tetano
Editor, Senior Moderator
AIDS
. 2022 Oct 19.
doi: 10.1097/QAD.0000000000003405. Online ahead of print.
COVID-19 Vaccine Effectiveness among a Population-based Cohort of People Living with HIV
Catharine Chambers[SUP] 1 2 [/SUP], Hasina Samji[SUP] 3 4 [/SUP], Curtis L Cooper[SUP] 5 [/SUP], Cecilia T Costiniuk[SUP] 6 [/SUP], Naveed Z Janjua[SUP] 3 7 8 [/SUP], Abigail E Kroch[SUP] 1 9 10 [/SUP], Gordon Arbess[SUP] 2 11 [/SUP], Anita C Benoit[SUP] 1 12 13 [/SUP], Sarah A Buchan[SUP] 1 10 14 15 [/SUP], Hannah Chung[SUP] 14 [/SUP], Claire E Kendall[SUP] 14 15 16 17 [/SUP], Jeffrey C Kwong[SUP] 1 10 11 14 15 18 [/SUP], Marc-André Langlois[SUP] 19 [/SUP], Samantha M Lee[SUP] 14 [/SUP], Lawrence Mbuagbaw[SUP] 20 21 22 [/SUP], John Mccullagh[SUP] 23 [/SUP], Rahim Moineddin[SUP] 1 [/SUP], Devan Nambiar[SUP] 24 [/SUP], Sharon Walmsley[SUP] 18 [/SUP], Aslam Anis[SUP] 7 8 [/SUP], Ann N Burchell[SUP] 1 2 11 [/SUP], COVAXHIV Study Team
Affiliations
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.
. 2022 Oct 19.
doi: 10.1097/QAD.0000000000003405. Online ahead of print.
COVID-19 Vaccine Effectiveness among a Population-based Cohort of People Living with HIV
Catharine Chambers[SUP] 1 2 [/SUP], Hasina Samji[SUP] 3 4 [/SUP], Curtis L Cooper[SUP] 5 [/SUP], Cecilia T Costiniuk[SUP] 6 [/SUP], Naveed Z Janjua[SUP] 3 7 8 [/SUP], Abigail E Kroch[SUP] 1 9 10 [/SUP], Gordon Arbess[SUP] 2 11 [/SUP], Anita C Benoit[SUP] 1 12 13 [/SUP], Sarah A Buchan[SUP] 1 10 14 15 [/SUP], Hannah Chung[SUP] 14 [/SUP], Claire E Kendall[SUP] 14 15 16 17 [/SUP], Jeffrey C Kwong[SUP] 1 10 11 14 15 18 [/SUP], Marc-André Langlois[SUP] 19 [/SUP], Samantha M Lee[SUP] 14 [/SUP], Lawrence Mbuagbaw[SUP] 20 21 22 [/SUP], John Mccullagh[SUP] 23 [/SUP], Rahim Moineddin[SUP] 1 [/SUP], Devan Nambiar[SUP] 24 [/SUP], Sharon Walmsley[SUP] 18 [/SUP], Aslam Anis[SUP] 7 8 [/SUP], Ann N Burchell[SUP] 1 2 11 [/SUP], COVAXHIV Study Team
Affiliations
- PMID: 36254892
- DOI: 10.1097/QAD.0000000000003405
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.