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COVID-19 Vaccination and Hospitalization Among Persons
Living With Diagnosed HIV in New York State
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Fifteen months after vaccines became available, more than 25% of PLWDH in NYS remained unvaccinated for COVID-19. Differences in vaccination status were most pronounced within categories of race/ethnicity, viral suppression, and HIV care status. Lower vaccination rates among non-Hispanic Black and Hispanic PLWDH could magnify already higher diagnosis rates and more severe COVID-19 outcomes experienced in these communities.28,38 More research is needed to understand why PLWDH are less likely to be vaccinated for COVID-19, and why PLWDH, particularly vaccinated PLWDH, have significantly higher hospitalizations rates compared with those in New Yorkers overall.
Among PLWDH in our study, unvaccinated persons had hospitalization rates approximately 2 times higher than those fully vaccinated during Delta (2.4) and Omicron (1.5) predominance periods. Of importance, this difference is being driven by higher hospitalization rates among vaccinated PLWDH.
Approximately 28% (28,255) of PLWDH in NYS remained unvaccinated for COVID-19, a rate roughly double of that observed in the overall adult NYS population.
PLWDH of color were more often than non-Hispanic White persons to be unvaccinated, as were the virally unsuppressed and those without evidence of HIV-related care, threatening to expand existing disparities in COVID-19–related outcomes.
JAIDS June 1 2023
Rosenthal, Elizabeth M. MPHa,b,c; Patterson, Wendy MPHd; Chicoine, Joyce BSd; Dorabawila, Vajeera PhDe; Adamashvili, Natalia MD, MPHa,f; Rajulu, Deepa T. MSd; Rosenberg, Eli S. PhDb,c,g; Tesoriero, James M. PhDa,b,c
Abstract
Background:
Persons living with diagnosed HIV (PLWDH) have higher COVID-19 diagnoses rates and poorer COVID-19–related outcomes than persons living without diagnosed HIV. The intersection of COVID-19 vaccination status and likelihood of severe COVID-19 outcomes has not been fully investigated for PLWDH.
Setting:
New York State (NYS).
Methods:
We matched HIV surveillance, immunization, and hospitalization databases to compare COVID-19 vaccination and COVID-19–related hospitalizations among PLWDH during B.1.617.2 (Delta) and B.1.1.529 (Omicron) predominance.
Results:
Through March 4, 2022, 69,137 of the 101,205 (68%) PLWDH were fully vaccinated or boosted for COVID-19.
PLWDH who were virally suppressed or in care were more often to be fully vaccinated or boosted compared with PLWDH who were not virally suppressed (77% vs. 44%) or without evidence of care (74% vs. 33%).
Overall hospitalization rates were lower among virally suppressed PLWDH. During Delta predominance, PLWDH with any vaccination history who were in care had lower hospitalization rates compared with those not in care; during Omicron predominance, this was the case only for boosted PLWDH.
Conclusions:
Approximately 28% (28,255) of PLWDH in NYS remained unvaccinated for COVID-19, a rate roughly double of that observed in the overall adult NYS population.
PLWDH of color were more often than non-Hispanic White persons to be unvaccinated, as were the virally unsuppressed and those without evidence of HIV-related care, threatening to expand existing disparities in COVID-19–related outcomes.
Vaccination was protective against COVID-19–related hospitalizations for PLWDH; however, differences in hospitalization rates between fully vaccinated and unvaccinated PLWDH were smaller than those among all New Yorkers.
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