P-190 Vaccine uptake pre and post COVID-19 pandemic among PLWH

• Published in: Sexually transmitted infections Vol. 100; no. Suppl 1; pp. A256 - A257
• Main Authors: Suardi, E, Ligresti, R, Zaninetta, E, Biasioli, L, Lundgren, B, Santoro, A, Di Bartolomeo, F, Bini, T, Bai, F, Marchetti, G
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.06.2024; BMJ Publishing Group LTD
• Subjects: COVID-19 vaccines; Immunization; Pandemics; Streptococcus infections; Vaccine hesitancy
• ISSN: 1368-4973; 1472-3263
• DOI: 10.1136/sextrans-ICAR-2024.249

Imunization for vaccine preventable diseases is highly recommended in people living with HIV (PLWH), but vaccination coverage is often inadequate and vaccination acceptance is poorly studied in PLWH. Some reasons for unsatisfactory uptake may rely on unclear responsibility for vaccine counseling and administration, as well as vaccine hesitancy. Furthermore, the effect of the COVID-19 pandemic on subsequent vaccine uptake in PLWH has not been thoroughly investigated.We aimed to evaluate vaccine uptake and its associated factors during the period 2018–2023 according to 3 time points: pre-COVID-19 pandemic, during COVID-19 pandemic and after COVID-19 pandemic. We further evaluated vaccine completeness.This is a retrospective observational study conducted at the Infectious Disease Unit of San Paolo University Hospital, Milan, from 2018 to 2023.We assessed subjects’ participation in vaccinations (HAV, HBV, HPV, S. pneumoniae, N. meningitidis, RZV) in 3 time periods: Jan2018-Dec2019 (pre-pandemic), Jan2020- Mar2022 (pandemic), Apr2022-Dec2023 (post-pandemic).Uptake has been evaluated as the proportion of patients who received at least one of the scheduled vaccinations. Vaccination was incomplete when all scheduled doses were not administered during follow-up. Factors associated with vaccine uptake in the whole follow up and according with time period were evaluated by univariable and multivariable logistic regression. Chi-square test was used to compare the proportion of uptake according to calendar period.1411 PLWH where enrolled, 77% were male and the majority (90%) were aged >50 (median age: 53 years, IQR 44–59)(table 1).Global uptake for all the vaccination proposed was 1317/1411 (93%), with the highest uptake observed for HBV (433/445 pts, 97.3%). For uptake and completeness for all the vaccinations see table 2.Only ageing was significantly associated to a lower uptake (each yr more, AOR 0.942, 95% CI 0.912–0.973 adjusting for AIDS and comobidities). Overall, 997/1317 (75%) pts received a complete schedule for all the vaccinations and the highest completeness was observed for HBV vaccination (373/433 pts, 86%).For Pneumococcal, HAV and MenB vaccine uptake was significantly lower during pandemic and post-pandemic compared to pre-pandemic period (p<0.001).Vaccination uptake is high for PLWH engaged to our clinic and only older age was associated with lower coverage. Yet, for some of the vaccinations, uptake has declined since the beginning of the pandemic and remained lower thereafter, in contrast with findings observed for influenza vaccination in the general population.COVID-19 pandemic has possibly led to changes in people’s attitude toward immunization programs, and further studies are needed to address hesitancy, especially in vulnerable populations.In this context, active vaccine offer along with patients’ engagement may play a crucial role in improving vaccine acceptance and adherence, thus incrementing vaccine coverage in PLWH.Abstract P-190 Table 1Characteristic of study population at the time of enrollmentAbstract P-190 Table 2Uptake and completeness overall and according to vaccination