Evaluation of Vaccination Rates and Factors associated with Vaccine Uptake among People Living with HIV in Detroit, MI

ABSTRACT

Background. Determination of vaccination rates for people living with HIV (PLWH) and factors that affect adherence to vaccination is important to ensure these vulnerable patients are optimally protected against vaccine-preventable diseases. We analyzed the rates of vaccination and associated factors in PLWH receiving care in the Henry Ford Health Infectious Diseases (HFH ID) Clinic in Detroit, MI. Methods. We implemented a retrospective, observational study. Inclusion criteria were all PLWH who had at minimum two clinic visits at HFH ID clinic within 12 months from 2015-2021. Charts were reviewed for demographic data. We analyzed the rates of all eligible vaccines including the hepatitis A and B, HPV, influenza, pneumococcal, tetanus, zoster, and COVID-19 vaccines. Results. A total of 661 met the inclusion criteria. Average age of the patients was 50 years. 78.6% were male, 74.3% black, and 57.6% patients were from Detroit. On average, patients had 1 clinic visit in the past year at HFH ID Clinic. Rates of influenza, pneumococcal, and tetanus vaccinations were above 90%. Rates of hepatitis A and B vaccinations were above 80%. Rates of zoster and HPV vaccinations were above 50%. COVID-19 vaccination had the lowest rate at 42.1%. Patients who had received all recommended vaccines were more likely to be male, have a HFH PCP, men who have sex with men (MSM), younger, more HFH ID clinic visits, and have a higher CD4 count on entry into care. Factors associated with increased vaccine uptake include having a HFH primary care physician (PCP), more HFH ID clinic visits, and a CD4 count above 200 on entry. Having 2 clinic visits in the previous year was associated with a higher likelihood of vaccine adherence [OR 5.85 (95% CI 0.360 - 0.723)]. Conclusion. Our study shows that even in this highly vulnerable, vaccinehesitant population, programs that integrate vaccines and promote adherence to clinic care into the routine care of PLWH results in high rates of vaccine uptake. (Table Presented).