The U.S. Dept. of Health & Human Services (HHS) Guidance for COVID-19 concerning people with HIV recommends that people with HIV should receive COVID-19 vaccines, regardless of their CD4 or viral load, because the potential benefits outweigh the potential risks.
In addition to getting vaccinated and following guidance for fully vaccinated people, those who have HIV should be counseled about the potential for reduced immune responses to COVID-19 vaccines and to follow current prevention measures (including wearing a mask, staying 6 feet apart from others they don’t live with, and avoiding crowds and poorly ventilated indoor spaces) to protect themselves against COVID-19. Close contacts of people with HIV should be encouraged to be vaccinated against COVID-19.
Moderately or severely immunocompromised people 6 months or older who received an initial Moderna COVID-19 vaccine primary series should receive an additional primary dose of Moderna at least 28 days after the second dose. Moderately or severely immunocompromised people age 5 or older who received an initial Pfizer COVID-19 vaccine primary series should receive an additional primary dose of Pfizer at least 28 days after the second dose. Moderately or severely immunocompromised people age 18 or older who received the Johnson & Johnson vaccine should receive a single dose of an mRNA vaccine (Pfizer or Moderna) at least 28 days after their first dose. Currently, an additional dose is not authorized for those who received a Novavax primary series.