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. 2021 Mar 4;17(3):791-796.
doi: 10.1080/21645515.2020.1802163. Epub 2020 Sep 3.

Predictors of vaccination rates in people living with HIV followed at a specialty care clinic

Tanner M Johnson  1   2   3 , Donald G Klepser  1 , Sara H Bares  4 , Kimberly K Scarsi  1   4
Affiliations

Predictors of vaccination rates in people living with HIV followed at a specialty care clinic

Tanner M Johnson et al. Hum Vaccin Immunother. .

Abstract

People Living with HIV (PLWH) remain disproportionately susceptible to vaccine-preventable illnesses due to increased morbidity and mortality from common pathogens, increased transmission related to epidemiologic factors, and decreased vaccination rates. We aimed to describe patient-specific predictive factors that may impact adherence to the CDC's recommended vaccination schedules in PLWH. We retrospectively evaluated adult PLWH in care at the University of Nebraska Medical Center's HIV clinic and collected information related to demographics, clinic visits, vaccination status, and measures of HIV disease control. Patients were categorized as "Adherent" if they had received all vaccinations for which they were eligible and were categorized as "Non-Adherent" if they were deficient or delayed in receiving one or more vaccinations. Participant characteristics were compared between groups by multivariable logistic regression to identify predictors associated with vaccine schedule non-adherence. We evaluated 502 PLWH who met our inclusion criteria; 206 of these (41%) had received all eligible vaccinations, while 296 (59%) were missing one or more vaccinations. The mean age of participants was 48 years old, 76% were male, and 53% were white. Our participants had a median of 2.83 clinic visits per year and missed 8.3% of scheduled clinic visits. Factors associated with non-adherence to vaccination schedules included a high frequency of missed clinic appointments (>10%), men who have sex with men, and a CD4 count <200 cells/mm3. Knowledge of variables associated with vaccination rates may be beneficial in identifying patients at-risk for under-vaccination and designing targeted education programs for providers and patients.

Keywords: HIV; PLWH; adherence; vaccination; vaccines.

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Figures

Figure 1.
Figure 1.
Percentage of eligible patients that received each vaccine. All patients (n = 502) were eligible for vaccination with Hepatitis B (HepB), Influenza, Pneumococcal Conjugate (PCV13), and Tetanus, Diptheria, with/without acellular pertussis (TDaP/TD) vaccines. The number of eligible patients for other vaccines is as follows: Hepatitis A (HepA): 271; Human Papillomavirus (HPV): 48; Pneumococcal Polysaccharide (PPSV23): 452; Zoster Vaccine Live (ZVL): 70
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Grants and funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.