If there is no immune system,it seems like vaccines wouldn't do much since there is no adaptive immune system to develop antibodies and memory cells. But can people with AIDS/HIV still be vaccinated? It is expected that a normal person will have antibodies to attack the minimal infection produced by the vaccine and generate memory cells, but without an immune system I expect vaccines to be deadly.

Is that right?


3 Answers 3


Can people with AIDS/HIV be vaccinated?

Yes. Immunization is an important part of the overall treatment strategy for HIV positive individuals. HIV infection is a risk factor for a number of vaccine preventable infectious diseases. Immunization in these patients is particularly important because of their increased risk of developing disease. (See Cecil Medicine Ch 396)

Can the immune system still mount a response to the vaccine?

Yes. HIV infection does lead to a decreased immune response. Though the primary deficiency is a decrease in both CD4+ (helper) T-cell count and function, there is, perhaps consequently, B-cell dysfunction as well. This would suggest that vaccines are less immunogenic. When this is studied directly, as would be expected, we see that vaccines are less immunogenic, but they are still effective.

Which vaccines are given?

Specific recommendations are based on both the age of the individual and their immune status. As a rule, vaccines are more effective when given early in the natural history of an HIV infection or after immune reconstitution with HAART, but there is some effectiveness and little risk of heat killed or subunit only vaccines even in highly immunosuppressed individuals. While live attenuated vaccines are contraindicated in individuals with a CD4+ cell count below 200, these vaccines are given routinely to other HIV positive patients. Current guidelines are found here. Here is the main figure from those guidelines:

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Can people with HIV still be vaccinated?

  • No (most of the time) if the vaccine is an attenuated vaccine, this means it contains living organisms that have been modified in order to reduce their virulence. The reduction would keep a healthy individual unharmed while still inducing an immune response to form antibodies, however it is considered dangerous to administer these kinds of vaccines to HIV positive people. Some physicians will decide to administer these kinds of vaccines if the patient has had excellent control of his/her disease and is strong enough to take for example, the influenza virus vaccine without any major complications.

  • Yes if the vaccine is not an attenuated vaccine. Being HIV positive doesn't mean "no immune system" right away. The damage to the immune system goes in function with the viral load and the CD4 count; if the viral load is low the HIV positive individual can still benefit from vaccination, moreover he should be vaccinated because he is more exposed to infections than an average person.

source: HIV InSite, University of California San Francisco.

I would suggest also reading more about CD4 count in HIV patients and viral HIV load.

  • $\begingroup$ I think I don't understand. If the vaccine is atenuated, they can't be vaccinated; but if the vaccine IS NOT atenuated they CAN be vaccinated? It's the opposite of what I would expect. $\endgroup$
    – Cure
    Commented Nov 12, 2018 at 16:55
  • 5
    $\begingroup$ @Gabriel the missing information here is that the alternative to live attenuated is killed or antigen component only. Vaccines that are not live vaccines cannot replicate in the vaccinated individual. There are no non-attenuated live vaccines. $\endgroup$
    – De Novo
    Commented Nov 12, 2018 at 17:05
  • 3
    $\begingroup$ To clear things up vaccines that don't belong to the group of attenuated vaccines do not contain any sort of living organisms and use other agents to induce immunization (polysaccharides, inactivated toxoids, etc.) and hence are safer to use in an individual with a compromised immune system. $\endgroup$
    – nsa
    Commented Nov 12, 2018 at 17:05
  • $\begingroup$ @DeNovo, there are no non-attenuated live vaccines any more. The original vaccine for smallpox was the live cowpox virus. $\endgroup$
    – Mark
    Commented Nov 12, 2018 at 21:00
  • $\begingroup$ @Mark vaccinia, in that instance was effectively an attenuated variola. $\endgroup$
    – De Novo
    Commented Nov 12, 2018 at 21:55

A person with AIDS cannot be vaccinated. The immune system is no longer functional and is unable to mount an immune response to your vaccine.

If the vaccine is a "live vaccine", the person will get a dose of viruses that body can no longer fight against. And the live vaccine would probably give the AIDS patient an infection of what the vaccine was suppose to protect against

However if the vaccine is an attenuated vaccine (which is the case for most vaccines made today), then all your be introducing into the body is parts and pieces of a virus or bacteria. These piece can trigger an immune response in a healthy person but as they just pieces, are not a live cell or a functional virus. So in a person with AIDS, the attenuated vaccine will be harmless.

A person with HIV can be vaccinated. The HIV virus is in the body multiplying. However the immune system while damaged is still functional.

  • 3
    $\begingroup$ >"if the vaccine is an attenuated vaccine (which is the case for most vaccines made today), then all your be introducing into the body is parts and pieces of a virus or bacteria." It sounds like the opposite of what the other answer said. $\endgroup$
    – Cure
    Commented Nov 12, 2018 at 17:55
  • $\begingroup$ Most vaccines contain dead virus today. Attenuated viruses are alive (as far as you can say that for a virus) but usually do not cause full blown disease. An example for this is the oral polio vaccine. $\endgroup$
    – Chris
    Commented Nov 12, 2018 at 19:58
  • $\begingroup$ With genetic engineering, its not possible for the immune system to be "completely" non-functional. This is because the body is constantly producing immune cells from non-terminal differentiated cells. These cells are almost never specifically targeted. Whatever is left can, with time, clean up the infection. $\endgroup$
    – Mikhail
    Commented Nov 15, 2018 at 6:24

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