Vaccine-Associated Measles Pneumonitis in an Adult with AIDS

The United States last encountered a measles epidemic in the late 1980s, a time when HIV infection was rapidly penetrating urban centers. The coincidence of these epidemics prompted reap-praisal of the long-standing proscription against the use of live-virus vaccine in immunocompromised pa-tients. Recognizing the severity of measles infection, particularly in patients with cell-mediated immune dysfunction (1-5), the Advisory Committee on Im-munization Practices (ACIP) revised its measles vac-cination guidelines in 1988. They began to recommend that 12- to 15-month-old children with asymptom-atic HIV infection be vaccinated and that vaccina-tion be considered for symptomatic HIV-infected children (1). Many HIV-infected children have since been safely immunized with live, attenuated measles