Which group of individuals is at risk when considering live vaccines and has a CD4 count of 200 or lower?

Individuals with HIV/AIDS are particularly at risk when it comes to live vaccines, especially when their CD4 count is 200 or lower. This low CD4 count indicates a severely compromised immune system, which significantly increases the risk of adverse reactions to live vaccines, as these vaccines contain weakened forms of the virus or bacteria they aim to protect against. In a healthy individual, the immune system is typically able to handle the weakened pathogen without causing disease. However, in someone with a significantly weakened immune response, such as those with advanced HIV/AIDS and a low CD4 count, there is a higher likelihood that they might develop an active infection from the vaccine itself.

Therefore, the recommended approach for individuals in this group is often to avoid live attenuated vaccines altogether and instead focus on inactivated or subunit vaccines, which do not pose the same risk. This distinction underscores the importance of careful evaluation of vaccination options for individuals with compromised immune systems, particularly those living with HIV/AIDS.