Effectiveness of COVID-19 vaccines in people living with HIV in British Columbia and comparisons with a matched HIV-negative cohort: a test-negative design

Objectives: We estimated the effectiveness of COVID-19 vaccines against laboratory-confirmed SARS-CoV-2 infection among people living with HIV (PLWH) and compared the estimates with a matched HIV -negative cohort.Methods: We used the British Columbia COVID-19 Cohort, a population-based data platform, which inte-grates COVID-19 data on SARS-CoV-2 tests, laboratory-confirmed cases, and immunizations with provin-cial health services data. The vaccine effectiveness (VE) was estimated with a test-negative design using the multivariable logistic regression.Results: The adjusted VE against SARS-CoV-2 infection was 71.1% (39.7, 86.1%) 7-59 days after two doses, rising to 89.3% (72.2, 95.9%) between 60 and 89 days. VE was preserved 4-6 months after the receipt of two doses, after which noticeable waning was observed (51.3% [4.8, 75.0%]). In the matched HIV-negative cohort (n = 375,043), VE peaked at 91.4% (90.9, 91.8%) 7-59 days after two doses and was sustained for up to 4 months, after which evidence of waning was observed, dropping to 84.2% (83.4, 85.0%) between 4 and 6 months.Conclusion: The receipt of two COVID-19 vaccine doses was effective against SARS-CoV-2 infection among PLWH pre-Omicron. VE estimates appeared to peak later in PLWH than in the matched HIV-negative co-hort and the degree of waning was relatively quicker in PLWH; however, peak estimates were comparable in both populations. (c) 2022 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )

Automated summary

The study aimed to assess the effectiveness of COVID-19 vaccines in people living with HIV compared to a matched HIV-negative cohort. Using data from the British Columbia COVID-19 Cohort, the study found that the vaccine effectiveness against SARS-CoV-2 infection was 71.1% seven to 59 days after two doses, increasing to 89.3% between 60 and 89 days. However, noticeable waning was observed, with effectiveness dropping to 51.3% after 4-6 months.