Real-world effectiveness of COVID-19 vaccine in people with HIV compared with a matched HIV-negative cohort: A test-negative design

Objectives: We estimated vaccine effectiveness (VE) against SARS-CoV-2 infection among a statewide cohort of people with HIV (PWH) and compared the estimates with a matched cohort of people without HIV (PWoH) in South Carolina (SC), USA. Methods: A population-based cohort was retrieved from statewid...

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Main Authors: Xueying Yang, Jiajia Zhang, Ziang Liu, Shujie Chen, Sharon Weissman, Gregory A. Poland, Refilwe Nancy Phaswana-Mafuya, Bankole Olatosi, Xiaoming Li
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:International Journal of Infectious Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S1201971224003862
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author Xueying Yang
Jiajia Zhang
Ziang Liu
Shujie Chen
Sharon Weissman
Gregory A. Poland
Refilwe Nancy Phaswana-Mafuya
Bankole Olatosi
Xiaoming Li
author_facet Xueying Yang
Jiajia Zhang
Ziang Liu
Shujie Chen
Sharon Weissman
Gregory A. Poland
Refilwe Nancy Phaswana-Mafuya
Bankole Olatosi
Xiaoming Li
author_sort Xueying Yang
collection DOAJ
description Objectives: We estimated vaccine effectiveness (VE) against SARS-CoV-2 infection among a statewide cohort of people with HIV (PWH) and compared the estimates with a matched cohort of people without HIV (PWoH) in South Carolina (SC), USA. Methods: A population-based cohort was retrieved from statewide electronic health records between January 2, 2021, and April 14, 2022, during which several variants were circulating in SC (i.e., Alpha, Delta, Omicron). We compared the odds of vaccination between test-positive cases and test-negative controls using logistic regression models for both SARS-CoV-2 infection and severe COVID-19 outcomes. The VE was derived as (1 − adjusted odds ratio) × 100%. Results: A total of 7279 test episodes in PWH and 72,790 matched test episodes in PWoH were included for analysis, representing 6561 unique PWH and 67,521 unique PWoH. The peak level of VE against SARS-CoV-2 infection occurred 7-59 days after receipt of the second dose of vaccine (PWH: 61.20%; PWoH: 67.09%), followed by a waning protective effect 90-119 days after the second dose in both PWH (35.80%) and PWoH (47.57%), where PWH had a proportionally lower and declined faster VE. Regarding the VE against severe outcomes of SARS-CoV-2 infection, a relatively higher level of protection was maintained in both populations (complete primary series: PWH: 69.06%; PWoH: 60.63%). Conclusions: A complete primary series of COVID-19 vaccines offered significant protection against SARS-CoV-2 infection and severe outcomes in both PWH and PWoH populations, although this wanes with time. However, the estimate of VE against SARS-CoV-2 infection appeared lower in PWH than in PWoH and the degree of waning over time was relatively quicker in PWH.
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spelling doaj-art-3ba4f3e9e943461e8fcb3e3b0d3758822024-12-18T08:47:34ZengElsevierInternational Journal of Infectious Diseases1201-97122025-01-01150107310Real-world effectiveness of COVID-19 vaccine in people with HIV compared with a matched HIV-negative cohort: A test-negative designXueying Yang0Jiajia Zhang1Ziang Liu2Shujie Chen3Sharon Weissman4Gregory A. Poland5Refilwe Nancy Phaswana-Mafuya6Bankole Olatosi7Xiaoming Li8Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, USA; Corresponding author.South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USASouth Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USASouth Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USASouth Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, USA; Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, USAMayo Vaccine Research Group, Mayo Clinic and Foundation, Rochester, USASouth African Medical Research Council/University of Johannesburg Pan African Centre for Epidemics Research (PACER) Extramural Unit, Johannesburg, South Africa; Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa; Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, USASouth Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, USA; Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, USADepartment of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, USAObjectives: We estimated vaccine effectiveness (VE) against SARS-CoV-2 infection among a statewide cohort of people with HIV (PWH) and compared the estimates with a matched cohort of people without HIV (PWoH) in South Carolina (SC), USA. Methods: A population-based cohort was retrieved from statewide electronic health records between January 2, 2021, and April 14, 2022, during which several variants were circulating in SC (i.e., Alpha, Delta, Omicron). We compared the odds of vaccination between test-positive cases and test-negative controls using logistic regression models for both SARS-CoV-2 infection and severe COVID-19 outcomes. The VE was derived as (1 − adjusted odds ratio) × 100%. Results: A total of 7279 test episodes in PWH and 72,790 matched test episodes in PWoH were included for analysis, representing 6561 unique PWH and 67,521 unique PWoH. The peak level of VE against SARS-CoV-2 infection occurred 7-59 days after receipt of the second dose of vaccine (PWH: 61.20%; PWoH: 67.09%), followed by a waning protective effect 90-119 days after the second dose in both PWH (35.80%) and PWoH (47.57%), where PWH had a proportionally lower and declined faster VE. Regarding the VE against severe outcomes of SARS-CoV-2 infection, a relatively higher level of protection was maintained in both populations (complete primary series: PWH: 69.06%; PWoH: 60.63%). Conclusions: A complete primary series of COVID-19 vaccines offered significant protection against SARS-CoV-2 infection and severe outcomes in both PWH and PWoH populations, although this wanes with time. However, the estimate of VE against SARS-CoV-2 infection appeared lower in PWH than in PWoH and the degree of waning over time was relatively quicker in PWH.http://www.sciencedirect.com/science/article/pii/S1201971224003862COVID-19SARS-CoV-2HIVVaccine effectivenessTest-negative design
spellingShingle Xueying Yang
Jiajia Zhang
Ziang Liu
Shujie Chen
Sharon Weissman
Gregory A. Poland
Refilwe Nancy Phaswana-Mafuya
Bankole Olatosi
Xiaoming Li
Real-world effectiveness of COVID-19 vaccine in people with HIV compared with a matched HIV-negative cohort: A test-negative design
International Journal of Infectious Diseases
COVID-19
SARS-CoV-2
HIV
Vaccine effectiveness
Test-negative design
title Real-world effectiveness of COVID-19 vaccine in people with HIV compared with a matched HIV-negative cohort: A test-negative design
title_full Real-world effectiveness of COVID-19 vaccine in people with HIV compared with a matched HIV-negative cohort: A test-negative design
title_fullStr Real-world effectiveness of COVID-19 vaccine in people with HIV compared with a matched HIV-negative cohort: A test-negative design
title_full_unstemmed Real-world effectiveness of COVID-19 vaccine in people with HIV compared with a matched HIV-negative cohort: A test-negative design
title_short Real-world effectiveness of COVID-19 vaccine in people with HIV compared with a matched HIV-negative cohort: A test-negative design
title_sort real world effectiveness of covid 19 vaccine in people with hiv compared with a matched hiv negative cohort a test negative design
topic COVID-19
SARS-CoV-2
HIV
Vaccine effectiveness
Test-negative design
url http://www.sciencedirect.com/science/article/pii/S1201971224003862
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