Key points
- People with HIV have increased vulnerability to diseases that vaccines can prevent.
- The British HIV Association (BHIVA) has a list of recommended vaccinations adults with HIV may need.
- Some live vaccines are risky for people with HIV and should be avoided.
The purpose of vaccinations and immunisations is to protect a person from infectious diseases. Compared to HIV-negative people, people living with HIV have increased vulnerability to diseases that could be prevented by vaccines.
This includes COVID-19: having the COVID-19 vaccine is recommended for all people living with HIV.
Vaccines recommended for people living with HIV
Below is a list of vaccinations that an adult living with HIV may need, based on the recommendations of the British HIV Association (BHIVA). The first column highlights whether the vaccine should be taken generally or when travelling to particular countries.
The second and third columns name the preventable diseases and how many times a vaccine needs to be taken to be effective. The interval between doses will depend on the vaccine.
Many vaccines are recommended for anyone who hasn’t previously had the infection or been vaccinated, but some are for specific groups or aren’t recommended for everyone. When this is the case, it is indicated in the fourth column.
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|
Vaccine |
Number of doses |
Additional information |
|---|---|---|---|
| General vaccines | COVID-19 | 2 doses |
A third vaccine dose is recommended if your CD4 count was less than 200 at the time of your first vaccine dose, if you have had a serious HIV-related illness in the 12 months before your first vaccine dose, if you are not taking recommended HIV treatment, or if you have a detectable viral load despite treatment. |
|
|
4 doses |
|
|
|
1 dose (annually) |
|
||
|
1 dose |
|
||
|
3 doses |
Recommended for women up to the age of 40, gay and bisexual men up to the age of 40, and heterosexual men up to the age of 26. While younger people who do not have HIV may be given one dose, three doses are recommended for people with HIV. |
||
|
2-3 doses |
Recommended for people travelling to countries where hepatitis A is common, gay and bisexual men, drug users, and other specific groups. |
||
|
Meningococcus |
2 doses |
Recommended for people under 25 years and sometimes for gay and bisexual men. |
|
|
Whooping cough (pertussis) |
1 dose |
Recommended during pregnancy. |
|
|
Measles, Mumps, Rubella (MMR) |
2 doses |
Not recommended if CD4 count is below 200. |
|
|
Chickenpox (varicella) |
2 doses |
Recommended for people who have never had chickenpox. Not recommended if CD4 cell is below 200 or during pregnancy. |
|
|
Shingles (herpes zoster) |
1 dose |
Recommended for people aged 70 to 79, and for people turning 65 years of age in 2023 or later. Also recommended for people aged over 50 who have a CD4 count below 200. BHIVA recommends use of the Shingrix vaccine. The Zostavax live vaccine should not be used by people with a CD4 count below 200. For more details, see BHIVA’s 2023 position statement. |
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|
Vaccines associated with travel |
Cholera |
2 doses |
|
|
|
Japanese encephalitis |
2 doses |
|
|
|
Tick-borne encephalitis |
3-4 doses |
|
|
|
Tetanus |
1 dose |
|
|
|
Diphtheria |
1 dose |
|
|
|
Polio |
1 dose |
|
|
|
Rabies |
3 doses |
|
|
|
Typhoid |
1 dose |
|
|
|
Yellow fever |
1 dose |
Not recommended if CD4 count is below 200. Not recommended for people over 60 years of age. |
BHIVA also has recommendations on vaccinations that may be needed because of your job (for example, in a laboratory, in healthcare or working with animals). They can be found in BHIVA’s guideline document.
Some of these vaccinations may be available from your HIV clinic, but for others you may need to see your GP. In some cases, you may need to have disclosed your HIV status to your GP to be eligible for free vaccination.
Vaccines NOT recommended for people living with HIV
Although vaccines generally provide protection from infectious diseases, some are too risky to take for people living with HIV. They include:
- live influenza vaccine
- live smallpox vaccine
- BCG (for TB)
- live typhoid vaccine.
British HIV Association. BHIVA guidelines on the use of vaccines in HIV-positive adults, 2015.
British HIV Association. Recommendations from the Joint Committee on Vaccination and Immunisation (JCVI) on COVID vaccine third doses and boosters: update for service users 24 September 2021.
British HIV Association. BHIVA position statement on shingles vaccine for people living with HIV, 2023.