Coronavirus disease 2019 vaccine effectiveness among a population-based cohort of people living with HIV
- DOI
- Language of the publication
- English
- Date
- 2022-12-01
- Type
- Article
- Author(s)
- Chambers, Catharine
- Samji, Hasina
- Cooper, Curtis L.
- Costiniuk, Cecilia T.
- Janjua, Naveed Z.
- Kroch, Abigail E.
- Arbess, Gordon
- Benoit, Anita C.
- Buchan, Sarah A.
- Chung, Hannah
- Kendall, Claire E.
- Kwong, Jeffrey C.
- Langlois, Marc-André
- Lee, Samantha M.
- Mbuagbaw, Lawrence
- McCullagh, John
- Moineddin, Rahim
- Nambiar, Devan
- Walmsley, Sharon
- Anis, Aslam H.
- Burchell, Ann N.
- COVAXHIV Study Team
- Publisher
- Wolters Kluwer Health, Inc.
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 ≥19 years 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 ≥7 days before specimen collection was 82% (95% confidence interval [CI] = 74–87%) against any infection, 94% (95% CI = 82–98%) against symptomatic infection, and 97% (95% CI = 85–100%) against hospitalization/death. Against any infection, VE declined from 86% (95% CI = 77–92%) within 7–59 days after the second dose to 66% (95% CI = −15–90%) after ≥180 days; 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.
Subject
- Health,
- Coronavirus diseases,
- Immunization
Rights
Pagination
F17-F26
Peer review
Yes
Identifiers
- PubMed ID
- 36254892
- ISSN
- 1473-5571
Article
- Journal title
- AIDS
- Journal volume
- 36
- Journal issue
- 15