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Gray A, Alemohammad SY, Ramírez-Ortiz D, Trepka MJ. A Systematic Review of Factors Associated with COVID-19 Vaccine Uptake, Hesitancy, and Acceptability Among Adults with HIV: Implications for Integrating COVID-19 Immunization into HIV Care. AIDS Patient Care STDS 2024. [PMID: 39058653 DOI: 10.1089/apc.2024.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024] Open
Abstract
The COVID-19 virus, once a public health emergency, is now endemic. Immunization remains an important measure for mitigating high levels of disease, morbidity, and mortality related to COVID-19 infection. People with HIV (PWH), in particular, benefit from COVID-19 vaccination because of increased risk for severe COVID-19 infection. However, previous data suggest vaccine hesitancy among this population. Given this context and the evolving epidemiology of COVID-19, this review examines factors associated with COVID-19 vaccine hesitancy, acceptability, and uptake among adults with HIV. Through a systematic search of electronic databases, we identified 56 peer-reviewed articles published between the years 2020 and 2023 that matched the objectives of our review out of a total of 797 screened citations. Among our final sample of articles, nearly all global regions were represented, and 61% of studies recruited only PWH. We identified eight categories of factors associated with COVID-19 vaccination outcomes, including HIV-specific factors (e.g., CD4 count), vaccine attitudes (e.g., vaccine confidence), factors related to the COVID-19 virus (e.g., concern about infection), factors specific to the COVID-19 vaccine (e.g., accessibility), social norms and peer factors (e.g., subjective norms), mental health (e.g., anxiety/depression) and other psychological factors (e.g., substance use), demographic characteristics (e.g., age), and health factors (e.g., vaccination history). Reflecting on these factors, we discuss populations in need of vaccine promotion, modifiable targets for intervention, and integrating immunization into HIV care. Public health efforts to promote COVID-19 immunization among PWH must include educational/informational, peer, and structural interventions and must now consider uptake of COVID-19 booster doses.
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Affiliation(s)
- Aaliyah Gray
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Seyedeh Yasaman Alemohammad
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Daisy Ramírez-Ortiz
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
- Research Center in Minority Institutions, Florida International University, Miami, Florida, USA
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Dong W, Miao Y, Shen Z, Zhang W, Bai J, Zhu D, Ren R, Zhang J, Wu J, Tarimo CS, Ojangba T, Li Y. Quantifying Disparities in COVID-19 Vaccination Rates by Rural and Urban Areas: Cross-Sectional Observational Study. JMIR Public Health Surveill 2024; 10:e50595. [PMID: 39028548 PMCID: PMC11297372 DOI: 10.2196/50595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 04/04/2024] [Accepted: 05/16/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Vaccination plays an important role in preventing COVID-19 infection and reducing the severity of the disease. There are usually differences in vaccination rates between urban and rural areas. Measuring these differences can aid in developing more coordinated and sustainable solutions. This information also serves as a reference for the prevention and control of emerging infectious diseases in the future. OBJECTIVE This study aims to assess the current coverage rate and influencing factors of COVID-19 (second booster) vaccination among Chinese residents, as well as the disparities between urban and rural areas in China. METHODS This cross-sectional study used a stratified random sampling approach to select representative samples from 11 communities and 10 villages in eastern (Changzhou), central (Zhengzhou), western (Xining), and northeast (Mudanjiang) Mainland China from February 1 to February 18, 2023. The questionnaires were developed by experienced epidemiologists and contained the following: sociodemographic information, health conditions, vaccine-related information, information related to the Protective Motivation Theory (PMT), and the level of trust in the health care system. Vaccination rates among the participants were evaluated based on self-reported information provided. Binary logistic regression models were performed to explore influencing factors of vaccination among urban and rural participants. Urban-rural disparities in the vaccination rate were assessed using propensity score matching (PSM). RESULTS A total of 5780 participants were included, with 53.04% (3066/5780) being female. The vaccination rate was 12.18% (704/5780; 95% CI 11.34-13.02) in the total sample, 13.76% (341/2478; 95% CI 12.40-15.12) among the rural participants, and 10.99% (363/3302; 95% CI 9.93-12.06) among the urban participants. For rural participants, self-reported health condition, self-efficacy, educational level, vaccine knowledge, susceptibility, benefits, and trust in the health care system were independent factors associated with vaccination (all P<.05). For urban participants, chronic conditions, COVID-19 infection, subjective community level, vaccine knowledge, self-efficacy, and trust in the health care system were independent factors associated with vaccination (all P<.05). PSM analysis uncovered a 3.42% difference in vaccination rates between urban and rural participants. CONCLUSIONS The fourth COVID-19 vaccination coverage rate (second booster) among the Chinese population was extremely low, significantly lower than the previous vaccine coverage rate. Given that COVID-19 infection is still prevalent at low levels, efforts should focus on enhancing self-efficacy to expand the vaccine coverage rate among the Chinese population. For rural residents, building awareness of the vaccine's benefits and improving their overall health status should be prioritized. In urban areas, a larger proportion of people with COVID-19 and patients with chronic illness should be vaccinated.
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Affiliation(s)
- Wenyong Dong
- Department of Hypertension, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhanlei Shen
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wanliang Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Junwen Bai
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Dongfang Zhu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ruizhe Ren
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jingbao Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Clifford Silver Tarimo
- Department of Science and Laboratory Technology, Dar Es Salaam Institute of Technology, Dar es Salaam, United Republic of Tanzania
| | - Theodora Ojangba
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yi Li
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
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Pereira M, Santos Aleluia IR, de Castro CT, de Almeida Oliveira T, Cunha MS, Magno L, Dourado I, Barreto F, Natividade M, Appiah SCY, Abade E, Paixao ES, de Souza MLT. COVID-19 Vaccine Acceptance and Hesitancy among People Living with HIV: Review and Meta-Analysis. AIDS Behav 2024; 28:2193-2204. [PMID: 38713281 DOI: 10.1007/s10461-024-04351-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 05/08/2024]
Abstract
This study aims to estimate the COVID-19 vaccine acceptance and hesitancy among people living with HIV (PLWHA). A search for observational studies was conducted in five databases and preprinted literature. Summary estimates were pooled using a random effects model and meta-regression. Of 150 identified studies, 31 were eligible (18,550 PLWHA). The weighted prevalence of COVID-19 vaccine hesitancy overall was 29.07% among PLWHA (95%CI = 24.33-34.32; I² = 98%,) and that of vaccine acceptance was 68.66% (95%CI = 62.25-74.43; I² = 98%). Higher hesitancy prevalence was identified in low/lower-middle income countries (35.05; 95% CI = 19.38-54.78). The heterogeneity was explained by the risk of bias, region, and year of data collection. The findings conclude that the COVID-19 vaccine hesitancy rate remains high, especially in low-income countries. Evidence-informed interventions aimed at increasing COVID-19 vaccine acceptance at the national and individual levels ought to be designed to increase COVID-19 vaccine acceptance among PLWHA.
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Affiliation(s)
- Marcos Pereira
- Institute of Collective Health, Federal University of Bahia, R. Basílio da Gama, s/n - Canela, Salvador, 45760-030, Bahia, Brazil.
| | | | - Caroline Tianeze de Castro
- Institute of Collective Health, Federal University of Bahia, R. Basílio da Gama, s/n - Canela, Salvador, 45760-030, Bahia, Brazil
| | - Tarcio de Almeida Oliveira
- Institute of Collective Health, Federal University of Bahia, R. Basílio da Gama, s/n - Canela, Salvador, 45760-030, Bahia, Brazil
| | - Mila Silva Cunha
- Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Laio Magno
- Institute of Collective Health, Federal University of Bahia, R. Basílio da Gama, s/n - Canela, Salvador, 45760-030, Bahia, Brazil
| | - Inês Dourado
- Institute of Collective Health, Federal University of Bahia, R. Basílio da Gama, s/n - Canela, Salvador, 45760-030, Bahia, Brazil
| | - Florisneide Barreto
- Institute of Collective Health, Federal University of Bahia, R. Basílio da Gama, s/n - Canela, Salvador, 45760-030, Bahia, Brazil
| | - Marcio Natividade
- Institute of Collective Health, Federal University of Bahia, R. Basílio da Gama, s/n - Canela, Salvador, 45760-030, Bahia, Brazil
| | - Seth Christopher Yaw Appiah
- Department of Sociology and Social Work, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Erick Abade
- Institute of Collective Health, Federal University of Bahia, R. Basílio da Gama, s/n - Canela, Salvador, 45760-030, Bahia, Brazil
| | - Enny S Paixao
- London School of Hygiene and Tropical Medicine, London, UK
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Duncan MC, Omondi FH, Kinloch NN, Lapointe HR, Speckmaier S, Moran-Garcia N, Lawson T, DeMarco ML, Simons J, Holmes DT, Lowe CF, Bacani N, Sereda P, Barrios R, Harris M, Romney MG, Montaner JS, Brumme CJ, Brockman MA, Brumme ZL. Effects of COVID-19 mRNA vaccination on HIV viremia and reservoir size. AIDS 2024; 38:1120-1130. [PMID: 38224350 PMCID: PMC11139238 DOI: 10.1097/qad.0000000000003841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/03/2024] [Accepted: 01/07/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVE The immunogenic nature of coronavirus disease 2019 (COVID-19) mRNA vaccines led to some initial concern that these could stimulate the HIV reservoir. We analyzed changes in plasma HIV loads (pVL) and reservoir size following COVID-19 mRNA vaccination in 62 people with HIV (PWH) receiving antiretroviral therapy (ART), and analyzed province-wide trends in pVL before and after the mass vaccination campaign. DESIGN Longitudinal observational cohort and province-wide analysis. METHODS Sixty-two participants were sampled prevaccination, and one month after their first and second COVID-19 immunizations. Vaccine-induced anti-SARS-CoV-2-Spike antibodies in serum were measured using the Roche Elecsys Anti-S assay. HIV reservoirs were quantified using the intact proviral DNA assay; pVL were measured using the cobas 6800 (lower limit of quantification: 20 copies/ml). The province-wide analysis included all 290 401 pVL performed in British Columbia, Canada between 2012 and 2022. RESULTS Prevaccination, the median intact reservoir size was 77 [interquartile range (IQR): 20-204] HIV copies/million CD4 + T-cells, compared to 74 (IQR: 27-212) and 65 (IQR: 22-174) postfirst and -second dose, respectively (all comparisons P > 0.07). Prevaccination, 82% of participants had pVL <20 copies/ml (max: 110 copies/ml), compared to 79% postfirst dose (max: 183 copies/ml) and 85% postsecond dose (max: 79 copies/ml) ( P > 0.4). There was no evidence that the magnitude of the vaccine-elicited anti-SARS-CoV-2-Spike immune response influenced pVL nor changes in reservoir size ( P > 0.6). We found no evidence linking the COVID-19 mass vaccination campaign to population-level increases in detectable pVL frequency among all PWH in the province, nor among those who maintained pVL suppression on ART. CONCLUSION We found no evidence that COVID-19 mRNA vaccines induced changes in HIV reservoir size nor plasma viremia.
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Affiliation(s)
- Maggie C. Duncan
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - F. Harrison Omondi
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Natalie N. Kinloch
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Hope R. Lapointe
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Sarah Speckmaier
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | | | - Tanya Lawson
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
| | - Mari L. DeMarco
- Department of Pathology and Laboratory Medicine, Providence Healthcare, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Janet Simons
- Department of Pathology and Laboratory Medicine, Providence Healthcare, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Daniel T. Holmes
- Department of Pathology and Laboratory Medicine, Providence Healthcare, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Christopher F. Lowe
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, Providence Healthcare, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Nic Bacani
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Paul Sereda
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Rolando Barrios
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Marianne Harris
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Marc G. Romney
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, Providence Healthcare, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Julio S.G. Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Chanson J. Brumme
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Mark A. Brockman
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
| | - Zabrina L. Brumme
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
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Rahbeni TA, Satapathy P, Itumalla R, Marzo RR, Mugheed KAL, Khatib MN, Gaidhane S, Zahiruddin QS, Rabaan AA, Alrasheed HA, Al-Subaie MF, Al Kaabil NA, Alissa M, Ibrahim AAAL, Alsaif HA, Naser IH, Rustagi S, Kukreti N, Dziedzic A. COVID-19 Vaccine Hesitancy: Umbrella Review of Systematic Reviews and Meta-Analysis. JMIR Public Health Surveill 2024; 10:e54769. [PMID: 38687992 PMCID: PMC11062401 DOI: 10.2196/54769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND The unprecedented emergence of the COVID-19 pandemic necessitated the development and global distribution of vaccines, making the understanding of global vaccine acceptance and hesitancy crucial to overcoming barriers to vaccination and achieving widespread immunization. OBJECTIVE This umbrella review synthesizes findings from systematic reviews and meta-analyses to provide insights into global perceptions on COVID-19 vaccine acceptance and hesitancy across diverse populations and regions. METHODS We conducted a literature search across major databases to identify systematic reviews and meta-analysis that reported COVID-19 vaccine acceptance and hesitancy. The AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews) criteria were used to assess the methodological quality of included systematic reviews. Meta-analysis was performed using STATA 17 with a random effect model. The data synthesis is presented in a table format and via a narrative. RESULTS Our inclusion criteria were met by 78 meta-analyses published between 2021 and 2023. Our analysis revealed a moderate vaccine acceptance rate of 63% (95% CI 0.60%-0.67%) in the general population, with significant heterogeneity (I2 = 97.59%). Higher acceptance rates were observed among health care workers and individuals with chronic diseases, at 64% (95% CI 0.57%-0.71%) and 69% (95% CI 0.61%-0.76%), respectively. However, lower acceptance was noted among pregnant women, at 48% (95% CI 0.42%-0.53%), and parents consenting for their children, at 61.29% (95% CI 0.56%-0.67%). The pooled vaccine hesitancy rate was 32% (95% CI 0.25%-0.39%) in the general population. The quality assessment revealed 19 high-quality, 38 moderate-quality, 15 low-quality, and 6 critically low-quality meta-analyses. CONCLUSIONS This review revealed the presence of vaccine hesitancy globally, emphasizing the necessity for population-specific, culturally sensitive interventions and clear, credible information dissemination to foster vaccine acceptance. The observed disparities accentuate the need for continuous research to understand evolving vaccine perceptions and to address the unique concerns and needs of diverse populations, thereby aiding in the formulation of effective and inclusive vaccination strategies. TRIAL REGISTRATION PROSPERO CRD42023468363; https://tinyurl.com/2p9kv9cr.
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Affiliation(s)
- Tahani Al Rahbeni
- Molecular Toxicology and Genetics, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | | | - Roy Rillera Marzo
- Faculty of Humanities and Health Sciences, Curtin University, Miri Sarawak, Malaysia
| | - Khalid A L Mugheed
- Molecular Toxicology and Genetics, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi Syed Zahiruddin
- South Asia Infant Feeding Research Network, Division of Evidence Synthesis, School of Epidemiology and Public Health and Research, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, India
| | - Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan
| | - Hayam A Alrasheed
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Maha F Al-Subaie
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Research Center, Dr Sulaiman Alhabib Medical Group, Riyadh, Saudi Arabia
| | - Nawal A Al Kaabil
- College of Medicine and Health Science, Khalifa University, Abu Dhabi, United Arab Emirates
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | - Mohammed Alissa
- Department of Medical Laboratory, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | | | | | - Israa Habeeb Naser
- Medical Laboratories Techniques Department, AL-Mustaqbal University, Babil, Iraq
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, India
| | - Neelima Kukreti
- School of Pharmacy, Graphic Era Hill University, Dehradun, India
| | - Arkadiusz Dziedzic
- Department of Conservative Dentistry with Endodontics, Medical University of Silesia, Katowice, Poland
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Zurashvili T, Chakhaia T, King EJ, DeHovitz J, Djibuti M. HIV stigma and other barriers to COVID-19 vaccine uptake among Georgian people living with HIV/AIDS: A mixed-methods study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003069. [PMID: 38547297 PMCID: PMC10977874 DOI: 10.1371/journal.pgph.0003069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/08/2024] [Indexed: 04/01/2024]
Abstract
We conducted a study in Georgia to examine behavioral insights and barriers to COVID-19 vaccine uptake among people living with HIV (PLWH). Between December 2021-July 2022, we collected quantitative data to evaluate participants' demographics, COVID-19 knowledge, attitude, perception, and HIV stigma as potential covariates for being vaccinated against COVID-19. We conducted a multivariate analysis to define the factors independently associated with COVID-19 vaccination among PLWH. We collected qualitative data to explore individual experiences of their positive or negative choices, main barriers, HIV stigma, and preferences for receiving vaccination. Of the total 85 participants of the study, 52.9% were vaccinated; 61.2% had concerns with the disclosure of HIV status at the vaccination site. Those who believed they would have a severe form of COVID-19 were more likely to be vaccinated (OR = 23.8; 95% CI: 5.1-111.7). The association stayed significant after adjusting for sex, age, education level, living area, health care providers' unfriendly attitudes, and their fear of disclosing HIV status at vaccination places. Based on the qualitative study, status disclosure was a significant barrier to receiving care; therefore, PLWH prefer to receive COVID-19 vaccination integrated in HIV services. Conclusions: In this study, around half of the participants were not vaccinated against COVID-19. The main reasons for not being vaccinated included stigma, misleading health beliefs, and low awareness about COVID-19. An integrated service delivery model may improve vaccination uptake among PLWH in Georgia.
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Affiliation(s)
- Tamar Zurashvili
- Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
- Partnership for Research and Action for Health, Tbilisi, Georgia
| | - Tsira Chakhaia
- Partnership for Research and Action for Health, Tbilisi, Georgia
- School of Public Health, Georgia State University, Atlanta, Georgia, United States of America
| | - Elizabeth J. King
- School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Jack DeHovitz
- Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, United States of America
| | - Mamuka Djibuti
- Partnership for Research and Action for Health, Tbilisi, Georgia
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7
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Huang X, Lin Z, Qin J, Yu D, Zhang F, Fang G, Chen X, He J, Cen P, Li M, Zhang R, Luo T, Jiang J, An S, Liang H, Ye L, Liang B. Willingness to accept monkeypox vaccine and its correlates among men who have sex with men in Southern China: a web-based online cross-sectional study. Front Public Health 2024; 12:1289918. [PMID: 38384873 PMCID: PMC10879393 DOI: 10.3389/fpubh.2024.1289918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/15/2024] [Indexed: 02/23/2024] Open
Abstract
Background The May 2022 global outbreak of monkeypox (MPX) poses a threat to the health of men who have sex with men. However, there is limited data on the willingness of MSM to receive monkeypox vaccination in Southern China. This study aimed to assess the knowledge of MPX, concerns regarding MPX, and willingness to receive monkeypox vaccination, as well as their correlates, among MSM in China. Methods We conducted a Web-based online survey of MSM in Southern China from August to September 2022. Data were collected on the socio-demographic characteristics, knowledge, worries, concerns regarding MPX and willingness to receive monkeypox vaccination. Multivariate logistic regression was employed to explore the factors associated with willingness to receive monkeypox vaccination. Results A total of 1903 participants completed the survey. Among them, approximately 69.9% reported being aware of MPX awareness, 94.1% of the participants supported the promotion of monkeypox vaccination. The majority of participants (91.4%) expressed their willingness to receive monkeypox vaccination. Participants who considered monkeypox vaccination safe [adjusted odds ratio (aOR) = 4.82, 95% CI: 1.35-17.18], agreed on the necessity of government promotion of monkeypox vaccination in China (aOR = 6.03, 95% CI: 1.07-33.93), believed in prioritizing monkeypox vaccination for MSM (aOR = 5.01, 95% CI: 1.10-22.71), and had friends or sexual partners who had already received the monkeypox or smallpox vaccination (aOR = 10.37, 95% CI: 2.11-50.99) are more likely to be vaccinated. Conversely, married individuals (aOR = 0.13, 95% CI: 0.03-0.47), those engaging in anal sex 4-6 times per week in the past 3 months (aOR = 0.26, 95% CI: 0.09-0.77) expressed hesitancy toward monkeypox vaccination. Conclusion There was a high willingness to receive monkeypox vaccination among MSM in China. The hesitancy toward the monkeypox vaccine can be effectively mitigated by addressing concerns about its safety and potential adverse reactions. Moreover, increasing acceptance of the monkeypox vaccination among MSM and their peers is crucial, as social influence significantly impacts vaccine attitudes and behaviors.
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Affiliation(s)
- Xinju Huang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Zhifeng Lin
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiao Qin
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Dee Yu
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Fei Zhang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Ganggang Fang
- Kaiyuan Center for Disease Control and Prevention, Kaiyuan, Yunnan, China
| | - Xi Chen
- Sanya Center for Disease Control and Prevention, Sanya, Hainan, China
| | - Jinfeng He
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Ping Cen
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Mu Li
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Rongjing Zhang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Tong Luo
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Junjun Jiang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Sanqi An
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Bingyu Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
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8
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Wang Y, Lai Y. The Interrelationship between HIV Infection and COVID-19: A Review of the Literature. Curr HIV Res 2024; 22:6-15. [PMID: 38151836 DOI: 10.2174/011570162x282739231222062830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/26/2023] [Accepted: 12/04/2023] [Indexed: 12/29/2023]
Abstract
The Corona Virus Disease 2019 (COVID-19) pandemic resulting from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to significant morbidity and mortality in patients and put a strain on healthcare systems worldwide. The clinical characteristics and results of COVID-19 in immunosuppressed patients, such as people living with human immunodeficiency virus (PLWH), considered at higher risk of severe disease, are not well-characterized. Accumulated evidence indicates that COVID-19 and the human immunodeficiency virus (HIV) can interact in various ways. This review explored the similarities and differences in virology between SARS-CoV-2 and HIV, the effect of the COVID-19 vaccine on PLWH, the impact of the COVID-19 pandemic on PLWH care and prevention, and the influence of HIV-related factors on COVID-19. Discovering the potential link between HIV and COVID-19 may provide a novel way to avoid the factors of HIV and SARS-CoV-2 co-infection and advance future research.
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Affiliation(s)
- Yiyu Wang
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Yu Lai
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
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Sulaiman SK, Musa MS, Tsiga-Ahmed FI, Sulaiman AK, Bako AT. A systematic review and meta-analysis of the global prevalence and determinants of COVID-19 vaccine acceptance and uptake in people living with HIV. Nat Hum Behav 2024; 8:100-114. [PMID: 37904021 PMCID: PMC10810755 DOI: 10.1038/s41562-023-01733-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/26/2023] [Indexed: 11/01/2023]
Abstract
People living with HIV (PLHIV) are at higher risk of poor outcomes of SARS-CoV-2 infection. Here we report the pooled prevalence of COVID-19 vaccine acceptance/uptake and determinants among this vulnerable population of PLHIV based on a systematic review and meta-analysis of studies published by 25 August 2023. Among the 54 included studies (N = 167,485 participants), 53 (N = 166,455) provided data on vaccine acceptance rate, while 27 (N = 150,926) provided uptake data. The global prevalences of COVID-19 vaccine acceptance and uptake were 67.0% and 56.6%, respectively. Acceptance and uptake rates were 86.6% and 90.1% for the European Region, 74.9% and 71.6% for the Region of the Americas, 62.3% and 78.9% for the South-East Asian Region, 64.6% and 19.3% for the Eastern Mediterranean Region, 58.0% and 35.5% for the African Region, and 57.4% and 44.0% for the Western Pacific Region. The acceptance rate increased from 65.9% in 2020 to 71.0% in 2022, and the uptake rate increased from 55.9% in 2021 to 58.1% in 2022. Men, PLHIV aged ≥40 years and those who had recently received the influenza vaccine were more likely to accept and receive the COVID-19 vaccine. Factors associated with lower uptake included Black race, other races (Latinx/Hispanic/mixed race), low education level and being unemployed. Vaccine-related factors associated with higher acceptance included belief in vaccine effectiveness, vaccine trust, perceived high susceptibility to SARS-CoV-2 infection and fear of potential COVID-19 effect in PLHIV. Sustained efforts and targeted interventions are needed to reduce regional disparities in COVID-19 vaccine uptake among PLHIV.
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Affiliation(s)
| | - Muhammad Sale Musa
- Department of Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | | | - Abdulwahab Kabir Sulaiman
- Department of Medicine, Murtala Muhammad Specialist Hospital, Kano, Nigeria
- Kwanar Dawaki COVID-19 Isolation Center, Kano, Nigeria
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10
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Hammond K, Lee T, Vulesevic B, Singer J, Needham J, Burchell AN, Samji H, Walmsley S, Hull M, Jenabian MA, Routy JP, Margolese S, Mandarino E, Anis AH, Cooper CL, Costiniuk CT. Preventative behaviours and COVID-19 infection in a Canadian cohort of people living with HIV. AIDS Res Ther 2023; 20:73. [PMID: 37858245 PMCID: PMC10588118 DOI: 10.1186/s12981-023-00571-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
Few studies have examined preventative behaviour practices with respect to COVID-19 among people living with HIV (human immunodeficiency virus). Using a cross-sectional survey from a Canadian Institutes of Health Research Canadian HIV Trials Network study (CTN 328) of people living with HIV on vaccine immunogenicity, we examined the relationships between participant characteristics and behavioural practices intended to prevent COVID-19 infection. Participants living in four Canadian urban centers were enrolled between April 2021-January 2022, at which time they responded to a questionnaire on preventative behaviour practices. Questionnaire and clinical data were combined to explore relationships between preventive behaviours and (1) known COVID-19 infection pre-enrolment, (2) multimorbidity, (3) developing symptomatic COVID-19 infection, and (4) developing symptomatic COVID-19 infection during the Omicron wave. Among 375 participants, 49 had COVID-19 infection pre-enrolment and 88 post-enrolment. The proportion of participants reporting always engaging in preventative behaviours included 87% masking, 79% physical distancing, 70% limiting social gatherings, 65% limiting contact with at-risk individuals, 33% self-isolating due to symptoms, and 26% self-quarantining after possible exposure. Participants with known COVID-19 infection pre-enrolment were more likely to self-quarantine after possible exposure although asymptomatic (65.0% vs 23.4%, p < 0.001; Chi-square test). Participants with multiple comorbidities more likely endorsed physical distancing (85.7% vs 75.5%, p = 0.044; Chi-square test), although this was not significant in logistic regression analysis adjusted for age, sex, race, number of household members, number of bedrooms/bathrooms in the household per person, influenza immunization, and working in close physical proximity to others. Overall, participants reported frequent practice of preventative behaviours.
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Affiliation(s)
- Keely Hammond
- Department of Medicine and Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, QC, Canada
| | - Terry Lee
- Canadian Institutes of Health Research (CIHR) Canadian HIV Trials Network, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada
| | - Branka Vulesevic
- Canadian Institutes of Health Research (CIHR) Canadian HIV Trials Network, Vancouver, BC, Canada
- The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Joel Singer
- Canadian Institutes of Health Research (CIHR) Canadian HIV Trials Network, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Judy Needham
- Canadian Institutes of Health Research (CIHR) Canadian HIV Trials Network, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada
| | - Ann N Burchell
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Hasina Samji
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Sharon Walmsley
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mark Hull
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Mohammad-Ali Jenabian
- Department of Biological Sciences, Université du Québec à Montréal, Montréal, QC, Canada
| | - Jean-Pierre Routy
- Department of Medicine and Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, QC, Canada
- Infectious Diseases and Immunity in Global Health Research Institute of McGill University Health Centre, 1001 Boulevard Decarie, Room EM2.3226, Montréal, QC, H3A 3J1, Canada
- Division of Hematology, Department of Medicine, McGill University Health Centre, Montréal, QC, Canada
| | - Shari Margolese
- Community Advisory Committee, CIHR Canadian HIV Trials Network, Vancouver, BC, Canada
| | - Enrico Mandarino
- Community Advisory Committee, CIHR Canadian HIV Trials Network, Vancouver, BC, Canada
| | - Aslam H Anis
- Canadian Institutes of Health Research (CIHR) Canadian HIV Trials Network, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Curtis L Cooper
- The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, ON, Canada
- University of Ottawa, Ottawa, ON, Canada
| | - Cecilia T Costiniuk
- Department of Medicine and Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, QC, Canada.
- Infectious Diseases and Immunity in Global Health Research Institute of McGill University Health Centre, 1001 Boulevard Decarie, Room EM2.3226, Montréal, QC, H3A 3J1, Canada.
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11
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Duncan MC, Omondi FH, Kinloch NN, Lapointe HR, Speckmaier S, Moran-Garcia N, Lawson T, DeMarco ML, Simons J, Holmes DT, Lowe CF, Bacani N, Sereda P, Barrios R, Harris M, Romney MG, Montaner JSG, Brumme CJ, Brockman MA, Brumme ZL. Effects of COVID-19 mRNA vaccination on HIV viremia and reservoir size. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.08.23296718. [PMID: 37873490 PMCID: PMC10593027 DOI: 10.1101/2023.10.08.23296718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Objective The immunogenic nature of COVID-19 mRNA vaccines led to some initial concern that these could stimulate the HIV reservoir. We analyzed changes in plasma HIV loads (pVL) and reservoir size following COVID-19 mRNA vaccination in 62 people with HIV (PWH) receiving antiretroviral therapy (ART), and analyzed province-wide trends in pVL before and after the mass vaccination campaign. Design Longitudinal observational cohort and province-wide analysis. Methods 62 participants were sampled pre-vaccination, and one month after their first and second COVID-19 immunizations. Vaccine-induced anti-SARS-CoV-2-Spike antibodies in serum were measured using the Roche Elecsys Anti-S assay. HIV reservoirs were quantified using the Intact Proviral DNA Assay; pVL were measured using the cobas 6800 (LLOQ:20 copies/mL). The province-wide analysis included all 290,401 pVL performed in British Columbia, Canada between 2012-2022. Results Pre-vaccination, the median intact reservoir size was 77 (IQR:20-204) HIV copies/million CD4+ T-cells, compared to 74 (IQR:27-212) and 65 (IQR:22-174) post-first and -second dose, respectively (all comparisons p>0.07). Pre-vaccination, 82% of participants had pVL<20 copies/mL (max:110 copies/mL), compared to 79% post-first dose (max:183 copies/mL) and 85% post-second dose (max:79 copies/mL) (p>0.4). The magnitude of the vaccine-elicited anti-SARS-CoV-2-Spike antibody response did not correlate with changes in reservoir size nor detectable pVL frequency (p>0.6). We found no evidence linking the COVID-19 mass vaccination campaign to population-level increases in detectable pVL frequency among all PWH in the province, nor among those who maintained pVL suppression on ART. Conclusion We found no evidence that COVID-19 mRNA vaccines induced changes in HIV reservoir size nor plasma viremia.
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Affiliation(s)
- Maggie C Duncan
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - F Harrison Omondi
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Natalie N Kinloch
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Hope R Lapointe
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Sarah Speckmaier
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | | | - Tanya Lawson
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
| | - Mari L DeMarco
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Janet Simons
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Daniel T Holmes
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Christopher F Lowe
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Nic Bacani
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Paul Sereda
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Rolando Barrios
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Marianne Harris
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Marc G Romney
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Julio S G Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Chanson J Brumme
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Mark A Brockman
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
| | - Zabrina L Brumme
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
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12
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Ejamo JY, Legese GL, Tesfaye YA, Liben FE. COVID-19 vaccine acceptance among people living with HIV: A systematic review and meta-analysis. Trop Med Int Health 2023. [PMID: 37402693 DOI: 10.1111/tmi.13908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
OBJECTIVE To assess coronavirus disease 2019 (COVID-19) vaccine acceptance among people living with HIV (PLHIV) worldwide. METHODS We searched MEDLINE, PSYINFO, CINHAL, Scopus and EMBASE databases and other sources including free Google search and subject-specific journals from January 2020 to September 2021. The study population included adults (aged 18+ years) living with HIV and evaluated for COVID-19 vaccine acceptance. A random effect meta-analysis model was used to estimate the pooled COVID-19 vaccine acceptance rate. Subgroup analyses were performed, and factors associated with COVID-19 vaccine hesitancy underwent narrative analysis. Of 558 initial records, 14 studies were eligible for review. RESULTS The overall pooled COVID-19 vaccine acceptance rate among adult PLHIV was 62% (95% confidence interval [CI], 56%-69%). In subgroup analysis, the estimated pooled COVID-19 vaccine acceptance rate was higher in high-income countries: 63% (95% CI, 55%-70%) versus 62% (95% CI, 54%-71%) in low- and middle-income countries, and in studies conducted in 2022 (66% [95% CI, 58%-75%]) than in studies conducted in 2021 (57% [95% CI, 47%-68%]). Reasons for lower COVID-19 vaccine acceptance included higher monthly income, being non-homosexual, history of chronic disease, COVID-19-related medical mistrust, not knowing anyone who died of COVID-19, believing oneself to be immune to COVID-19, general vaccine refusal, negative attitude to the vaccine, concerns about efficacy, safety and side effects, distrust in common sources of vaccine-related information and using social media as a source of information on COVID-19. CONCLUSION Among PLHIV, acceptance of COVID-19 vaccine is generally low. A greater emphasis on collaborative efforts between all concerned bodies is needed to boost vaccine acceptance in this population.
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Affiliation(s)
- Janet Yohannes Ejamo
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Gebrehiwot Lema Legese
- School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yeabsira Aklilu Tesfaye
- School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fitsum Endale Liben
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
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13
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Wu J, Guo X, Zhou X, Wang M, Gu J, Miao Y, Tarimo CS, He Y, Xing Y, Ye B. The pattern from the first three rounds of vaccination: declining vaccination rates. Front Public Health 2023; 11:1124548. [PMID: 37250076 PMCID: PMC10213674 DOI: 10.3389/fpubh.2023.1124548] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/04/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Vaccination rates for the COVID-19 vaccine have recently been stagnant worldwide. We aim to analyze the potential patterns of vaccination development from the first three doses to reveal the possible trends of the next round of vaccination and further explore the factors influencing vaccination in the selected populations. Methods On July 2022, a stratified multistage random sampling method in the survey was conducted to select 6,781 people from 4 provinces China, who were above the age of 18 years. Participants were divided into two groups based on whether they had a chronic disease. The data were run through Cochran-Armitage trend test and multivariable regression analyses. Results A total of 957 participants with chronic disease and 5,454 participants without chronic disease were included in this survey. Vaccination rates for the first, second and booster doses in chronic disease population were93.70% (95% CI: 92.19-95.27%), 91.12% (95%CI: 94.43-95.59%), and 83.18% (95%CI: 80.80-85.55%) respectively. By contrast, the first, second and booster vaccination rates for the general population were 98.02% (95% CI: 97.65-98.39%), 95.01% (95% CI: 94.43-95.59%) and 85.06% (95% CI: 84.11-86.00%) respectively. The widening gap in vaccination rates was observed as the number of vaccinations increases. Higher self-efficacy was a significant factor in promoting vaccination, which has been observed in all doses of vaccines. Higher education level, middle level physical activity and higher public prevention measures play a positive role in vaccination among the general population, while alcohol consumption acts as a significant positive factor in the chronic disease population (p < 0.05). Conclusion As the number of vaccinations increases, the trend of decreasing vaccination rate is becoming more pronounced. In future regular vaccinations, we may face low vaccination rates as the increasing number of infections and the fatigue associated with the prolonged outbreak hamper vaccination. Measures need to be found to counter this downward trend such as improving the self-efficacy of the population.
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Affiliation(s)
- Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Enginering, Research Center of Health Economy and Health Technology Assessment, Zhengzhou, Henan, China
| | - Xinghong Guo
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Xue Zhou
- Department of Public Utilities Management, College of Health Management, Mudanjiang Medical University, Mudanjiang, Heilongjiang, China
| | - Meiyun Wang
- Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jianqin Gu
- School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Enginering, Research Center of Health Economy and Health Technology Assessment, Zhengzhou, Henan, China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Yilin He
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Yuhan Xing
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Beizhu Ye
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
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14
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Krause KD, Pérez-Figueroa RE, Halkitis PN. Barriers and facilitators related to COVID-19 vaccine acceptance and uptake among people living with HIV. Curr Opin HIV AIDS 2023; 18:142-147. [PMID: 36943471 DOI: 10.1097/coh.0000000000000788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
PURPOSE OF REVIEW This review reports on the myriad barriers and facilitators related to COVID-19 vaccine hesitancy and factors contribution to uptake among people living with HIV (PLWH) globally published over the past year (2021-2022). RECENT FINDINGS Across the literature, participants indicated concerns about the safety, efficacy and overall rapid development of the COVID-19 vaccine as a reason for delaying or not being vaccinated. Medical mistrust and perceptions about the risk of COVID-19 immune response and severity also played a role in COVID-19 vaccine hesitancy among PLWH. Almost every study examined different sociodemographic characteristics associated with COVID-19 vaccination acceptance and uptake, and although strong themes emerged around race/ethnicity, sex and educational attainment, the results were mixed across other characteristics, including age. Some studies also examined medical factors specifically related to PLWH including CD4 + cell count and adherence to antiretroviral therapy. SUMMARY The findings highlight individual, structural and social differences in COVID-19 vaccine acceptance and uptake among PLWH, which are varied throughout the world. We call on researchers and interventionists to not just consider the role of medical mistrust and disinformation, but also how emotional, financial and political vulnerability plays into making decisions around COVID-19 vaccine uptake and overall healthcare.
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Affiliation(s)
- Kristen D Krause
- Center for Health, Identity, Behavior, and Prevention Studies (CHIBPS)
- Department of Urban-Global Health
| | - Rafael E Pérez-Figueroa
- Center for Health, Identity, Behavior, and Prevention Studies (CHIBPS)
- Department of Urban-Global Health
| | - Perry N Halkitis
- Center for Health, Identity, Behavior, and Prevention Studies (CHIBPS)
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey, USA
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15
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Wang Y, Qiao Y, Huo Y, Wang L, Liang S, Yu M, Lan X, Song M, Zhang X, Yan Y, Xu J. The safety and immunogenicity of a two-dose schedule of CoronaVac, and the immune persistence of vaccination for six months, in people living with HIV: A multicenter prospective cohort study. Front Immunol 2023; 14:1129651. [PMID: 36993947 PMCID: PMC10040764 DOI: 10.3389/fimmu.2023.1129651] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
BackgroundPeople living with HIV (PLWH) are more vulnerable to SARS-CoV-2. However, evidence on the immunogenicity of coronavirus disease 2019 (COVID-19) vaccines in this population is insufficient. The objective of this study is to assess the immunogenicity and safety of the two-dose schedule of Sinovac CoronaVac for 6 months postvaccination in PLWH.MethodsWe conducted a multicenter prospective cohort study among PLWH and HIV-negative adults in China. Participants who received two doses of CoronaVac prior to the recruitment were allocated into two groups and followed up for 6 months. The neutralizing antibodies (nAbs), immunoglobulin G against the receptor-binding domain of the spike protein (S-IgG), and gamma-interferon (IFN-γ) were measured to assess the associations among CoronaVac immunogenicity and related factors. Adverse reactions were collected to evaluate the safety profile of vaccination.ResultsA total of 203 PLWH and 100 HIV-negative individuals were enrolled. A small portion of participants reported mild or moderate adverse reactions without serious adverse events. Median nAbs level in PLWH (31.96 IU/mL, IQR: 12.34-76.40) was lower than that in the control group (46.52 IU/mL, IQR: 29.08-77.30) at the 2-4 weeks postvaccination (P=0.002), and the same trend was presented for median S-IgG titer (37.09 vs. 60.02 IU/ml) (both P <0.05). The nAbs seroconversion rate in the PLWH group was also lower than in the control group (75.86% vs. 89.00%). After then, the immune responses reduced over time in term of only 23.04% of PLWH and 36.00% of HIV-negative individuals had a positive seroconversion for nAbs at 6-month. The multivariable generalized estimating equation analysis showed that PLWH with CD4+T count≥350 cells/µL presented higher immune response than PLWH with CD4+T count <350 cells/µL in terms of antibody seroconversion and titers. The immunogenicity did not differ in participants with low or high HIV viral load. The S-antigen specific IFN-γ immunity was generally stable and had a slow attenuation in both two groups for 6 months postvaccination.ConclusionThe Sinovac CoronaVac was generally safe and immunogenic in PLWH, but the immunity response was inferior and the antibodies vanished faster compared to HIV-negative individuals. This study suggested a shorter than 6-month interval of prime-boost vaccination for PLWH to ensure a better protection.
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Affiliation(s)
- Yuxiao Wang
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Ying Qiao
- Department of infection, The Second Hospital of Huhhot, Huhhot, China
| | - Yuqi Huo
- Translational Medicine Research Center, The Sixth People’s Hospital of Zhengzhou, Zhengzhou, China
| | - Li Wang
- Department of Infection, Heilongjiang Provincial Hospital, Heilongjiang, Harbin, China
| | - Shijie Liang
- Department of infectious disease prevention, Zhengzhou Centers for Disease Control and Prevention, Zhengzhou, China
| | - Maohe Yu
- Department of HIV prevention, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Xinquan Lan
- Department of Epidemiology, China Medical University, Shenyang, China
| | - Moxin Song
- Department of Epidemiology, China Medical University, Shenyang, China
| | - Xiangjun Zhang
- College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Ying Yan
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, China
- Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, China
- *Correspondence: Junjie Xu, ; Ying Yan,
| | - Junjie Xu
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, China
- *Correspondence: Junjie Xu, ; Ying Yan,
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Fu L, Sun Y, Li Y, Wang B, Yang L, Tian T, Wu X, Peng X, Liu Q, Chen Y, Lin YF, Li H, Meng X, Zou H. Perception of and Vaccine Readiness towards Mpox among Men Who Have Sex with Men Living with HIV in China: A Cross-Sectional Study. Vaccines (Basel) 2023; 11:vaccines11030528. [PMID: 36992114 DOI: 10.3390/vaccines11030528] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) living with HIV make up the majority of cases in the current Mpox outbreak. We aimed to investigate the perception of and vaccine readiness towards Mpox among MSM living with HIV in China. METHODS This cross-sectional online study was conducted from 10 August to 9 September 2022. Participants responded to survey questions about their socio-demographic information, HIV status, sexual behaviors, knowledge of Mpox, and attitudes towards Mpox vaccines. RESULTS A total of 577 MSM living with HIV participated in the study. A total of 37.6% expressed concerns about the Mpox epidemic in China, and 56.8% were willing to get the Mpox vaccine. Men who had > four sexual partners in the previous three months (aOR = 1.9 95% CI: 1.2-2.8 Ref: 0), had close contact with > four individuals in a day (3.1, 1.5-6.5 Ref: 0-3), were worried about the Mpox epidemic in China (1.6, 1.1-2.3 Ref: No), and believed that Mpox vaccines are safe (6.6, 2.7-16.4 Ref: No or not sure) and effective (1.9, 1.1-3.3 Ref: No) for people living with HIV were more likely to be willing to get the Mpox vaccine. MSM living with HIV with a high school education or below (0.5, 0.3-0.9 Ref: Postgraduate diploma), and sometimes (0.5, 0.3-0.8 Ref: Often), seldom, or never (0.5, 0.3-0.9 Ref: Often) followed news about Mpox were unwilling to get the Mpox vaccine. CONCLUSION The ongoing Mpox pandemic has not attracted widespread concerns among MSM living with HIV in China. Having more sexual partners and close contacts, worrying about the Mpox epidemic, and believing in the vaccine's safety and efficacy were predictors of their willingness to get the Mpox vaccine. Efforts should be made to raise awareness of the potential risk of Mpox in this at-risk population. Public health strategies should fully address predictors of vaccination willingness.
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Affiliation(s)
- Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Yinghui Sun
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Yuwei Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Luoyao Yang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Tian Tian
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Xinsheng Wu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Xin Peng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Qi Liu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Yuanyi Chen
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Yi-Fan Lin
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Hui Li
- Center for Disease Control and Prevention, Shizhong District, Jinan 250004, China
| | - Xiaojun Meng
- Wuxi Municipal Center for Disease Control and Prevention, Wuxi 214023, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
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Kabir Sulaiman S, Sale Musa M, Isma'il Tsiga-Ahmed F, Muhammad Dayyab F, Kabir Sulaiman A, Dabo B, Idris Ahmad S, Abubakar Haruna S, Abdurrahman Zubair A, Hussein A, Usman S, Usman Wada J, Yekeen Ayodele A, Wulgo Ali M, Tijjani Makama B, Tijjani Bako A, Garba Ismail A, Tijjani Makama B, Dalhatu Abdulkadir A, Jamal Abdulnasir N, Zakar Gambo B, Usman Mustapha M, Mohammed M, Ibrahim G, Adamu Dogo H, Ishaq Abubakar F, kurugu Y, Auwal Yusufari G, Saleh S, Yakubu A, Sulaiman S, Tijjani Bako A. COVID-19 vaccine hesitancy among people living with HIV in a low-resource setting: A multi-center study of prevalence, correlates and reasons. Vaccine 2023; 41:2476-2484. [PMID: 36932032 PMCID: PMC9946883 DOI: 10.1016/j.vaccine.2023.02.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/31/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Hesitancy to COVID-19 vaccine may worsen the burden of COVID-19 among people living with HIV (PLHIV), who are at a higher risk of COVID-19-related hospitalization and death, compared to HIV non-infected individuals. Therefore, we evaluate the predictors and reasons for COVID-19 vaccine hesitancy among unvaccinated PLHIV in six antiretroviral therapy (ART) clinics across northern Nigeria. METHODOLOGY In this cross-sectional study, conducted between October 2021 and February 2022 in six hospitals across two geopolitical regions of Nigeria, we utilized interviewer-administered questionnaires to assess COVID-19 vaccine hesitancy among a convenience sample of 790 eligible adult PLHIV. Hesitancy was defined as answering 'no' or 'maybe' to a question asking participants their willingness to accept the COVID-19 vaccine. A multivariate logistic regression model was used to estimate the adjusted odds ratio (aOR) and 95% confidence interval (CI) of the factors associated with COVID-19 vaccine hesitancy among PLHIV. RESULTS Of the total 660 unvaccinated participants included in the analysis (61.82% female, mean age [SD] of 39.76 [10.75]), 381 (57.72%) were hesitant to COVID-19 vaccine. Being 50 years and older (aOR: 0.43; 95% CI: 0.21-0.89), being unemployed (aOR: 0.57; 95% CI: 0.34-0.95), experiencing the adverse effects of ART (aOR: 0.36; 95% CI: 0.15-0.86), and perception of being at high risk of contracting COVID-19 (aOR: 0.22; 95% CI: 0.13-0.37) were associated with significantly lower odds of hesitancy. Conversely, being female (aOR: 1.64; 95% CI: 1.02-2.61) and attending ART clinics at state administrative capital cities (IIDH Kano [aOR: 2.40; 95% CI: 1.10-5.25], MMSH Kano [aOR: 5.59; 95% CI: 1.97-10.66], YSSH Damaturu [aOR: 9.88; 95% CI: 4.02-24.29] vs. GH Gashua) were associated with significantly higher odds of hesitancy. The most common reasons for hesitancy include fear of potential adverse effects, skepticism about vaccine efficacy, the rapid development of the COVID-19 vaccine, and the perceived lack of effort to develop a cure or vaccine for HIV/AIDS. CONCLUSION Interventions aimed at combating misperceptions and misinformation regarding the COVID-19 vaccination program may reduce the prevalence of COVID-19 vaccine hesitancy among unvaccinated PLHIV.
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Affiliation(s)
| | - Muhammad Sale Musa
- Department of Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | | | - Farouq Muhammad Dayyab
- Infectious Diseases Hospital, Kano, Nigeria; Department of Medicine, Kwanar Dawaki COVID-19 Isolation Center, Kano, Nigeria
| | - Abdulwahab Kabir Sulaiman
- Department of Medicine, Kwanar Dawaki COVID-19 Isolation Center, Kano, Nigeria; Department of Medicine, Murtala Muhammad Specialist Hospital, Kano, Nigeria
| | - Bashir Dabo
- Department of Epidemiology, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Saidu Idris Ahmad
- Department of Medicine, Murtala Muhammad Specialist Hospital, Kano, Nigeria
| | - Salisu Abubakar Haruna
- Department of Family Health, Kano State Primary Healthcare Management Board, Kano, Nigeria
| | | | - Aminu Hussein
- Department of Family Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | - Sadiya Usman
- HIV Clinic, General Hospital Gashua, Gashua Yobe State, Nigeria
| | | | | | | | | | | | | | | | | | | | | | - Bashir Zakar Gambo
- Department of Nursing, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | | | - Mustapha Mohammed
- Department of Nursing, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | - Gambo Ibrahim
- Department of Nursing, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | - Hadiza Adamu Dogo
- Department of Nursing, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | | | - Yakubu kurugu
- Department of Nursing, General Hospital Geidam, Yobe State
| | | | | | - Abubakar Yakubu
- College of Health Sciences, Bayero University Kano, Kano, Nigeria
| | - Saeed Sulaiman
- College of Health Sciences, Bayero University Kano, Kano, Nigeria
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Kang L, Shang W, Gao P, Wang Y, Liu J, Liu M. Immunogenicity and Safety of COVID-19 Vaccines among People Living with HIV: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10091569. [PMID: 36146647 PMCID: PMC9503586 DOI: 10.3390/vaccines10091569] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/06/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The immunogenicity and safety of COVID-19 vaccines among people living with human immunodeficiency virus (PLWH) are unclear. We aimed to evaluate the immunogenicity and safety of COVID-19 vaccines among PLWH. METHODS We systematically searched PubMed, EMBASE, and Web of Science from 1 January 2020 to 28 April 2022 and included observational studies, randomized clinical trials, and non-randomized clinical trials reporting extractable data about the immunogenicity and safety of COVID-19 vaccines among PLWH. RESULTS A total of 34 eligible studies covering 4517 PLWH were included. The pooled seroconversion rates among PLWH after the first and second doses were 67.51% (95% confident interval (CI) 49.09-85.93%) and 96.65% (95%CI 95.56-97.75%), respectively. The seroconversion was similar between PLWH and healthy controls after the first (risk ratio (RR) = 0.89, 95%CI 0.76-1.04) and the second (RR = 0.97, 95%CI 0.93-1.00) dose. Moreover, the geometric mean titer (GMT) showed no significant difference between PLWH and healthy controls after the first dose (standardized mean difference (SMD) = 0.30, 95%CI -1.11, 1.70) and the second dose (SMD = -0.06, 95%CI -0.18, 0.05). Additionally, the pooled incidence rates of total adverse events among PLWH after the first and the second dose were 46.55% (95%CI 28.29-64.82%) and 30.96% (95%CI 13.23-48.70%), respectively. There was no significant difference in risks of total adverse events between PLWH and healthy controls after the first (RR = 0.86, 95%CI 0.67-1.10) and the second (RR = 0.88, 95%CI 0.68-1.14) dose. CONCLUSIONS The available evidence suggested that the immunogenicity and safety of COVID-19 vaccines among PLWH were acceptable. There was no significant difference in the seroconversion rates and incidence rates of adverse events of COVID-19 vaccines between PLWH and healthy controls.
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Affiliation(s)
| | | | | | | | | | - Min Liu
- Correspondence: ; Tel./Fax: +86-10-82805146
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