Vaccines You Need if You Have HIV or AIDS

If you have HIV (human immunodeficiency virus) or AIDS (acquired immunodeficiency syndrome), you should take special precautions against other infections, such as the flu. That's because you have a disease that makes it difficult for your immune system to fight them. Vaccines (i mmunizations) can help your body defend itself against infections. However, if you have HIV/AIDS immunizations may effect you differently than people who don't have HIV/AIDS.

Not all vaccines are safe for people with HIV/AIDS. Vaccines made from live viruses should be avoided because they may cause a mild case of the disease. Live vaccines are a weaker form of the germ that causes a particular disease. People with HIV/AIDS should receive vaccines made from inactivated diseases. Inactivated vaccines don't contain a living germ.

Vaccine Side Effects and HIV/AIDS

Anyone, regardless of their HIV status, is at risk of side effects associated with vaccines, including:

However, if you have HIV/AIDS, vaccines carry additional risks including:

  • Vaccines may increase your viral load
  • Vaccines may not work as well if your CD4 count is very low. CD4 cells are a type of immune cell. It may help to take strong antiretroviral medications before having a vaccine if your CD4 count is low.
  • Vaccines made from a live virus may cause you to get the disease the vaccine is supposed to prevent. In general, you should avoid live vaccines, such as chickenpox and smallpox vaccines, and the flu vaccine in the form of a nose spray. Also, avoid close contact with anyone who has had a live vaccine in the past two or three weeks. The measles, mumps, and rubella (MMR) vaccine is the only live vaccine that is sometimes recommended for people with HIV/AIDS. Do not have it, however, if your CD4 count is less than 200, you have a history of AIDS-defining illness, or you've had symptoms of HIV.

What Kinds of Vaccines Do People With HIV Need?

Here are general guidelines about vaccines for people with HIV. These will help you know which to take and how often.


Recommended for All Adults Who Are HIV-Positive




Hepatitis B virus (HBV)

three shots over six months

  • Receive unless you have active hepatitis or immunity is present.
  • After the series is completed, get a blood test to check for immunity. If it's too low, you may need extra tests.
  • Effective for about 10 years.

Influenza [flu]

one shot

  • Receive injectable flu vaccine only.
  • Repeat every year by mid-November for best protection.

Measles, mumps, and rubella (MMR)

one or two shots

  • Not needed, if you were born before 1957.
  • You can receive individual components separately.
  • This is the only live vaccine that's recommended if you're HIV-positive, but only if your CD4 cell count is above 200.

Polysaccharide pneumococcal (pneumonia)

one or two shots

  • Receive soon after HIV diagnosis, unless you've been vaccinated within the last five years.
  • Effective within two to three weeks.
  • If given when CD4 count is less than 200, repeat once CD4 count reaches 200.
  • Repeat every five years.

Tetanus and diphtheria toxoid (Td) or Tdap (Tetanus, diphtheria and pertussus)

one shot

  • Repeat every 10 years.
  • Get it earlier if you have an injury such as a cut that requires stitches.

Recommended for Some Adults Who Are HIV-Positive

Hepatitis A virus (HAV)

two shots over 6 months

  • Recommended for health care workers, men who have sex with men, injection drug users, people with chronic liver disease, hemophiliacs, and people traveling to certain parts of the world.
  • Effective for at least 20 years.

Hepatitis A/Hepatitis B combined virus (Twinrix)

three shots over one year

  • This is available for people who require both HAV and HBV vaccinations.

Haemophilus influenzae type B (bacterial meningitis)

one shot

  • Discuss the need for this vaccination with your health care provider.

Meningococcal (bacterial meningitis)

one shot

  • Recommended for college students, military recruits, and people traveling to certain parts of the world.

If You Travel Out of the Country

If you have HIV, be sure to get vaccinated against hepatitis A and B. Make sure your routine vaccines are up to date and that you have the ones that are required by the country you're traveling to. However, make sure these are the inactivated, not the live, vaccines. If an inactivated version is not available, do not get the live vaccine. Examples of live vaccines include some forms of typhoid fever vaccine and yellow fever vaccine. Instead, have your doctor provide a letter explaining that you are medically unable to be vaccinated.

WebMD Medical Reference Reviewed by David T. Derrer, MD on February 27, 2016


AIDS InfoNet: "Vaccinations and HIV."
CDC: "HIV/AIDS and the Flu" and "Preventing Infections During Travel."
U.S. Department of Health and Human Services: "Recommended Immunizations for HIV Positive Adults."

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