Abstract
The administration of COVID-19 vaccines is the primary strategy used to prevent further infections by COVID-19, especially in people living with HIV (PLWH), who are at increased risk for severe symptoms and mortality. However, the vaccine hesitancy, safety, and immunogenicity of COVID-19 vaccines among PLWH have not been fully characterized. We estimated vaccine hesitancy and status of COVID-19 vaccination in Chinese PLWH, explored the safety and impact on antiviral therapy (ART) efficacy and compared the immunogenicity of an inactivated vaccine between PLWH and healthy controls (HC). In total, 27.5% (104/378) of PLWH hesitated to take the vaccine. The barriers included concerns about safety and efficacy, and physician counselling might help patients overcome this vaccine hesitancy. A COVID-19 vaccination did not cause severe side effects and had no negative impact on CD4+ T cell counts and HIV RNA viral load. Comparable spike receptor binding domain IgG titer were elicited in PLWH and HC after a second dose of the CoronaVac vaccine, but antibody responses were lower in poor immunological responders (CD4+ T cell counts < 350 cells/µL) compared with immunological responders (CD4+ T cell counts ≥ 350 cells/µL). These data showed that PLWH have comparable safety and immune response following inactivated COVID-19 vaccination compared with HC, but the poor immunological response in PLWH is associated with impaired humoral response.
Highlights
IntroductionThe rapid spread of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to significant morbidity and mortality as well as substantial psychological and economic costs worldwide [1]
Our data showed that People living with HIV (PLWH) have a comparable immune response following CoronaVac vaccinations compared with healthy controls (HC), but poor immunological response might be associated with impaired humoral response in
4 weeks [23,24,25], and we further demonstrated a similar outcome over a longer period of time, supporting the current advice for PLWH to be immunized with COVID-19 vaccines
Summary
The rapid spread of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to significant morbidity and mortality as well as substantial psychological and economic costs worldwide [1]. People living with HIV (PLWH) have been disproportionately affected by COVID-19 and are at increased risk for severe clinical symptoms and mortality due to SARS-CoV-2 infection, especially among those with lower CD4+ T cell counts or unsuppressed HIV viral replication [3,4,5,6]. The administration of a COVID-19 vaccine is considered the most effective and economic way to prevent infection by COVID-19 and to control its spread. Central to achieving high levels of vaccination coverage needed to effectively control the spread of COVID-19 is overcoming vaccine hesitancy [7]. Attitudes toward COVID-19 vaccines and potential risk factors of vaccine hesitancy have not yet been well characterized
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