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Efficacy of COVID-19 Vaccination Among People Living With HIV in Taiwan

In a study of people living with HIV in Taiwan, COVID-19 vaccination was highly effective when implemented alongside non-pharmaceutical interventions.

COVID-19 vaccination is recommended, especially for immunocompromised people, but the efficacy of vaccines in people living with HIV is not fully understood.

One study, presented virtually during the 2022 Annual Conference on Retroviruses and Opportunistic Infection (CROI) by lead author Dr. Kuan-Yin Lin, sought to evaluate the effectiveness of single and 2-dose COVID-19 vaccination among Taiwanese adults living with HIV.

The study was conducted at the National Taiwan University Hospital from March 1-September 30, 2021. From April-August 2021, a large-scale, community-wide COVID-19 outbreak occurred in conjunction with strict non-pharmaceutical interventions, such as mask wearing and social distancing.

The prospective cohort study included adult participants living with HIV and without a history of COVID-19 infection. The 3131 included participants were all advised to receive 2 doses of a COVID-19 vaccine; the government-funded vaccination campaign allowed the participants to choose from the AZD1222, Pfizer-BioNTech, Moderna, and Medigen vaccines.

The investigators estimated the efficacy of COVID-19 vaccination in people living with HIV by comparing incidence rates among the unvaccinated, partially vaccinated, and fully vaccinated cohorts. Among the 3131 people living with HIV, 15.7% did not undergo vaccination, 73.6% received 1 dose of a COVID-19 vaccine, and 10.7% were fully vaccinated with 2 doses.

Of the vaccinated participants, 70.4% received the AZD122 vaccine, 23.9% received Moderna, 4.4% received Medigen. 99.9% were on antiretroviral therapy (ART), and 99.8% were men who have sex with men (MSM). The median CD4+ cell count of all participants was 627 cells/mm3.

The incidence rate of COVID-19 was 6.4 per 100000 people living with HIV in the unvaccinated group, 2.9 per 100000 among the partially vaccinated cohort, and 0 per 100000 in the fully vaccinated cohort. The adjusted incidence rate ratios yielded 53.4% protection for single-dose COVID-19 vaccination, and 99.9% vaccine efficacy for people living with HIV who received 2 doses.

The investigators concluded that vaccination was clinically effective among people living with HIV in an outbreak setting with staunch non-pharmaceutical interventions. The high vaccine efficacy suggests people living with HIV in the cART era should complete a primary COVID-19 vaccine regimen.

The study, “Effectiveness of COVID-19 Vaccination Among People Living With HIV During an Outbreak,” was presented virtually during the 2022 Annual Conference on Retroviruses and Opportunistic Infection (CROI).