Table. Recommendations for vaccination in children and adults with HIV

• People who are severely immunocompromised (see Table. Levels of immunocompromise in children and adults with HIV), or those with a higher CD4⁺ count who are not on effective antiretroviral therapy are recommended to receive 2-dose primary schedule and can consider a 3rd dose
• 1 additional dose or ongoing doses every 6–12 months, based on individual risk benefit assessment (see comments)

• See also Catch-up vaccination
• Adults who have received a routine course of polio vaccination in childhood are recommended to receive a booster every 10 years if they plan to travel to a polio-endemic area or have an ongoing risk of polio exposure. See also Vaccination for international travellers.

2-dose schedule recommended for non-immune people with HIV if they have risk factors such as:

• chronic liver disease
• chronic hepatitis B or hepatitis C infection
• living in or travelling to endemic areas
• men who have sex with men or disordered use of substances

• See Table. Recommended doses and schedules for monovalent hepatitis A vaccines and Table. Recommended doses and schedules for combination hepatitis A and hepatitis B vaccines.
• See also Vaccination for international travellers and Vaccination for other groups (inmates, men who have sex with men, people who inject drugs, and sex workers).

• Seronegative children with HIV are recommended to receive 3 doses using an adult formulation.
• Seronegative adults with HIV are recommended to receive 4 larger-than-usual doses.

• Check hepatitis B surface antibody titres 4–8 weeks after the last dose. If titres are <10 mIU/mL, give an extra dose.
• See Table. Recommended doses and schedules for combination hepatitis A and hepatitis B vaccines and Table. Accelerated hepatitis B vaccination schedules for people with imminent risk of exposure.

• Gardasil 9 is registered for people aged 9–45 years.
• Assess the need for, and potential benefits of, vaccination in older adults. Consult a specialist if required.

• Use age-appropriate vaccine option
• Children with HIV aged 6 months to 9 years should receive 2 doses (4 weeks apart) if receiving influenza vaccine for the first time, then 1 dose every year after that.

• Recommended for people with HIV regardless of disease stage or CD4⁺ count.
• The number of doses needed depends on the vaccine brand used and the person’s age when they start the vaccine course. See Table. Recommendations for MenACWY vaccine for people with a specified medical condition that increases their risk of invasive meningococcal disease and Table. Recommendations for MenB vaccine for people with a specified medical condition that increases their risk of invasive meningococcal disease.

Aged <18 years: 1 dose of 20vPCV at least 8 weeks after any previous dose of PCV

Aged ≥18 years:

• 1 dose of PCV (in addition to those routinely offered in childhood)
• 1 dose of PPV 2–12 months after a dose of PCV, and
• 2nd dose of PPV at least 5 years later

• Children who have received either a routine course of 3 doses of any PCV, or 4 doses of 13vPCV or 15vPCV, or 4 doses of any PCV plus 1 dose of PPV, are recommended to receive 1 dose of 20vPCV at least 8 weeks after any previous doses of PCV.
• Children who received either a routine course of 4 doses of 20vPCV or 4 doses of any PCV plus 2 doses of PPV (i.e. Aboriginal and Torres Strait Islander children) have already received the recommended number of doses of pneumococcal vaccine and do not require any additional doses.
• For children who have not received a full routine infant course of pneumococcal vaccination, see Table. Catch-up schedule for 20vPCV for children aged <5 years who are either Aboriginal and Torres Strait Islander (including those living in ACT, NSW, Tas or Vic born on or after 1 March 2025), or have a risk condition(s) for pneumococcal disease 

• Adults ≥60 years: 1 dose of RSV vaccine
• At-risk neonates and infants aged <24 months: 1 dose of RSV-specific monoclonal antibody

• May receive if not severely immunocompromised at that time, or consult with a specialist.
• See also Vaccination for international travellers.

• Use non-live vaccine option if indicated.
• See also Vaccination for international travellers.

• Use non-live vaccine option if indicated.
• See also Vaccination for international travellers.

• If seronegative or unvaccinated, complete a 2-dose schedule for children and 1–2 doses for adults (depending on the number of previous doses), provided the person is not severely immunocompromised at that time.

• Use non-live vaccine option if indicated.

See also Vaccination for international travellers.

• If seronegative or unvaccinated, complete a 2-dose schedule for children and adults, provided the person is not severely immunocompromised at that time.

• May receive if not severely immunocompromised at that time or consult a specialist.

See also Vaccination for international travellers.

Acronyms used: 

• – = none
• BCG = bacille Calmette–Guérin
• DTPa/dTpa = diphtheria-tetanus-pertussis
• MenACWY = meningococcal ACWY
• MenB = meningococcal B
• PCV = pneumococcal conjugate vaccine
• PPV = pneumococcal polysaccharide vaccine
• RSV = respiratory syncytial virus

Footnotes:
^a DTPa for children <10 years of age; dTpa for those ≥10 years of age
^b May be given as combined vaccines
^c Recommended but not funded under the National Immunisation Program
^d Measles-mumps-rubella-varicella combination vaccines are not recommended.