Current recommendations for HIV infected children is to give an additional early dose at 6 months followed by the scheduled dose at 9 months. For children with advanced HIV, the risks and benefits must be weighed for each particular situation. Urban measles Densely populated urban areas are particularly at risk, where the virus may be kept circulating by numerous pockets of susceptibles, despite a relatively high overall level of coverage. The urban poor usually have less access to immunization services, as well as frequently having ethnic or cultural reasons which might hinder their accepting immunization. Refugees Introduction of measles infection into disaster populations with a high proportion of susceptibles can result in a devastating epidemic with high fatality.
Refugee camps have the highest priority for achieving vaccination for every infant and child.
Even one case of measles in this situation may spell disaster. Medical settings have been the foci of a number of measles outbreaks. Children admitted to hospital and siblings who visit them must be immunized at the earliest opportunity within the national schedule. In some settings, medical personnel have been the source of measles spread. Policies requiring immunization or proof of immunization among health workers may need to be implemented in such settings.