Welcome to the third episode of the 2021 BMJ STI podcast series! As you listen to this podcast, globally thousands of people will receive a dose of SARS-CoV-2 vaccine along with hope for the future. In this podcast, we will explore the main classes of COVID-19 vaccine and issues pertinent to the administration of COVID-19 vaccine to people with HIV, and will also hear the views from a representative of the HIV community. Join Dr. Fabiola Martin with Professor Anna Maria Geretti, Dr. Laura Waters and Mr. Simon Collins in this informative episode of STI podcast!
The COVID-19 vaccines:
- The main classes of SARS-CoV2 vaccines include mRNA, adenovirus vector, protein subunit and inactivated vaccines. Large scale randomized control trials have shown these vaccines are safe and highly effective at preventing severe COVID-19.
- Longer duration studies and more data on people with underlying conditions, including people with HIV (PWH), are awaited. Although available data are currently insufficient to allow in-depth analyses specific to PWH, the evidence from people with well-controlled HIV infection is promising.
- The protective effect of COVID-19 vaccination is not immediate but takes time to develop after administration, therefore PWH should be aware that precautions should still be taken while protection develops, and also in case of risk factors for a reduced response to the vaccine. The ability of vaccines to protect against variants of the SARS-CoV-2 virus is being monitored.
- A link has been proposed between adenovirus-vectored DNA vaccines and a rare condition known as vaccine-induced thrombotic thrombocytopenia (VITT). This condition is currently thought to be related to an overenthusiastic immune response involving a body protein, and to be more common in younger age groups. There is no known recognised association between HIV status and risk of VITT.
Use of COVID-19 vaccines in people with HIV
- HIV has been associated with an increased risk of severe COVID-19 and vaccination is very important and strongly recommended for PWH.
- It is considered safe for PWH to receive a vaccine belonging to one of the main classes of COVID-19 vaccines, regardless of their CD4 cell count. At present, we have insufficient data to recommend one vaccine over another for PWH.
- More data are needed on the strength and durability of vaccine responses in PWH and the requirements for booster doses. Ongoing studies will provide answers to these important questions.
Messages from the HIV community
- PWH have the same concerns as the general population and want to be protected from COVID-19.
- Disclosure of HIV status is not necessary to receive a COVID-19 vaccine.
- PWH should always be treated with the same care as all other patients and the confidentiality of their HIV status should be respected.