Coronavirus disease 2019 vaccine effectiveness among a population-based cohort of people living with HIV

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DOI

https://doi.org/10.1097/qad.0000000000003405

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

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Collection(s)

Communicable diseases

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