Measles immunization in HIV-infected children

Children infected with human immunodeficiency virus (HIV) have had high rat es of mortality attributable to measles, but until recently, measles vaccin e was assumed to be safe for these children. A single fatal case of pneumon ia attributable to vaccine type-measles virus has been documented in a youn g adult with acquired immunodeficiency syndrome. Because a protective immun e response often does not develop in severely immunocompromised HIV-infecte d patients after immunization and some risk of severe complications exists, HIV-infected children, adolescents, and young adults who are severely immu nocompromised (based on age-specific CD4 lymphocyte enumeration) attributab le to HIV infection should not receive measles vaccine, All other HIV-infec ted children, adolescents, and young adults who are not severely immunocomp romised should receive measles-mumps-rubella vaccine.