The University of Toledo Translation Journal of Medical Sciences 
Infectious Diseases Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

Successful Administration of the Influenza 
Vaccine after Prior Serum Sickness in an 
HIV-Positive Patient 
M. Deutsch, M31*, K. Girdhar, M41, R. Fabian, DO1, J. Kammeyer, MD2

1Division of Internal Medicine, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 
2Division of Infectious Diseases, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 

*Corresponding author: joel.kammeyer@utoledo.edu

Published: 05 May 2023 

Serum sickness is a type III hypersensitivity reaction to an antigen, leading to accumulation of immune 
complexes, inflammation, and vasculitis; causing symptoms like fever, rash, abdominal pain, and 
arthralgia (1). Serum sickness reactions to vaccination have previously been described (2-6), and are 
treated with steroids and removal of the offending agent (1). However, successful desensitization has 
been previously described (7). We present a case of successful re-administration of the influenza vaccine 
in an HIV+ patient, with previous history of serum sickness secondary to influenza vaccination.  A 48-
year-old male with uncontrolled HIV was admitted in October 2017 due to rash after receiving the 
influenza vaccine. The rash started on his arm and spread medially; and was associated with joint 
swelling and extremity pain. The patient was admitted and treated with prednisone, which resolved his 
serum sickness. At the time of presentation, the patient’s last CD4 count was 4, and a viral load was 
177,000. HIV genotype revealed M184V and K65R mutations. In July 2018, the patient established care 
for uncontrolled HIV. He was prescribed lamivudine-zidovudine, dolutegravir, and darunavir-cobicistat. 
Adherence to therapy resulted in CD4 count of 223 and an undetectable viral load in September 2021. In 
November 2021, he successfully received the inactivated influenza vaccine, without resultant serum 
sickness.  In this case, after immune reconstitution, the patient was able to tolerate the influenza vaccine. 
Serum sickness reaction to influenza vaccination has not previously been described in HIV+ patients but 
may be an important consideration prior to vaccination in immunocompromised individuals. 

https://dx.doi.org/10.46570/utjms.vol11-2023-750  

https://dx.doi.org/10.46570/utjms.vol11-2023-750
mailto:joel.kammeyer@utoledo.edu