. 2016 Jul 13;12(11):2729–2741. doi: 10.1080/21645515.2016.1207013

Table 1.

Comparison of vaccines recommendations for HIV infected people in France, US,UK and Europe (EACS) Differences between other countries guidelines and French ones were underscored.

	French recommendations 2014		US recommendations 2013		UK recommendations 2015^e		EACS recommendations 2015
		Comments		Comments		Comments		Comments
Diphtheria, tetanus, poliomyelitis, acellular pertussis	For all patients^aas in the general population	Boosters every 10 yrs (dTP)	Diphtheria, tetanus, acellular pertussis For all patients as in the general population^a Poliomyelitis: recommended only for children as in general population^a	Boosters every 10 yrs (Tetanus toxoid and reduced diphtheria toxoid (Td) Tdap during each pregnancy	Diphtheria, tetanus, poliomyelitis: For all patients as in the general population^a Acellular pertussis: HIV positive adults meet general indications for pertussis vaccination including HIV positive pregnant women (between week 28 and week 32 of pregnancy)^a	Boosters every 10 yrs (dTP)	No EACS specific Guidelines, vaccines as recommended in each country
Pneumococcal disease	For all patients^a	-In previously unvaccinated adults: 1 dose of the 13-valent conjugate vaccine followed by one dose of the 23-valent polysaccharide vaccine at least 2 months later. -In patients previously vaccinated with the 23-valent polysaccharide vaccine since at least 3 years: 1 dose of the 13-valent conjugate vaccine followed by one dose of the 23-valent polysaccharide vaccine at least 2 months later.	For all patients^a	In previously unvaccinated adults ≥ 19 years-old: 1 dose of the 13-valent conjugate vaccine followed by one dose of the 23-valent polysaccharide vaccine at least 2 months later. In patients previously vaccinated with the 23-valent polysaccharide vaccine since at least 1 year: 1 dose of the 13-valent conjugate vaccine followed by one dose of the 23-valent polysaccharide vaccine at least 2 months later.	For all patients^a	A single dose of PCV 13 (should be given at least 3 months after any use of PPV-23) For HIV positive adults who meet the indications for PPV-23 vaccination within the national program (aged> 65 years or with co-morbidity other than HIV) follow general guidance and also receive a single dose of PPV-23 (PPV-23 should be given at least 3 months after any PCV-13	For all patients^a	Prefer 13-Valent Vaccine
Influenza	For all patients^a	Every year	inactivated influenza vaccine for all patients^a	Every year	For all patients^a For close contacts of HIV positive persons	Quadrivalent may be preferred where available	For all patients^a	Every year
Hepatitis A	At-risk non immune patients^a (chronic liver disease; HBV or HCV co-infection; MSM; intravenous drug addiction; traveling to endemic countries).	Two injections administered 6 months apart – Depending on antibody titer after the second dose, a third injection should be administered.	At-risk non immune patients^a (chronic liver disease; HBV or HCV co-infection; MSM; intravenous drug addiction; traveling to endemic countries Hemophiliacs and other individuals who receive clotting factor concentrates).	Two injections administered 6 months apart – Depending on antibody titer after the second dose, a third injection should be administered.	HIV-positive adults at risk of hepatitis A exposure^a (household and sexual contacts of infected persons, travelers to countries where HAV is common, MSM, injecting and non-injecting drug user individuals at risk of infection during outbreaks, those with occupational exposure to HAV (laboratory workers, sewage workers), persons with hemophilia, persons with special needs living in residential institutions and their carers) Pre-vaccination testing for evidence of HAV immunity cost-effective in some clinical settings : people who were born or lived in extensive periods in geographical areas that have a high to intermediate HAV endemicity, MSM, IDU, those aged > 50 years	Patients with CD4>350 : 2 vaccine doses at 0 and 6 months Patients with CD4 <350 : 3 dosses at 0, 1 and 6 months For patients at continued risk of exposure : a boosting vaccine dose every 10 years	At-risk non immune patients^a (chronic liver disease; HBV or HCV co-infection; MSM; intravenous drug addiction; traveling to endemic countries).	Two injections administered 6 months apart – Depending on antibody titer after the second dose, a third injection.
Hepatitis B	For all patients^a without serological HBV markers	In non vaccinated patients: 4 double-dose injections at M0, M1, M2 and M6 Titrage of anti-HBs antibodies levels after vaccination and once a year; booster injection if anti-HBs < 10 mIU/mL.	For all patients^a without anti-HBs markers	3 single-dose injections at M0, M1 and M6^b 3 or (4) double-dose injections at M0, M1, (M2) and M6^c Titrage of anti-HBs antibodies levels after vaccination and once a year; booster injection if anti-HBs < 10 mIU/mL.	For all patients^a without serological HBV markers HBsAb levels <10IU/L after primary vaccine course : 3 further vaccine doses at monthly intervals (high dose(40 μg) with Engerix or HBvaxPro and standard dose(20 μg) with Fendrix (preferred in non responders)	Yeast-based vaccines :EngerixB total 40 μg, HBvaxPro 40 μg formulation When using the adjuvanted vaccine Fendrix the standard 20 μg formulation be given An ultra-rapid vaccination course (3 standard-dose administrations given over 3 weeks) can be considered only in selected patients with CD4 > 500/ mm³	For all patients^a without serological HBV markers	In non vaccinated patients: 4 double-dose injections at M0, M1, M2 and M6 Titrage of anti-HBs antibodies levels after vaccination and once a year; booster injection if anti-HBs < 10 mIU/mL.
Meningococcal disease	Meningococcal C: As for the general population up to 24 years. In MSM (> 24 years)^a Meningococcal B non-recommended specifically in HIV infected patients	Two doses of the conjugate vaccine 6 months apart If traveling to endemic areas, or in cases of anatomical or functional asplenia or complement or properdin deficiencies, quadrivalent conjugated vaccines: 2 doses 6 months apart.	Meningococcal conjugate quadrivalent: As for the general population^a: Recommended for persons with a risk factor (medical, occupational, lifestyle, or other indication)
And in MSM in several geographical areas (New York city, Los Angeles)Meningococcal B:
Recommended for persons with a risk factor ^a (medical such as aplenic patients, persistent complement component deficiencies)
	Two doses of the conjugate vaccine 8 weeks between doses. Two doses	HIV positive adults follow the general indications for meningococcal vaccination^a :<25 years of age who have not been previously vaccinated or received the last MenC vaccine below the age of 10 years : MenC and MenACWY and possibly MenB according to national guidance functional or anatomical asplenia or persistent complement deficiency : MenC, MenB and/or MenACWY, according to vaccination history at risk of exposure through travel : MenACWY at risk of exposure through an outbreack : MenC, MenB or MenACWY	Two vaccine doses at the interval of 2 months(in order to increase immunogenicity)	As recommended in general population^a
Human Papilloma Virus	In girls and boys^a (11–19 years).	In young girls: 3 doses depending on the marketing authorization of the vaccine. In boys: 3 doses of quadrivalent vaccine (M0, M2, M6).	Male and female ≥ 26 years-old not vaccinated in childhood^a	For female: 9-, quadri-, or bi-valent vaccine: 3 doses at 0, 1–2, 6 months For male: quadri- or 9-valent vaccine ACIP recommendations	Previously unvaccinated HIV-positive men and women aged up to 26 years^a Previously unvaccinated HIV-positive MSM aged up to 40 years^a Previously unvaccinated HIV-positive women aged up to 40 years^a Considered for HIV positive patients who develop high grade HPV disease (with the aim of potentially reducing the risk of recurrences)^a	Three doses of the quadrivalent 4vHPV at 0,1–2, and 6 months Use 9vHPV once it becomes available in place of 4vHPV	For all patients^a
BCG	Contraindicated		Contraindicated		Absolutely contraindicated		Contraindicated
Measles, mumps, rubella	Only for patients with CD4 cell count > 200//mm³ non immune patients (routine serological testing for measles and routine serological testing for rubella in women), non pregnant women of childbearing age	In adults: 2 doses of measles, mumps, rubella vaccine at least 1 month apart.	Only for patients with CD4 cell count > 200//mm³ non immune patients	In adults born after 1957: 2 doses of measles, mumps, rubella vaccine at least 1 month apart for secondary school students in postsecondary educational institutions; Work in a healthcare facility; Plan to travel internationally One dose for other patients	Only for patients with CD4 cell count > 200/mm³ non immune patients (routine serological testing for measles and routine serological testing for rubella in women), non pregnant women of childbearing age After exposure to measles : MMR vaccine within 3 days of contact if CD4> 200/mm³ and stable viral load suppression on ART		No EACS specific guidelines
Varicella	Non immune adolescents and adults, non pregnant women of childbearing age Only for patients with CD4 cell count > 200/mm³	Two doses 4–8 weeks apart.	Non immune adolescents and adults born after 1979 non pregnant women of childbearing age Only for patients with CD4 cell count > 200/mm³	Two doses 3 months apart	Non immune adolescents and adults, non pregnant women of childbearing age Only for patients with CD4 cell count > 200/mm³	Two doses 3 months apart	Recommended for all HIV positive VZV seronegative patients with CD4 cell count > 200/mm³	Two doses 4–8 weeks apart.
Zoster	Not recommended		Contraindicated^b ACIP has not made recommendation Recommended for patients ≥ 60 years old and with CD4 cell count > 200/mm^{3 d}		We recommend VZV IgGseropositive patients who have CD4>200 and preferably are established on ART be offered one dose of the shingles vaccine (in line with national age related indications From the age of 60 years		no specific recommendations
Yellow fever	Mandatory in French Guiana and for travels incountries where yellow fever is endemic Only for patients with CD4 cell count > 200/mm³	One injection	Mandatory for travels in countries where yellow fever is endemic Only for patients with CD4 cell count > 200/mm³	One injection	Persons aged < 60 years and CD4> 200 for travels in countries where yellow fever is endemic		Only for patients with CD4 cell count > 200/mm³	One injection
Haemophilusinfluenzae serotype b	For all children as in the general population		For all children as in the general population		Not recommended routinely in hiv-positive adults	Hiv positive adults with aspenia, splenic dysfunction or complement deficiency should receive one parenteral dose of a Hib containing vaccine (Hib/Men C in UK)	No specific recommendations

whatever CD4 cells count

Recommended by Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: Recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf

2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host

Aberg JA, Gallant JE, Ghanem KG, et al. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV medicine association of the Infectious Diseases Society of America. Clin Infect Dis 2014; 58:e1.

accessible at http://www.bhiva.org/documents/Guidelines/Vaccination/2015-Vaccination-Guidelines.pdf.