Measles immunization in HIV-infected children

Children infected with human immunodeficiency virus (HIV) have had high rates of mortality attributable to measles, but until recently, measles vaccine was assumed to be safe for these children. A single fatal case of pneumonia attributable to vaccine type-measles virus has been documented in a young adult with acquired immunodeficiency syndrome. Because a protective immune response often does not develop in severely immunocompromised HIV- infected patients after immunization and some risk of severe complications exists, HIV-infected children, adolescents, and young adults who are severely immunocompromised (based on age-specific CD4 lymphocyte enumeration) attributable to HIV infection should not receive measles vaccine. All other HIV-infected children, adolescents, and young adults who are not severely immunocompromised should received measles-mumps-rubella vaccine.