To which patient would the MMR be safe to administer?
Unusual or serious adverse events following the administration of the MMR have not been documented in HIV-infected children who were not severely immunocompromised. Because measles may cause a severe infection in HIV-infected persons, vaccination is recommended if noimmunosupression is present. Live vaccines should be avoided during pregnancy. Patients with leukemia in remission may receive live vaccines only if chemotherapy has been terminated for at least three months. An oral dose of 2 mg/kg or 20 mg of prednisone for two weeks or more is considered sufficient to induce immunosuppression and warrants concern about the safety of administration of a live vaccine.
A 15-month-old HIV-infected child with a CD4 cell count of 700
A 25-year-old pregnant woman
A 12-year-old asthmatic on 20 mg of oral prednisone daily for the last 20 days
An 18-year-old with leukemia in remission whose chemotherapy was terminated 1 month ago