Freitas Cassandra, Cooper Curtis L, Kroch Abigail E, Moineddin Rahim, Arbess Gordon, Benoit Anita C, Buchan Sarah A, Chambers Catharine, Habanyama Muluba, Kendall Claire E, Kwong Jeffrey C, Mbuagbaw Lawrence, McCullagh John, Moqueet Nasheed, Nambiar Devan, Rueda Sergio, Tran Vanessa, Walmsley Sharon, Burchell Ann N
Dalla Lana School of Public Health, University of Toronto, 155 College Street Room 500, Toronto, ON M5T 3M7, Canada; MAP Centre for Urban Health Solutions, Unity Health Toronto, 30 Bond Street,Toronto, Ontario M5B 1W8, Canada.
Ottawa Hospital Research Institute, 725 Parkdale Avenue, Ottawa, ON K1Y 4E9, Canada; Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Road., Ottawa, ON K1H 8M5, Canada.
Vaccine. 2025 Aug 13;61:127422. doi: 10.1016/j.vaccine.2025.127422. Epub 2025 Jul 1.
COVID-19 vaccination significantly reduces COVID-19-related hospitalization and mortality and is important for those who may be at increased risk of SARS-CoV-2 infection, including people living with HIV. Using a population-based approach, we examined COVID-19 vaccine uptake among people living with and without HIV in Ontario, Canada.
A retrospective population-based matched cohort study was conducted using provincial clinical and health administrative data from December 14, 2020 to August 31, 2022. Community-dwelling adults living with HIV aged ≥19 years were matched one-to-one with a person without a diagnosis of HIV based on age, sex, geography, and immigration status. To identify predictors of vaccine uptake, modified Poisson regression with robust standard errors accounting for geographical clustering was used. To estimate vaccine uptake comparing the HIV and non-HIV cohorts, conditional Poisson regression with robust error variance was used to estimate crude and adjusted risk ratios with 95 % confidence intervals (CI).
Among 20,903 people living with HIV, most (85.4%) had received ≥2 COVID-19 vaccine doses, with 64.7% receiving a third dose and 24.3% receiving a fourth dose. Disparities in uptake of ≥3 doses by sex were observed (males vs females: 68.5% vs 50.9%). Predictors of receiving ≥3 doses among people living with HIV included older age, male sex, and receipt of a recent influenza vaccine. Men living with HIV were more likely to receive ≥3 doses compared with men living without HIV, whereas women living with HIV were less likely than women living without HIV to receive ≥3 doses.
Uptake of the first two doses of COVID-19 vaccine was high among people living with HIV in Ontario, Canada, however, disparities in uptake of ≥3 doses remain, especially by sex. Continued monitoring of COVID-19 vaccine uptake is crucial to informing immunization programs, policies and guidelines for people living with HIV in Canada.
新冠病毒病（COVID-19）疫苗接种可显著降低与COVID-19相关的住院率和死亡率，对包括艾滋病毒感染者在内的可能感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）风险增加的人群很重要。我们采用基于人群的方法，研究了加拿大安大略省艾滋病毒感染者和未感染者的COVID-19疫苗接种情况。
利用2020年12月14日至2022年8月31日的省级临床和卫生管理数据进行了一项基于人群的回顾性匹配队列研究。年龄≥19岁的社区居住艾滋病毒感染者按年龄、性别、地理位置和移民身份与未诊断出艾滋病毒的人进行一对一匹配。为了确定疫苗接种的预测因素，使用了考虑地理聚类的稳健标准误差的修正泊松回归。为了估计艾滋病毒感染者和非艾滋病毒感染者队列的疫苗接种情况，使用了具有稳健误差方差的条件泊松回归来估计粗风险比和调整风险比以及95%置信区间（CI）。
在20903名艾滋病毒感染者中，大多数（85.4%）接种了≥2剂COVID-19疫苗，64.7%接种了第三剂，24.3%接种了第四剂。观察到≥3剂疫苗接种在性别上存在差异（男性与女性：68.5%对50.9%）。艾滋病毒感染者中接种≥3剂疫苗的预测因素包括年龄较大、男性以及近期接种流感疫苗。与未感染艾滋病毒的男性相比，感染艾滋病毒的男性更有可能接种≥3剂疫苗，而与未感染艾滋病毒的女性相比，感染艾滋病毒的女性接种≥3剂疫苗的可能性较小。
在加拿大安大略省，艾滋病毒感染者中COVID-19疫苗前两剂的接种率较高，然而，≥3剂疫苗接种的差异仍然存在，尤其是在性别方面。持续监测COVID-19疫苗接种情况对于为加拿大艾滋病毒感染者的免疫规划、政策和指南提供信息至关重要。
