HIV-infected children should be protected from vaccine-preventable diseases. Most vaccines recommended
for routine use can be administered safely to HIV-exposed or HIV-infected children. The recommended
vaccination schedules for HIV-exposed and HIV-infected children aged 0 to 18 years correspond to the
ACIP-approved schedule with ACIP-approved additions specific to HIV-infected children incorporated (see
Figures 1 and 2). These schedules will be updated periodically to reflect additional ACIP-approved vaccine
recommendations that pertain to HIV-exposed or HIV-infected children.
All inactivated vaccines—whether killed whole organism or recombinant, subunit, toxoid, polysaccharide, or
polysaccharide protein-conjugate—can be administered safely to individuals with altered
immunocompetence. In addition, because of the risks of increased vaccine-preventable disease severity in
HIV-infected children, specific vaccines like pneumococcal conjugate vaccine are also recommended or
encouraged for children beyond the routinely recommended ages for healthy children (if not previously
administered at routinely recommended ages in early childhood); additional vaccines are also recommended,
such as pneumococcal polysaccharide vaccine for children aged ≥2 years following receipt of pneumococcal
conjugate vaccine. Similarly, before influenza vaccination was routinely recommended for children aged ≥6
months, trivalent influenza vaccine (TIV) was routinely recommended for HIV-infected children because of
their increased risk of severe disease. TIV continues to be recommended for HIV-infected children as part of
routine prevention for influenza.1 If inactivated vaccines are indicated for individuals with altered
immunocompetence, the usual doses and schedules are often recommended. However, the effectiveness of
such vaccinations may be suboptimal.2