[en] [en] BACKGROUND: Despite antiretroviral therapy, people living with HIV (PLWH) remain vulnerable to vaccine-preventable diseases. Although vaccination is strongly recommended, data on vaccine uptake among PLWH in Belgium remain scarce. This study aims to assess pneumococcal, COVID-19, and influenza vaccine coverage in PLWH in Belgium and identify factors associated with vaccine uptake.
METHODS: We conducted a retrospective study using the data from the HIV database of the Liege University Hospital in Belgium from 2017 to 2022. We evaluated vaccine coverage and collected demographic, clinical, and biological data to assess factors associated with vaccine uptake. Vaccine adherence was characterized as follows: partial adherence: receipt of at least one of the recommended vaccines during the study period and complete vaccination: pneumococcal vaccination, full COVID-19 primary vaccination, and annual influenza vaccination throughout the study period.
RESULTS: Among 791 participants, 89.1% received at least 1 dose of COVID-19 vaccine. Sixty-eight percent received at least 1 dose of influenza vaccine, but only 10.1% were vaccinated annually. Pneumococcal vaccine coverage was only 37.8%. Complete vaccine adherence was correlated with age (adjusted odds ratio [aOR]: 1.02, P = .024). Partial vaccine adherence was associated with age (aOR: 2.66, P = .026) and number of consultations (aOR: 1.23, P = .0002) and negatively associated with intravenous drug use (aOR: 0.15, P = .015).
CONCLUSIONS: While COVID-19 vaccine uptake was high, vaccination coverage for influenza and pneumococcal disease remains insufficient. Age, healthcare encounters, and drug use were key factors influencing vaccine uptake. Targeted interventions and vaccine reminders should be conducted to increase vaccination rates.
Disciplines :
Immunology & infectious disease
Author, co-author :
Destordeur, Li-Cécile ; Université de Liège - ULiège > Faculté de Médecine > Master méd. (180 crédits)
Lopez Delhoulle, Victoria ; Université de Liège - ULiège > Faculté de Médecine > Master méd. (180 crédits)
Papadopoulos, Iraklis ; Université de Liège - ULiège > Santé publique : de la Biostatistique à la Promotion de la Santé
Maes, Nathalie ; Université de Liège - ULiège > Département des sciences de la santé publique
Fombellida, Karine; Infectious Diseases Department, Liège University Hospital of Liège, Liège, Belgium
Financial support. G.D. is an FNRS (National Fund for Scientific Research) Clinical Researcher. L.-C.D. has received financial support from University of Li\u00E8ge.G.D. is an FNRS (National Fund for Scientific Research) Clinical Researcher. L.-C.D. has received financial support from University of Li\u00E8ge.
Harboe ZB, Larsen MV, Ladelund S, et al. Incidence and risk factors for invasive pneumococcal disease in HIV-infected and non-HIV-infected individuals before and after the Introduction of combination antiretroviral therapy: persistent high risk among HIV-infected injecting drug users. Clin Infect Dis 2014; 59:1168-76.
Abadom TR, Smith AD, Tempia S, Madhi SA, Cohen C, Cohen AL. Risk factors associated with hospitalisation for influenza-associated severe acute respiratory illness in South Africa: a case-population study. Vaccine 2016; 34:5649-55.
Fabbiani M, Sidella L, Corbi M, et al. HIV-infected patients show impaired cellular immune response to influenza vaccination compared to healthy subjects. Vaccine 2013; 31:2914-8.
Garcia Garrido HM, Schnyder JL, Haydari B, et al. Immunogenicity of the 13-valent pneumococcal conjugate vaccine followed by the 23-valent pneumococcal polysaccharide vaccine in people living with HIV on combination antiretroviral therapy. Int J Antimicrob Agents 2022; 60:106629.
Geretti AM, Doyle T. Immunization for HIV-positive individuals. Curr Opin Infect Dis 2010; 23:32.
Frésard A, Gagneux-Brunon A, Lucht F, Botelho-Nevers E, Launay O. Immunization of HIV-infected adult patients -French recommendations. Hum Vaccines Immunother 2016; 12:2729-41.
EACSociety [Internet]. [cité 15 nov 2023]. EACS Guidelines. Disponible sur: Available at: https://www.eacsociety.org/guidelines/eacs-guidelines/
Larsen L, Nguyen MTT, Johansen IS. The coverage of influenza and pneumococcal vaccinations among people living with HIV in Denmark: a single-center cross-sectional survey. Hum Vaccines Immunother 2021;17:2700-5.
Marchese V, Storti S, Morganti C, et al. Explorative study regarding influenza vaccine hesitancy among HIV-infected patients. Hum Vaccines Immunother 2022; 18:2046434.
Grace D, Gaspar M, Paquette R, et al. HIV-positive gay men’s knowledge and perceptions of Human Papillomavirus (HPV) and HPV vaccination: a qualitative study. PLoS One 2018; 13:e0207953.
Grewal R, Grennan T, Gillis JL, et al. Low human papillomavirus (HPV) vaccine uptake among men living with human immunodeficiency virus (HIV): cross-sectional findings from a clinical cohort. Prev Med 2021; 143:106329.
Chambers C, Gillis J, Lindsay J, et al. Low human papillomavirus vaccine uptake among women engaged in HIV care in Ontario, Canada. Prev Med 2022; 164: 107246.
Donneau AF, Guillaume M, Bours V, et al. University population-based prospective cohort study of SARS-CoV-2 infection and immunity (SARSSURV-ULiège): a study protocol. BMJ Open 2022; 12:e055721.
Paridans M, Monseur J, Gillain N, et al. Impact of the COVID-19 vaccination on confusion around vaccination in general: a longitudinal study on a university population over 18 months. PLOS Glob Public Health 2024; 4:e0004066.
Conseil Supérieur de la Santé [Internet]. [cité 4 août 2024]. Vaccination antipneumococcique (adultes). Disponible sur: Available at: https://www.hgr-css.be/fr/avis/9674/vaccination-antipneumococcique-adultes
CBIP [Internet]. [cité 16 août 2023]. Révision des avis du Conseil Supérieur de la Santé concernant la vaccination antipneumococcique des adultes et des enfants à risque accru. Disponible sur: Available at: https://www.cbip.be/fr/revision-des-avisdu-conseil-superieur-de-la-sante-concernant-la-vaccination-antipneumococciquedes-adultes-et-des-enfants-a-risque-accru/
Vaccination antipneumococcique/adultes. Conseil Supérieur de la Santé (CSS). Avis 9562, 2020. Available at: https://www.health.belgium.be/sites/default/files/uploads/fields/fpshealth_theme_file/20200707_css_9562_vacpneumocoque_ version_site.pdf
Conseil Supérieur de la Santé. Vaccination antipneumococcique (adultes). Bruxelles: CSS, 2022. Avis n° 9674.
Conseil Supérieur de la Santé. Vaccination contre la grippe saisonnière-saison hivernale 2024-2025. Bruxelles: CSS, 2024. Avis n° 9831.
Remboursement du vaccin contre la grippe saisonnière, INAMI [Internet]. [cité 2 sept 2024]. Disponible sur: Available at: https://www.inami.fgov.be/fr/themes/soins-de-sante-cout-et-remboursement/les-prestations-de-sante-que-vousrembourse-votre-mutualite/medicaments/remboursement-d-un-medicament/remboursement-du-vaccin-contre-la-grippe-saisonniere
Catteau L, Haarhuis F, Dequeker S, et al. Surveillance de la vaccination COVID-19 dans les maisons de repos et maisons de repos et de soins belges. Résultats jusqu’au 24 Mars 2021. Bruxelles, Belgique: Sciensano, 2021. Numéro de dépôt légal: D/2021/14.440/31.
Tsachouridou O, Georgiou A, Naoum S, et al. Factors associated with poor adherence to vaccination against hepatitis viruses, streptococcus pneumoniae and seasonal influenza in HIV-infected adults. Hum Vaccines Immunother 2019; 15: 295-304.
Birk NK, Monday L, Singh T, et al. Vaccine coverage and factors associated with vaccine adherence in persons with HIV at an urban infectious disease clinic. Hum Vaccines Immunother 2023; 19:2204785.
Johnson TM, Klepser DG, Bares SH, Scarsi KK. Predictors of vaccination rates in people living with HIV followed at a specialty care clinic. Hum Vaccines Immunother 2021; 17:791-6.
Valour F, Cotte L, Voirin N, et al. Vaccination coverage against hepatitis A and B viruses, Streptococcus pneumoniae, seasonal flu, and A(H1N1)2009 pandemic influenza in HIV-infected patients. Vaccine 2014; 32:4558-64.
Boey L, Bosmans E, Ferreira LB, et al. Vaccination coverage of recommended vaccines and determinants of vaccination in at-risk groups. Hum Vaccines Immunother 2020; 16:2136-43.
CBIP [Internet]. [cité 1 sept 2024]. CBIP | Vaccin contre les infections à pneumocoques. Disponible sur: Available at: https://www.cbip.be/fr/chapters/13?frag= 11718
Loubet P, Samih-Lenzi N, Galtier F, et al. Factors associated with poor outcomes among adults hospitalized for influenza in France: a three-year prospective multicenter study. J Clin Virol Off Publ Pan Am Soc Clin Virol 2016; 79:68-73.
Han L, Ran J, Mak YW, et al. Smoking and influenza-associated morbidity and mortality: a systematic review and meta-analysis. Epidemiology 2019; 30:405.
Stouten V, Billuart M, Van Evercooren I, et al. Rapport thématique: couverture vaccinale et impact épidémiologique de la campagne de vaccination COVID-19 chez les personnes présentant des maladies sous-jacentes en belgique. Bruxelles, Belgique: Sciensano, 2023. Numéro de rapport: D/2023.14.440/37.
Paridans M, Monseur J, Donneau AF, et al. The dynamic relationship between the intention and final decision for the COVID-19 booster: a study among students and staff at the university of liège, Belgium. Vaccines (Basel) 2022; 10:1485.
Lv X, Zhao C, Song B, et al. COVID-19 vaccination in people living with HIV and AIDS (PLWHA) in China: a cross-sectional study. Hum Vaccines Immunother 2023; 19:2151798.
Eiden AL, Barratt J, Nyaku MK. A review of factors influencing vaccination policies and programs for older adults globally. Hum Vaccines Immunother 2023; 19:2157164.
Lane J, Palacio A, Chen LE, et al. Access to health care improves COVID-19 vaccination and mitigates health disparities among medicare beneficiaries. J Racial Ethn Health Disparities 2023; 10:1569-1575. doi: 10.1007/s40615-022-01343-1.
Ali F, Kaura A, Russell C, et al. Identifying barriers and facilitators to COVID-19 vaccination uptake among People Who Use Drugs in Canada: a National Qualitative Study. Harm Reduct J 2023; 20:99.
Heidari O, O’Conor KJ, Meyer D, Cargill V, Lowensen K, Farley JE. High primary COVID-19 vaccine series completion by people who inject drugs when colocating services at a syringe services van. J Addict Med 2023; 17:e287-9.
Stephens AB, Wynn CS, Hofstetter AM, et al. Effect of electronic health record reminders for routine immunizations and immunizations needed for chronic medical conditions. Appl Clin Inform 2021; 12:1101-9.