Should People With Hiv Get Vaccines
Yes. Vaccines play an important role in keeping people healthy. They protect you against serious and sometimes deadly diseases.
Vaccines are especially important for people with chronic health conditions like HIV, which can make it harder to fight off vaccine-preventable diseases like pneumococcal disease or the flu. HIV can also make it more likely that youll have serious complications from those diseases, which is why getting recommended vaccines is an important part of your overall HIV medical care.
Vaccines are very effective and they dont just protect individuals from disease. They also protect communities. When most people in a community get vaccinated and become immune to a disease, there is little chance of a disease outbreak. Eventually, the disease becomes rareand sometimes, its wiped out altogether.
Which Vaccines Are Recommended For People With Hiv
The following vaccines are recommended for people with HIV:
Based on age or other circumstances, you provider may recommend other vaccines as well.
Talk to your health care provider about which vaccines are recommended for you. For more details, read this information from the Centers for Disease Control and Prevention : HIV Infection and Adult Vaccination.
The Hunt For An Hiv Vaccine
On 23 April 1984, Margaret Heckler, the then US Secretary of Health and Human Services, announced to a packed press conference that scientists had discovered the virus that caused acquired immune deficiency syndrome . She went on to express the hope that a vaccine would be developed within two years.
Thirty-two years later and AIDS-related illnesses have claimed at least 30 million lives. In 2015, around 2.1 million people were newly infected with the virus and approximately 1.1 million people died as a result of the disease. Globally, the rate of infections and deaths have declined over the years thanks to the use of antiretroviral therapy and reduced spread of the human immunodeficiency virus responsible for the disease however the availability of treatment and impact of the disease vary widely across the world. It is widely acknowledged that the most effective way to end the HIV pandemic would be to develop and roll out an effective protective vaccine.
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Hiv Testing In Vaccine Prevention Postexposure And Gene Therapy Studies
One recent issue concern in laboratory evaluation of HIV-1 infection is evaluation of patients enrolled in vaccine trials using one or more HIV antigens for immunization. If the vaccines themselves are effective immunogens, it is possible that patients will artifacually seroconvert for HIV in the absence of true infection. For example, individuals immunized with a single gene product may develop specific gp160 reactivity.342 If such individuals already have a nonspecific reactivity for p24, then the combination of reactivity to gp160 and to p24 will result in positive HIV screening and supplemental assays. Current and planned candidate vaccines include multiple HIV components, and effective immune responses may affect positive routine testing. Vaccine-induced seropositivity has important social implications, and vaccine recruitment trials clearly and plainly address possible outcomes.343 Alternatively, patients in vaccine trials may become truly infected, and authentic infection requires identification. Careful history and physical examination are essential application of NAT in such circumstances may yield useful results in establishing the presence of infection,344 and individuals receiving HIV DNA vaccines have not yielded positive HIV NATs. CD4 counts and percentage of CD4 cells in peripheral blood are also useful because serial samples are likely available for comparison in vaccine studies.
Targeting The Envelope Spike
Today, scientists seeking to identify bNAbs benefit from recent advances in the fine mapping of the structures on the outside of the virus. Its genetic material and protective protein shell are surrounded by an external envelope that includes glycoproteins, which together form an envelope spike that allows it to bind to and enter host cells.
The more structural information you have, the better you can design immunogens to mimic what is on the virus spike to induce neutralising antibodies, says Professor John Moore, a British immunologist at Cornell Universitys medical school in New York.
What makes mimicking the HIV envelope spike difficult is that it undergoes a series of rearrangements to enable it to carry out its functions. In 2013, Moores group produced the first stabilised recombinant envelope protein compound capable of inducing antibodies against itself. It was the first time somebody has been able to induce strong neutralisation against HIV, says Shattock.
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Can A Person Get Hiv From A Preventive Hiv Vaccine
No, a person cannot get HIV from a preventive HIV vaccine. The preventive HIV vaccines being studied in clinical trials do not contain HIV. Of the approximately 30,000 people who have participated in HIV vaccine studies around the world in the last 25 years, no one has gotten HIV from any of the vaccines tested.
World Aids Day: Is The World Closer To An Hiv Vaccine In The Face Of Covid
As Covid-19 brought nearly every corner of the Earth to a halt early last year, researchers around the world scrambled to develop a vaccine to fend off the deadly respiratory coronavirus. And just several months later in a process that normally takes years several vaccines were ready for worldwide distribution.
In comparison, about 40 years since the earliest reports of what became known as AIDS, scientists are still scratching their heads to develop a vaccine against the virus that causes the life-threatening disease HIV.
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So Why Is That So Hard To Do With Hiv
First of all, said Jefferys, lack of interest and funding are no longer really among the reasons. There was a period in the early 1990s when you could argue that HIV vaccine research was underfunded, he said. But by now, its a substantial budget. According to an analysis by the Resource Tracking for HIV Prevention Research & Development Working Group, a project of the HIV vaccine advocacy group AVAC, nearly $15.3 billion was spent on HIV vaccine research between 2000 and 2019. The money comes from philanthropic, public, and private groups like the Bill & Melinda Gates Foundation.
And if that money hasnt led yet to an effective vaccine, it has led to an enormous amount of information about both HIV and the immune system that led, in part, to the rapid development of COVID vaccines. HIV research helped reveal the importance of creating a vaccine using modified forms of invaders outer spike proteins to generate immune responses. HIV vaccine research also led to the perfection of mRNA as a vaccine method conceptused successfully for COVID, not so much for HIV.
Why the disparity? The short answer is that HIV is one of the wiliest, most slippery viruses known to modern science. And that answer breaks down into many factors.
What Are Vaccines And What Do They Do
Vaccines are products made from very small amounts of weak or dead germs that can cause diseases. They help your immune system fight infections faster and more effectively.
When you get a vaccine, it sparks your immune response, helping your body fight off and remember the germ so it can attack it if the germ ever invades again. And since vaccines are made of very small amounts of weak or dead germs, they wont make you sick.
Vaccines are usually administered by a shot, but sometimes can be administered by mouth or nasal spray. They are widely used to prevent diseases like polio, chicken pox, measles, mumps, rubella, influenza , hepatitis A and B, and human papillomavirus .
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Progress And Challenges In Hiv Vaccine Development
After decades of research and clinical trials, it may be difficult to contend with the fact that there have been new vaccines for other more recent infectious diseases but not for HIV. The reasons are both numerous and complex.
For example, HIV has multiple variants that are constantly evolving. This is likely due to their ability to work around the immune system. As the virus hides itself in the body, it can spread unknowingly 1 to 2 weeks after exposure.
The success of non-vaccine prevention methods like PrEP have also created logistical and ethical difficulties in designing accurate trials for HIV vaccine efficacy.
While such challenges may seem discouraging, the fact is, the research and development of an HIV vaccine has actually seen significant progress.
Researchers found the most success to date in humans during the RV144 Thai trial, which ran from 2003 to 2009. This trial involved a two-dose vaccine and yielded an estimated 31 percent efficacy rate.
Furthermore, as well discuss later, the perceived failed attempts at developing an HIV vaccine have led to stepping-stones in the creation of other vaccines that protect from different infectious diseases. One recent example is the COVID-19 vaccine.
A Brief History Of Hiv Vaccine Development
From 1987 to 2021, there have been three major approaches driving HIV-1 vaccine development. Each of these approaches involved one or more clinical trials and is summarized in . Though the first two approaches have mostly been concluded, it is worth noting that each approach has been continually reexplored as researchers learn more .
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Hiv Cure Research Approaches
There are a few different approaches to research cures. While each is promising, as of yet, there is no cure.
Why Do We Need A Vaccine To Prevent Hiv
Today, more people living with HIV than ever before have access to life-saving treatment with HIV medicines , which is good for their health. When people living with HIV achieve and maintain viral suppression by taking HIV medication daily as prescribed, they can stay healthy and have effectively no risk of sexually transmitting HIV to their partners. In addition, others who are at high risk for HIV infection may have access to pre-exposure prophylaxis , or ART being used to prevent HIV. Yet, unfortunately, in 2018, 37,968 people were diagnosed with HIV infection in the United States, and in 2019, approximately 1.7 million people newly acquired HIV worldwide. To control and ultimately end HIV globally, we need a powerful array of HIV prevention tools that are widely accessible to all who would benefit from them.
Vaccines historically have been the most effective means to prevent and even eradicate infectious diseases. They safely and cost-effectively prevent illness, disability, and death. Like smallpox and polio vaccines, a preventive HIV vaccine could help save millions of lives.
Developing safe, effective, and affordable vaccines that can prevent HIV infection in uninfected people is the NIHs highest HIV research priority given its game-changing potential for controlling and ultimately ending the HIV/AIDS pandemic.
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More Than 37 Million People Around The World Have Hiv
HIV attacks the bodys immune system, and if it goes untreated, it can lead to AIDS .
People with AIDS have badly damaged immune systems, which makes them vulnerable to a number of severe illnesses, called opportunistic infections. If AIDS goes untreated, the survival rate is about three years, according to the Centers for Disease Control and Prevention .
There were approximately 37.7 million people around the world with HIV in 2020, and 680,000 AIDS-related deaths, according to HIV.gov.
It’s estimated that 1.2 million people in the United States have HIV. In 2019, there were an estimated 34,800 new infections, with the highest rates of new diagnoses in the South, according to HIV.gov.
Kicking And Killing Latent Hiv
One of the greatest obstacles to developing an HIV vaccine is the speed by which the virus is able to establish latent reservoirs to evade immune detection. It is believed that this can happen as quickly as four hours in the case of some forms of sexual transmissionmoving quickly from the site of infection to the lymph nodesto up to four days in other types of sexual or non-sexual transmission.
To date, were neither entirely sure how extensive or large these reservoirs may be nor their potential to cause viral rebound in those believed cleared of infection.
Some of the most aggressive facets of research involve a so-called “kick-kill” strategy, using stimulating agents that can “kick” latent HIV out of hiding, thereby allowing a secondary agent or strategy to “kill” the newly exposed virus.
In this regard, scientists have had some success using drugs called HDAC inhibitors, which have been traditionally used to treat epilepsy and mood disorders. While studies have shown that newer HDAC drugs are capable of “waking” a dormant virus, none have yet been able to clear the reservoirs or even reduce their size. Hopes are currently being pinned on the combined use of HDAC and other novel drug agents .
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Should I Tell The Person Administering My Vaccine That I Am Hiv
A person with HIV should make the person administering the COVID-19 vaccine aware of this. One reason for this is that the COVID-19 vaccine guidelines differ slightly for people with HIV.
While the waiting time between the second dose and booster is 5 months for the general population, it is 28 days for someone with HIV.
Additionally, recommendations for boosters in people with HIV depend on the persons viral load and the strength of their immune system. Blood tests that measure viral load and immunity may be necessary beforehand to determine whether they need a booster and, if so, which one is best.
People with HIV should also tell the person administering the COVID-19 vaccine if they have any allergies or other health conditions.
Mosaic Vaccine Design Approach And Hvtn 705
Given HIV-1s vast genetic diversity and several strains, some researchers reconstructed global HIV-1 sequences in silico to generate mosaic immunogens . These immunogens have the maximum of potential T cell epitopes and, if administered as a vaccine, induce broader cellular and humoral immune responses as compared to wild-type of consensus HIV-1 antigens . In theory, mosaic antigens could generate a global HIV-1 vaccine . A phase I clinical trial testing mosaic Env and Gag-pol antigen set in adenovirus serotype 26 proved that the vaccine induced strong Env-specific immune responses in the bloodstream and colorectal mucosa .
Building on the positive phase I/II results of the Ad26 mosaic vaccine, a phase II clinical trial, HVTN 705/Imbokodo, evaluated the efficacy and was expected to be completed in 2022 . Unfortunately, this study was terminated in 2021 after the primary endpoint results showed that the vaccine did not confer any statistically significant efficacy. This study proved that the necessary immune response to confer protection against HIV is greater than the immune response to confer protection against other viruses such as COVID-19 . The Ad26 vector was successfully utilized to manufacture Ad26.COV2.S, a recombinant vaccine to protect against COVID-19 .
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What Is An Hiv Vaccine
Today, an effective vaccine against HIV does not exist. A vaccine that can prevent infection would teach the immune system to respond to HIV by making antibodies that can bind to the virus and stop it from infecting cells, or by promoting other immune responses that kill the virus.
No vaccine is 100% effective, and this is likely to be the same for HIV. Some people who receive a vaccine will not respond strongly enough to the vaccine and will not be protected, as in the case of the seasonal flu vaccine. But finding at least a partially effective vaccine remains of critical importance for the HIV response, as all successful disease elimination strategies have included a vaccine among their arsenal.
There Is No Change To Vaccine Ingredients Between The First And Second Dose
The video claims that there is a reduced amount of saline in the second dose of vaccine, and increased harmful ingredients.
This is wrong.
The Medicines and Healthcare products Regulatory Agency told Full Fact: The same COVID-19 vaccines are used for the first, second andwhere usedthird booster vaccinations.
The same vial can be used for any of these three uses so there is no difference in composition between first and second doses.
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Prophylactic Vs Therapeutic Vaccines
Despite these obstacles, researchers continue to try to find a vaccine. There are two main types of vaccines: prophylactic and therapeutic. Researchers are pursuing both for HIV.
Most vaccines are prophylactic, which means they prevent a person from getting a disease. Therapeutic vaccines, on the other hand, are used to increase the bodys immune response to fight disease that the person already has. Therapeutic vaccines are also considered treatments.
Therapeutic vaccines are being investigated for several conditions, such as:
- cancerous tumors
- the bacteria that cause gastric ulcers
An HIV vaccine would theoretically have two goals. First, it could be given to people who dont have HIV to prevent contracting the virus. This would make it a prophylactic vaccine.
But HIV is also a good candidate for a therapeutic vaccine. Researchers hope a therapeutic HIV vaccine could reduce a persons viral load.
Researchers are trying many different approaches to develop an HIV vaccine. Possible vaccines are being explored for both prophylactic and therapeutic uses.
Currently, researchers are working with the following types of vaccines:
Making The Right Immune Response
There are now hopeful signs that vaccine developers working on a variety of platforms might be on the right track to make an effective shot that provides sterilizing immunity. Still, I dont think at this point we should be taking any approach off the table, says Zolla-Pazner.
One approach is tapping into the idea that some infected people naturally make antibodies capable of attacking a wide assortment of HIV variants and stopping those viruses from infecting cells . These antibodies take a long time to develop. Sometimes they dont develop until years after an HIV infection has taken hold, Haynes says. HIV vaccine-makers want to speed up the process.
There are several ways to do that. One, being tested now in a clinical trial led by Johnson & Johnson, is to spark a broad immune response using an HIV protein composed of a mosaic of different HIV strains circulating around the world. Another way is to teach the immune system to make broadly neutralizing antibodies.
To do that, researchers identify broadly neutralizing antibodies in people infected with HIV. Then they can analyze the steps the body took to create those immune proteins. The goal is to craft a vaccine that tells vaccinated people to make similar antibodies when exposed to specific viral fragments, says Kevin Saunders, a vaccinologist at the Duke Human Vaccine Institute.
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