Question about vaccinations and HIV

[Gaguy2know]

I got accepted into Veterinarian Technology program at local Technical college.  They require a rabies vaccination along with tetanus vaccination.  i called the biologist and told her i was HIV+.  she said i didnt have anything to worry if i chose to take the vaccinations because they were "dead" vaccinations.  but i also called my health care provider and she said she didnt recommend me to get them.  well i did anyway since i wanted to get into this program.  well i took the vac cinations on friday and they made me sick with flu like symptoms till sunday.  I have to go back and get my second set of rabies vaccination on this coming friday.  will it make me sick again and is it harming my body each time i get sick?  it kind of worries me abit.

[Matty the Damned]

Hey Doll,

I found the following at MedScape which discusses rabies vaccination and immuno-compromised people. It's aimed at travelers but the principles are the same:

Rabies Vaccination: Protecting Vulnerable Travelers
from Infections in Medicine ®

Immunosuppressed Travelers

Current statistics from the Joint United Nations Programme on HIV/ AIDS indicate that more than 95 million people worldwide are infected with HIV. With the advent of spe-cific drugs to control HIV replication and despite underlying health conditions, many HIV-infected persons choose to travel to foreign destinations. Therefore, it is important that physicians and HIV-infected patients understand current WHO-recommended rabies vaccination protocols for immunosuppressed patients.

The immune response to preexposure and postexposure vaccination regimens has been examined in populations of HIV-infected children and adults.[26,27] In one study, a 5-dose simulated postexposure vaccination schedule was evaluated in 3 groups of adults: uninfected controls, asymptomatic HIV-infected patients, and symptomatic HIV-infected patients.[26] Evaluation of serum from blood drawn on day 37 after primary vaccination indicated that 100%, 76%, and 57% of the control, asymptomatic, and symptomatic patients, respectively, had a measurable RVNA titer of at least 0.5 IU/mL. RVNA was not measurable in more than 40% of the symptomatic patients with CD4 counts below 400/µL despite their having received 5 intramuscular doses of a highly potent cell culture rabies vaccine.

Similar results were reported in a second study, wherein HIV-infected children were vaccinated with a 3-dose preexposure series.[27] In this study, children who had only 15% of the normal number of CD4 cells did not develop any measurable RVNA after vaccination.

The results of these clinical trials indicate that HIV-infected patients with low CD4 cell counts may not be able to mount an adequate immune response after a preexposure or postexposure vaccination regimen. With the potential for a reduced active immune response in immunosuppressed patients, immediate wound treatment and passive immunization with RIG following possible rabies exposure are critical. All patients with transdermal wounds should have prompt wound care, including proper cleaning and copious irrigation of the wound with soap and water and, if possible, application of disinfectant. In addition, the WHO has extended the recommended administration of RIG in immunosuppressed patients to include category II exposures as well as category III exposures.[3] (In the United States, according to the recommendations of the ACIP, all immunosuppressed patients should receive RIG as part of their postexposure prophylaxis.[9]) As much of the RIG as anatomically feasible should be administered into and around the wound(s).

Preexposure vaccination may be indicated in immunosuppressed patients before they travel to countries where canine rabies is endemic. This is especially true if there is a chance that the health condition of the patient may deteriorate during travel. Patients suffering from other immunosuppressed conditions, including those taking immunosuppressive drugs to prevent organ rejection, might be expected to have lower antibody levels after vaccination and should consider having serologic testing after vaccination to monitor vaccination response.

Section 5 of 6

I would provide the direct link, but it fails requiring a login when I post it -- hence the cut and paste.

My reading is that far from being dangerous (ie you won't become rabid), rabies vaccine may not always provide effective immunity when normal dosages are used in poz people. You should flag this matter with the biologist at your local Tech college.

The flu like symptoms you report are not uncommon in people receiving vaccines. Whilst unpleasant they are usually harmless. It's your immune system reacting to the rabies antigens. If your symptoms get worse after the next dose seek medical attention without delay.

MtD

[Gaguy2know]

thanks so much for taking the time to look up such a responsive answer. i appreciate that.

eric

[milker]

Congrats for your new position !

Milker.

[Cerrid]

Current statistics from the Joint United Nations Programme on HIV/ AIDS indicate that more than 95 million people worldwide are infected with HIV.

That's a wee bit more than the official numbers of 39,5 million infected people as of end 2006. Is this a typo or am I missing something?

[Matty the Damned]

Typo, something else, who knows?

MtD