COVID- 19 Vaccination in an Inner City HIV Clinic

ABSTRACT

Background. Patients (pts) living with HIV (PLWH) are more likely to be hospitalized and experience increased rates of death from COVID-19. Vaccination has been shown to reduce hospitalization and death. Vaccination rate for general population in the state of New Jersey is 74.9%. We sought to analyze vaccination rates and its effects in an HIV outpatient clinic. Methods. Retrospective review in an outpatient HIV clinic, study period 12/01/ 2020 - 12/30/2021. Data was collected on demographics, CD4 count, HIV Viral loads (VL), type and number of vaccines received, incidence and outcome of COVID-19 infection. Student t-test used for comparison. Results. We included 635 pts, median age 53years (range 33-84), males 316 (49.7%), transgender 3 (0.48%). African American 568(89%), Hispanic 52 (8.1%), Caucasian 12 (1.9%), Asian 3(0.5%). HIV risk factors were heterosexual 451(71%), male having sex with male 122(19.2%), intravenous drug use 8(1.25%). CD4 > 200 cells/mm3 in 587 (92.4%), HIV VL < 200 copies/mL in 562 (88.5%). Two doses COVID vaccine was received by 442 (69.6%) pts. BNT162b2 (Pfizer) in 192 (43.4%), mRNA-1273(Moderna) in 181(40.9%), Ad.26.COV2.S (J & J) in 43(9.7%), unknown in 25 (5.7%). Booster dose in 126 (28.5%). Incomplete immunization in 7(4.4%). Vaccination in men 217/316(68.7%) vs. women 224/316 (70.8%) (p=NS). COVID-19 infection was diagnosed in 67(10.6%);49(73%) were unvaccinated vs. 18 (27%) vaccinated;14 received 2 doses and 4 were boosted (p< 0.05);15 pts were hospitalized for COVID-19, 13/15 (86.7%) unvaccinated vs. 2/15 (13.3%) vaccinated (p< 0.05). CD4 was > 200 cells/mm3 in 46/49(94%) in unvaccinated vs. 16/18 (88.8%) vaccinated pts (p=NS);HIV VL < 200copies/mL in 46/49 (94%) unvaccinated vs.17/ 18(94%) vaccinated and infected (p=NS). One unvaccinated pt. expired. Conclusion. In our outpatient HIV clinic, PLWH had vaccine acceptance rates similar to the general population. More unvaccinated became infected and hospitalized than vaccinated pts. There was no difference in CD4 and HIV VL in COVID infected pts who were vaccinated vs. unvaccinated pts.