Table 3.

Summary of Vaccine Considerations for Adult PWH (vaccines featured in manuscript)

	Incidence/severity in PWH compared to non-PWH	Vaccine Immunogenicity in PWH compared to non-PWH	Whom to vaccinate		Serological Monitoring?	Notes
			General Population	PWH
Pneumococcal	↑ incidence[9]	↓ [18, 19]	19–64 yrs with risk factors; all 65 + yrs	All	No	See Fig. 1
Meningococcal	↑ incidence[22, 23]	↓ [28]/↔ [29]	MenACWY: with risk factors MenB: with risk factors	MenACWY: all MenB: with risk factors	No	See Box 1 for possible efficacy of 4CMenB in gonorrhea
Mpox	↑ incidence and severity[39, 41]	↓ [47–49]	Adults with potential for exposure	Adults with potential for exposure	No	See Box
HBV	↑ incidence and severity[27]	↓ conventional vaccine [55] ↔ TLR-9 adjuvanted vaccine [57, 58]	HBV nonimmune (anti-HBs < 10 mIU/mL) without HBV	HBV nonimmune (anti-HBs < 10 mIU/mL) without HBV	Yes	HepB-CpG is now preferred for PWH
HAV	↑ severity[27]	↓[61]	Adults at increased risk of infection or severe disease	All HAV nonimmune	Yes
HPV	↑ persistent HPV and related diseases[62, 63]	↓[65]	All up to 26 yrs, shared decision-making up to 45 yrs	All up to 26 yrs, shared decision-making up to 45 yrs	No	3-dose schedule recommended for all PWH
VZV	↑ incidence and severity	↔[74]	≥ 50 yrs; ≥ 19 yrs if immuno-compromised	≥ 18 yrs (≥ 19 yrs ACIP)	No	Live varicella vaccine contrain-dicated if CD4 < 200
RSV	Minimal data	Minimal data	Pregnant women weeks 32–36 yrs; 60–74 yrs with risk factors; all 75 + yrs	Pregnant women weeks 32–36 yrs; 60–74 yrs with advanced/untreated HIV or other risk factors; all 75 + yrs	No	Also FDA-approved for high-risk adults 50–59
COVID-19	↑ severity when CD4 < 350[94]	↓[88, 98, 99]	All	All	No	mRNA: reactogenicity
Influenza	Possible ↑ severity but data inconsistent[102–104]	↓[106, 107]	All	All	No	Live attenuated vaccine contraindicated

For more information see individual vaccination recommendations at www.cdc.gov/vaccines/index.html or DHHS Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV available at https://clinicalinfo.hiv.gov/