With little substantiation, evidence-based techniques were utilized to provide recommendations for immunization against vaccine-preventable illnesses for HIV-infected and HIV-exposed persons. Researchers did a comprehensive review and meta-analysis of randomized controlled trials (RCTs), cohort studies, and case–control studies using vaccination efficacy and effectiveness in HIV-infected and HIV-exposed children as outcomes. Articles were found by searching the databases Web of Science, Cochrane Library, PubMed, and Scopus. The 9-valent pneumococcal conjugate vaccination (PCV9) had a 32% efficacy against total vaccine serotype invasive pneumococcal illness in HIV-infected children and a 78% efficacy in HIV-uninfected children. Vaccine efficacy of the Bacillus Calmette–Guérin vaccine in preventing TB in HIV-infected children was nil, compared to 59 percent protection in HIV-uninfected children. Similarly, HIV-uninfected children outperform HIV-infected children in terms of protection against invasive Haemophilus influenzae type b illness. Rotavirus vaccination efficacy studies reveal that HIV-exposed uninfected children had equivalent protection against rotavirus gastroenteritis as non-exposed children. Children who are highly immunocompromised are vulnerable to invasive pneumococcal infections.
When compared to unexposed children, HIV-infected children have lower vaccination protection against vaccine-preventable illnesses. Immunocompetent HIV-infected children are more likely to have stronger vaccination protection against vaccine-preventable illnesses than immunocompromised children. The general quality of the observational studies was poor, with limited confidence in the impact estimates. Overall, the quality of evidence supporting RCT outcomes was generally good. This research indicates a scarcity of efficacy and effectiveness studies in HIV-infected and exposed youngsters.