A 6-week-old infant with confirmed HIV infection (asymptomatic, CD4% 30%) is brought for routine vaccination. Which of the following vaccine schedules is most appropriate according to current guidelines?
- A Defer all live vaccines; give only inactivated vaccines
- B Give inactivated vaccines as scheduled; give MMR and varicella only if CD4% remains above 15% and child is asymptomatic ✓
- C Give all routine vaccines including MMR at the scheduled age since CD4% is above 15%
- D Withhold all vaccinations until ART is initiated and viral load is suppressed
Correct answer: B. Give inactivated vaccines as scheduled; give MMR and varicella only if CD4% remains above 15% and child is asymptomatic
Explanation
For HIV-infected infants who are asymptomatic with CD4% above 15%, live attenuated vaccines such as MMR and varicella can be safely administered. Inactivated vaccines (DPT, HepB, IPV, Hib, PCV) should be given routinely regardless of immune status. Option A incorrectly defers all live vaccines when the child meets criteria for MMR. Option C is partially correct but incomplete. Option D is wrong because withholding all vaccines would leave the child unprotected against serious diseases. In India, OPV is replaced by IPV in the schedule, so VAPP is not a concern.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.