Poliovirus vaccines

There are very little data on wild-type poliomyelitis in HIV-infected individuals. Poliomyelitis is exceedingly rare in South Africa but continues to occur in a few countries in the world. The live attenuated oral polio vaccine should be avoided in immunocompromised HIV-infected individuals due to the potential risk of paralytic polio ⁶⁶, hence the inactivated vaccine is recommended.

As with many other vaccines, HIV-infected adults have reduced vaccine-induced immune response to inactivated polio vaccine ^43,67 , which is better if the CD4+ cell count is above 200 cells/μL.

We recommend that all unvaccinated HIV-infected adults be vaccinated with the inactivated polio vaccine, regardless of CD4+ count especially if the individuals are travelling to high-risk regions (such as Nigeria, Pakistan and Afghanistan). Three doses should be administered at 0, 1-2, 6-12 months with a further dose after 10 years if at high risk ⁶⁸.