Which vaccine is contraindicated in symptomatic HIV patients?

The BCG vaccine, which protects against tuberculosis, is contraindicated in symptomatic HIV patients because of the compromised immune system associated with HIV infection. In individuals who are symptomatic or have advanced HIV disease, there is a significantly heightened risk of developing infections due to the live attenuated strain of the Mycobacterium bovis present in the BCG vaccine. This can lead to severe complications, as their immunity is not sufficient to handle the exposure to the live bacteria.

In contrast, the other vaccines listed generally have different considerations for administration in HIV patients. The Oral Polio Vaccine, while a live attenuated vaccine, is typically avoided in immunocompromised individuals due to a risk of vaccine-derived poliovirus, but it is not as strictly contraindicated as the BCG vaccine. The Intranasal Influenza Vaccine, also a live attenuated vaccine, is advised against in severely immunocompromised patients but might be acceptable in those with stable, asymptomatic HIV. The Yellow Fever Vaccine is another live vaccine that poses risks but is sometimes considered based on individual risk assessments.

Thus, the BCG vaccine is clearly designated as contraindicated for those with symptomatic HIV due to the direct implications for their health and safety.