIV-positive persons 1990-2016.

Monday, 6th of August 2018

PLoS One. 2018 Jun 19;13(6):e0199229. doi: 10.1371/journal.pone.0199229. eCollection 2018.

Adverse events after vaccination among HIV-positive persons 1990-2016.

Su JR¹ Ng C¹ Lewis PW¹ Cano MV¹.

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Abstract

Human immunodeficiency virus (HIV) causes immune dysregulation potentially affecting response to vaccines in infected persons. We investigated if unexpected adverse events (AEs) or unusual patterns of AEs after vaccination were reported among HIV-positive persons. We searched for domestic reports among HIV-positive persons to the Vaccine Adverse Event Reporting System (VAERS) during 1990-2016. We analyzed reports by age group (<19 and ≥19 years) sex serious or non-serious status live vaccine type (live versus inactivated) AEs reported and CD4 counts. Of 532235 reports received 353 (0.07%) described HIV-positive persons of whom 67% were aged ≥19 years and 57% were male; most reports (75%) were non-serious. The most commonly reported inactivated vaccines were pneumococcal polysaccharide (27%) and inactivated influenza (27%); the mostly reported common live virus vaccines were combination measles mumps and rubella (8%) and varicella (6%). Injection site reactions were commonly reported (39%). Of 67 reports with CD4 counts available 41 (61%) described persons immunocompromised at time of vaccination (CD4 count <500 cells/mm3) and differed from overall reports only in that varicella was the most common live virus vaccine (4 reports). Of 22 reports describing failure to protect against infection 6 described persons immunocompromised at time of vaccination among whom varicella vaccine was most common (3 reports). Of 66 reports describing live virus vaccines 7 described persons with disseminated infection: 6 had disseminated varicella 3 of whom had vaccine strain varicella-zoster virus. Of 18 reported deaths 7 resulted from disseminated infection: 6 were among immunocompromised persons 1 of whom had vaccine strain varicella-zoster virus. We identified no unexpected or unusual patterns of AEs among HIV-positive persons. These data reinforce current vaccine recommendations for this risk group. However healthcare providers should know their HIV-positive patients immune status because immunocompromising conditions can potentially increase the risk of rare but severe AEs following vaccination with live virus vaccines.

PMID: 29920551 PMCID: PMC6007919 DOI: 10.1371/journal.pone.0199229