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Nomah DK, Reyes-Urueña J, Alonso L, Díaz Y, Moreno-Fornés S, Aceiton J, Bruguera A, Martín-Iguacel R, Imaz A, Gutierrez MDM, Román RW, Suanzes P, Ambrosioni J, Casabona J, Miro JM, Llibre JM. Comparative Analysis of Primary and Monovalent Booster SARS-CoV-2 Vaccination Coverage in Adults with and without HIV in Catalonia, Spain. Vaccines (Basel) 2023; 12:44. [PMID: 38250857 PMCID: PMC10819920 DOI: 10.3390/vaccines12010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/18/2023] [Accepted: 12/23/2023] [Indexed: 01/23/2024] Open
Abstract
People with HIV (PWH) may be more susceptible to SARS-CoV-2 infection and worse clinical outcomes. We investigated the disparity in SARS-CoV-2 vaccination coverage between PWH and those without HIV (PWoH) in Catalonia, Spain, assessing primary and monovalent booster vaccination coverage from December 2021 to July 2022. The vaccines administered were BNT162, ChAdOx1-S, mRNA-127, and Ad26.COV2.S. Using a 1:10 ratio of PWH to PWoH based on sex, age, and socioeconomic deprivation, the analysis included 201,630 individuals (183,300 PWoH and 18,330 PWH). Despite a higher prevalence of comorbidities, PWH exhibited lower rates of complete primary vaccination (78.2% vs. 81.8%, p < 0.001) but surpassed PWoH in booster coverage (68.5% vs. 63.1%, p < 0.001). Notably, complete vaccination rates were lower among PWH with CD4 <200 cells/μL, detectable HIV viremia, and migrants compared to PWoH (p < 0.001, all). However, PWH with CD4 < 200 cells/μL received more boosters (p < 0.001). In multivariable logistic regression analysis of the overall population, a prior SARS-CoV-2 diagnosis, HIV status, migrants, and mild-to-severe socioeconomic deprivation were associated with lower primary vaccination coverage, reflecting barriers to healthcare and vaccine access. However, booster vaccination was higher among PWH. Targeted interventions are needed to improve vaccine coverage and address hesitancy in vulnerable populations.
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Affiliation(s)
- Daniel Kwakye Nomah
- Center for Epidemiological Studies of Sexually Transmitted Diseases and HIV/AIDS in Catalonia (CEEISCAT), Department of Health, Government of Catalunya, 08916 Badalona, Spain; (J.R.-U.); (L.A.); (Y.D.); (S.M.-F.); (J.A.); (A.B.); (R.M.-I.); (J.C.)
- Germans Trias i Pujol Research Institute (IGTP), 08916 Badalona, Spain
| | - Juliana Reyes-Urueña
- Center for Epidemiological Studies of Sexually Transmitted Diseases and HIV/AIDS in Catalonia (CEEISCAT), Department of Health, Government of Catalunya, 08916 Badalona, Spain; (J.R.-U.); (L.A.); (Y.D.); (S.M.-F.); (J.A.); (A.B.); (R.M.-I.); (J.C.)
| | - Lucía Alonso
- Center for Epidemiological Studies of Sexually Transmitted Diseases and HIV/AIDS in Catalonia (CEEISCAT), Department of Health, Government of Catalunya, 08916 Badalona, Spain; (J.R.-U.); (L.A.); (Y.D.); (S.M.-F.); (J.A.); (A.B.); (R.M.-I.); (J.C.)
| | - Yesika Díaz
- Center for Epidemiological Studies of Sexually Transmitted Diseases and HIV/AIDS in Catalonia (CEEISCAT), Department of Health, Government of Catalunya, 08916 Badalona, Spain; (J.R.-U.); (L.A.); (Y.D.); (S.M.-F.); (J.A.); (A.B.); (R.M.-I.); (J.C.)
- Germans Trias i Pujol Research Institute (IGTP), 08916 Badalona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), 08003 Barcelona, Spain
| | - Sergio Moreno-Fornés
- Center for Epidemiological Studies of Sexually Transmitted Diseases and HIV/AIDS in Catalonia (CEEISCAT), Department of Health, Government of Catalunya, 08916 Badalona, Spain; (J.R.-U.); (L.A.); (Y.D.); (S.M.-F.); (J.A.); (A.B.); (R.M.-I.); (J.C.)
- Germans Trias i Pujol Research Institute (IGTP), 08916 Badalona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), 08003 Barcelona, Spain
| | - Jordi Aceiton
- Center for Epidemiological Studies of Sexually Transmitted Diseases and HIV/AIDS in Catalonia (CEEISCAT), Department of Health, Government of Catalunya, 08916 Badalona, Spain; (J.R.-U.); (L.A.); (Y.D.); (S.M.-F.); (J.A.); (A.B.); (R.M.-I.); (J.C.)
- Germans Trias i Pujol Research Institute (IGTP), 08916 Badalona, Spain
| | - Andreu Bruguera
- Center for Epidemiological Studies of Sexually Transmitted Diseases and HIV/AIDS in Catalonia (CEEISCAT), Department of Health, Government of Catalunya, 08916 Badalona, Spain; (J.R.-U.); (L.A.); (Y.D.); (S.M.-F.); (J.A.); (A.B.); (R.M.-I.); (J.C.)
- Germans Trias i Pujol Research Institute (IGTP), 08916 Badalona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), 08003 Barcelona, Spain
- Departament de Pediatria, d’Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Raquel Martín-Iguacel
- Center for Epidemiological Studies of Sexually Transmitted Diseases and HIV/AIDS in Catalonia (CEEISCAT), Department of Health, Government of Catalunya, 08916 Badalona, Spain; (J.R.-U.); (L.A.); (Y.D.); (S.M.-F.); (J.A.); (A.B.); (R.M.-I.); (J.C.)
- Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark
| | - Arkaitz Imaz
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-(IDIBELL), 08907 L’Hospitalet de Llobregat, Spain;
| | | | - Ramón W. Román
- Agència de Qualitat i Avaluació Sanitàries de Catalunya, 08005 Barcelona, Spain;
| | - Paula Suanzes
- Hospital Universitari Vall d’Hebron, Vall d’Hebron Research Institute (VHIR), 08035 Barcelona, Spain;
| | - Juan Ambrosioni
- Hospital Clínic-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain; (J.A.); (J.M.M.)
- CIBERINFEC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Jordi Casabona
- Center for Epidemiological Studies of Sexually Transmitted Diseases and HIV/AIDS in Catalonia (CEEISCAT), Department of Health, Government of Catalunya, 08916 Badalona, Spain; (J.R.-U.); (L.A.); (Y.D.); (S.M.-F.); (J.A.); (A.B.); (R.M.-I.); (J.C.)
- Germans Trias i Pujol Research Institute (IGTP), 08916 Badalona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), 08003 Barcelona, Spain
- Departament de Pediatria, d’Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Jose M. Miro
- Hospital Clínic-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain; (J.A.); (J.M.M.)
- CIBERINFEC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Josep M. Llibre
- Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain;
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Nomah DK, Llibre JM, Díaz Y, Moreno S, Aceiton J, Bruguera A, Gutiérrez-Macià M, Imaz A, Suanzes P, Navarro G, Orti A, Miro JM, Casabona J, Reyes-Urueña J. SARS-CoV-2 Vaccination Coverage and Factors Associated with Low Uptake in a Cohort of People Living with HIV. Microorganisms 2022; 10:microorganisms10081666. [PMID: 36014083 PMCID: PMC9412260 DOI: 10.3390/microorganisms10081666] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 01/14/2023] Open
Abstract
People living with HIV (PLWH) are prioritised for SARS-CoV-2 vaccination due to their vulnerability to severe COVID-19. Therefore, the epidemiological surveillance of vaccination coverage and the timely identification of suboptimally vaccinated PLWH is vital. We assessed SARS-CoV-2 vaccination coverage and factors associated with under-vaccination among PLWH in Catalonia, Spain. As of 11.12.2021, 9945/14942 PLWH (66.6%) had received ≥1 dose of a SARS-CoV-2 vaccine. Non-Spanish origin (adjusted odds ratio (aOR) 0.64, 95% CI 0.59−0.70), CD4 count of 200−349 cells/μL (aOR 0.74, 95% CI 0.64−0.86) or 350−499 cells/μL (aOR 0.79, 95% CI 0.70−0.88), detectable plasma HIV-RNA (aOR 0.61 95% CI 0.53−0.70), and previous SARS-CoV-2 diagnosis (aOR 0.58 95% CI 0.51−0.65) were associated with under-vaccination. SARS-CoV-2 diagnosis (437 [9.5%] vs. 323 [3.5%], p < 0.001), associated hospitalisations (10 [2.3%] vs. 0 [0%], p < 0.001), intensive care unit admissions (6 [1.4%] vs. 0 [0%], p < 0.001), and deaths (10 [2.3%] vs. 0 [0%], p < 0.001) were higher among unvaccinated PLWH. Vaccination coverage was lower among PLWH with a CD4 count >200 cells/μL, detectable plasma HIV-RNA, previous SARS-CoV-2 diagnosis, and migrants. SARS-CoV-2 diagnosis, associated hospitalisations, and deaths among PLWH were lower among the vaccinated compared with the unvaccinated. SARS-CoV-2 vaccination prioritisation has not completely reached vulnerable PLWH with poorer prognosis. This information can be used to inform public health strategies.
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Affiliation(s)
- Daniel Kwakye Nomah
- Centre Estudis Epidemiològics Sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, 08916 Badalona, Spain
- Departament de Pediatria, d’Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
- Institut d’Investigació Germans Trias i Pujol (IGTP), 08916 Barcelona, Spain
| | | | - Yesika Díaz
- Centre Estudis Epidemiològics Sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, 08916 Badalona, Spain
- Institut d’Investigació Germans Trias i Pujol (IGTP), 08916 Barcelona, Spain
| | - Sergio Moreno
- Centre Estudis Epidemiològics Sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, 08916 Badalona, Spain
- Institut d’Investigació Germans Trias i Pujol (IGTP), 08916 Barcelona, Spain
| | - Jordi Aceiton
- Centre Estudis Epidemiològics Sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, 08916 Badalona, Spain
- Institut d’Investigació Germans Trias i Pujol (IGTP), 08916 Barcelona, Spain
| | - Andreu Bruguera
- Centre Estudis Epidemiològics Sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, 08916 Badalona, Spain
- Departament de Pediatria, d’Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
- Institut d’Investigació Germans Trias i Pujol (IGTP), 08916 Barcelona, Spain
| | | | - Arkaitz Imaz
- Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Hospital Universitari de Bellvitge, 08907 L’Hospitalet de Llobregat, Spain
| | - Paula Suanzes
- Vall d’Hebron Research Institute (VHIR), Hospital Universitari Vall d’Hebron, 08935 Barcelona, Spain
| | - Gemma Navarro
- Unitat de VIH/SIDA, Corporació Sanitària i Universitària Parc Taulí-Universitat Autònoma de Barcelona, 08208 Barcelona, Spain
| | - Amat Orti
- Hospital de Tortosa, Verge de la Cinta, 43500 Tortosa, Spain
| | - Jose Maria Miro
- Hospital Clínic-Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, 08036 Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), 08036 Barcelona, Spain
| | - Jordi Casabona
- Centre Estudis Epidemiològics Sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, 08916 Badalona, Spain
- Departament de Pediatria, d’Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
- Institut d’Investigació Germans Trias i Pujol (IGTP), 08916 Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), 08036 Barcelona, Spain
| | - Juliana Reyes-Urueña
- Centre Estudis Epidemiològics Sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, 08916 Badalona, Spain
- Institut d’Investigació Germans Trias i Pujol (IGTP), 08916 Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), 08036 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-497-8890
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