Abstract
Live attenuated measles virus vaccine is currently recommended by the 1994 Red Book and the U.S. Public Health Service for administration to children, adolescents and adults with known HIV infection. However, a 21-year-old college student has provided the first indication of potential harmful consequence of administering the measles vaccine to a severely immunocompromised HIV-infected person. These recommendations attempted to prevent the occurrence of severe measles in symptomatic HIV-infected children, since no data previously existed to indicate serious or unusual reactions to measles, mumps and rubella (MMR) immunization. The case fatality rate for measles in HIV-infected individuals is reportedly as high as 40 percent. The immune status of HIV-infected children declines as disease progresses, prompting recommendation that HIV-exposed/infected children receive MMR vaccine routinely between ages 12 months to 15 months. HIV-infected children exposed to wild type measles virus should receive passive immunoglobulin (IG) whether or not they have been immunized; immunity may have declined and/or they may not have responded to the vaccine. Several studies have substantiated the less than optimal and unpredictable response to measles vaccines in HIV-infected infants.
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