A child with known HIV infection, currently asymptomatic with CD4 count of 20% (CD4% above 15), is due for immunization. Which live vaccine is CONTRAINDICATED in this child?

• A MMR (measles, mumps, rubella)
• B BCG (bacillus Calmette-Guérin)
• C Rotavirus vaccine
• D OPV (oral polio vaccine) ✓

Explanation

In HIV-infected children, live vaccines are generally contraindicated when significantly immunosuppressed. OPV is specifically and absolutely contraindicated in HIV-positive individuals regardless of CD4 count due to risk of vaccine-associated paralytic poliomyelitis (VAPP) and also in their household contacts. IPV is used instead. MMR is recommended in asymptomatic HIV-positive children with CD4% ≥15% (as measles itself is far more dangerous in immunocompromised children). BCG is contraindicated in symptomatic HIV or low CD4, but may be given at birth before HIV status is known in high-TB-burden settings per national guidelines.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.