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HIV Primary Care

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13 Table 4. Routine Immunizations for HIV-Infected Adults Vaccine Status Dose/Regimen Comments Haemophilus influenzae type B Consider in selected settings (see comments) 0.5 mL IM • Administer to asplenic patients Hepatitis A Recommended in selected settings (see comments) 1 mL IM with revaccination in 6-12 mo for Havrix ® or 6-18 mo for Vaqta ® ; also available in combination with hepatitis B vaccine as Twinrix ® administered as 3 or 4 doses • HAV vaccination is recommended for all susceptible MSM as well as others with indications for HAV vaccine (eg, injection drug users, travelers to countries of high endemicity, persons with chronic liver disease, or who are infected with hepatitis B and/or C) • Vaccination can be considered for all nonimmune patients Hepatitis B Recommended in selected settings (see comments) 1 dose of 40 µg/ mL (Recombivax HB ® ) admin- istered on a 3-dose schedule or 2 doses of 20 µg/mL (Engerix-B ® ) administered simultaneously on a 4-dose schedule at 0, 1, 2, and 6 mo • Administer to patients without evidence of past or present hepatitis B infection • Vaccinated patients should be tested for HBsAb response 1-2 mo after or at the next scheduled clinic visit after the third dose HPV Ideally given prior to sexual activity; indicated for females age 9-26 and males age 9-26 Gardasil ® 0.5 mL IM for 3-dose series given at 0, 2, and 6 mo — Influenza Inactivated influenza vaccine recommended; do NOT use live attenuated intranasal vaccine (FluMist ® ) 0.5 mL IM annually • All patients • Especially important in patients at high risk for exposure to or morbidity from influenza Continued on next page

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