Soru

An adolescent girl, aged $17$ years, comes to the outpatient office for a pre-college physical examination. She plans to move into a university dormitory next month. The patient has a history of perinatally acquired human immunodeficiency virus (HIV) infection. Her adherence to antiretroviral therapy has been poor over the past year. She currently feels well and reports no fever, cough, or weight loss. Her temperature is $37.1^{\circ}\text{C}$ ($98.8^{\circ}\text{F}$), blood pressure is $110/70 \text{ mmHg}$, and pulse is $78/\text{min}$. Physical examination is notable for white plaques on the buccal mucosa that can be scraped off with a tongue depressor, as well as generalized non-tender lymphadenopathy. Laboratory studies show a CD4+ T-cell count of $140 \text{ cells/mm}^3$ and an HIV viral load of $150,000 \text{ copies/mL}$. A review of her immunization records shows she received all recommended primary vaccines during infancy but has not received any immunizations since $4$ years of age. Which of the following vaccines is contraindicated for this patient during today's visit?