Sociodemographic factors influencing SARS-CoV-2 vaccination uptake in people with and without HIV: Insights from a Swedish Nationwide cohort
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: There is limited data regarding SARS-CoV-2 vaccine uptake in people with HIV (PWH) compared to people without HIV (PWoH). METHODS: Swedish nationwide study of individuals born 1930-2003, assessing SARS-CoV-2 vaccine uptake of 1-5 doses by HIV-status from first SARS-CoV-2 vaccination (2020-12-27) until 2023-02-23. PWH were categorized by prioritization: clinically vulnerable (CD4+ T-cells <50cells/μL, recent opportunistic disease, or CD4+ T-cells <200 in combination with detectable HIV-RNA > 200copies/mL), and not prioritized (non-vulnerable PWH). Relative risks (adjRR) for doses 1-5 were estimated using modified Poisson regression, adjusted for sociodemographics, SARS-CoV-2 infections, and comorbidities. RESULTS: 7233 non-vulnerable PWH, 435 clinically vulnerable PWH, and 8,168,340 PWoH were included. While unadjusted 3-dose uptake was lower in both PWH groups compared to PWoH, adjusted analysis showed higher uptake in non-vulnerable PWH (adjRR1.17, 95 % CI 1.15-1.19), with similar trends in clinically vulnerable. An interaction between country of birth and HIV-status was identified (p < 0.001). Migrants with HIV had higher 3-dose uptake vs. migrants without HIV, but were less likely vaccinated than Swedish-born with HIV. Among people ≥65 years old, PWH were less likely to receive 3 or more doses compared to PWoH ≥65 years (dose 5: adjRR 0.90, 95 % CI 0.85-0.96). CONCLUSIONS: We found lower vaccination uptake in migrants, irrespective of HIV-status, consistent with previous studies. Most concerningly we identified a lower vaccine uptake among people with HIV who were 65 years or older. This nationwide study highlights the need for targeted vaccination strategies and interventions that address both HIV-status and demographic factors.
Source: Vaccine
Authors: Isabela Killander Möller, Pontus Hedberg, Philippe Wagner, Pär Sparén, Magnus Gisslén, Pontus Nauclér, Soo Aleman, Peter Bergman, Christina Carlander, Soo Aleman, Peter Bergman, Lisa Blixt, Christina Carlander, Sandra Eketorp Sylvan, Mats Fredrikson, Lotta Hansson, Pontus Hedberg, Fredrik Kahn, Isabela Killander Möller, Hannes Lindahl, Åsa Nilsdotter-Augustinsson, Sofia Nyström, Anders Österborg
Language: English
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $3,620
OpenAlex ID: W4413093838