ABSTRACT
Background: COVID-19 vaccination is effective at preventing symptomatic infection, hospitalization, and death from COVID-19, but many people have experienced barriers to receiving this life preserving intervention. A study examining COVID-19 vaccination in New York state found that persons with HIV (PWH) were less likely to be vaccinated than the general population. We examined whether PWH are less likely to be vaccinated than persons without HIV (PWoH) in the Veterans Affairs (VA) Healthcare System. Method(s): We examined COVID-19 vaccination receipt by HIV status in the Veterans Aging Cohort Study (VACS), an open cohort of PWH and 1:2 age-, race/ethnicity-, sex-, and site-matched PWoH. Among participants with a VA encounter from 10 December 2020 to 12 September 2022, we calculated the proportion of individuals who were fully vaccinated and boosted. Fully vaccinated was defined as: 14 days after second dose of mRNA vaccine (either Pfizer BNT162b2 or Moderna mRNA-1273) or single dose of a viral vector vaccine (Janssen Ad26.COV2.S). Boosted was defined as an additional vaccination at least 180 days after full vaccination. We assessed differences using chi-square tests. Result(s): Among 109,421 participants, PWH (n=31,337) were more likely than PWoH (n=78,084) to be fully vaccinated (77.6% vs 68.7%, p< 0.001) and boosted (71.1% vs 63.0%, p< 0.001) (Table). Most people received an mRNA vaccine with 6.9% of fully vaccinated PWH and 7.5% of fully vaccinated PWoH receiving the Janssen vaccine. Among PWH, having an undetectable HIV viral load was more common in those fully vaccinated than those not fully vaccinated (79.4% vs 72.0%, p< 0.001). Conclusion(s): In a matched cohort of veterans with and without HIV in VA care, we found that PWH were more likely than PWoH to be fully vaccinated and boosted. These findings contrast with a New York state study which found lower COVID-19 vaccination rates in PWH, possibly due to differential healthcare access;all patients in our cohort have access to VA care. Further studies are needed to understand differences in vaccine acceptance and receipt to prevent COVID-19 hospitalizations and deaths. COVID-19 Vaccination in People with HIV (PWH) and People without HIV (PWoH) - Veterans Aging Cohort Study, as of 12 September 2022.