Coronavirus disease 2019 vaccine effectiveness among a population-based cohort of people living with HIV.
AIDS
; 36(15): F17-F26, 2022 12 01.
Article
in English
| MEDLINE | ID: covidwho-2116555
ABSTRACT
OBJECTIVE:
People with HIV were underrepresented in coronavirus disease 2019 (COVID-19) vaccine clinical trials. We estimated vaccine effectiveness (VE) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection for the BNT162b2, mRNA-1273, and ChAdOx1 vaccines among a population-based cohort of people with HIV in Ontario, Canada.DESIGN:
Test-negative design.METHODS:
We identified people with HIV aged ≥19âyears who were tested for SARS-CoV-2 by RT-PCR between December 14, 2020 (first availability of COVID-19 vaccines) and November 21, 2021 (pre-Omicron circulation). Outcomes included any infection, symptomatic infection, and COVID-19-related hospitalization/death. We compared the odds of vaccination between test-positive cases and test-negative controls using multivariable logistic regression with adjustment for age, sex, region, calendar time, SARS-CoV-2 test histories, influenza vaccination, comorbidities, and neighborhood-level socio-economic status. VE was derived as (1 - adjusted odds ratio) × 100%.RESULTS:
Among 21 023 adults living with HIV, there were 801 (8.3%) test-positive cases and 8,879 (91.7%) test-negative controls. 20.1% cases and 47.8% of controls received ≥1 COVID-19 vaccine dose; among two-dose recipients, 93.4% received ≥1 mRNA dose. Two-dose VE ≥7âdays before specimen collection was 82% (95% confidence interval [CI]â=â74-87%) against any infection, 94% (95% CIâ=â82-98%) against symptomatic infection, and 97% (95% CIâ=â85-100%) against hospitalization/death. Against any infection, VE declined from 86% (95% CIâ=â77-92%) within 7-59âdays after the second dose to 66% (95% CIâ=â-15-90%) after ≥180âdays; we did not observe evidence of waning protection for other outcomes.CONCLUSION:
Two doses of COVID-19 vaccine offered substantial protection against symptomatic illness and hospitalization/death in people with HIV prior to the emergence of the Omicron variant. Our findings do not support a broad conclusion that COVID-19 VE is lower among people with HIV in populations that, for the most part, are attending HIV care, taking antiretroviral medication, and are virally suppressed.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Influenza Vaccines
/
HIV Infections
/
Influenza, Human
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
/
Vaccines
/
Variants
Limits:
Adult
/
Humans
Country/Region as subject:
North America
Language:
English
Journal:
AIDS
Journal subject:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Year:
2022
Document Type:
Article
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