National strategies for vaccination against COVID‐19 in people living with HIV in Central and Eastern European region

Abstract

Introduction People living with HIV (PLWH) are at higher risk of poorer COVID‐19 outcomes. Vaccination is a safe and effective method of prevention against many infectious diseases, including COVID‐19. Here we investigate the strategies for national COVID‐19 vaccination programmes across central and eastern Europe and the inclusion of PLWH in vaccination programmes. Methods The Euroguidelines in Central and Eastern Europe Network Group consists of experts in the field of infectious diseases from 24 countries in the region. Between 1 November 2020 and 19 March 2021 the group proceeded an on‐line survey consisting of 20 questions. Results Twenty‐two countries (out of 24 invited) participated in the survey and 20/22 countries in the period between December 2020 and March 2021 had already started their COVID‐19 vaccination programme. In total, seven different vaccines were used by participating countries. In 17/21 countries (81%), vaccinated persons were centralized within the national registry. In 8/21 countries (38%) PLWH were prioritized for vaccination (the Czech Republic, Greece, Hungary, Lithuania, Montenegro, Romania, Slovakia, Slovenia) and the Czech Republic, Greece and Serbia had put in place national guidelines for vaccination of PLWH. In 14/20 countries (70%) vaccination was only provided by designated centres. Eighteen respondents (18/21; 85.7%) reported that they planned to follow up HIV patients vaccinated against COVID‐19, mainly by measuring antibody levels and checking COVID‐19 incidence (11/21; 52.3%). Conclusions This survey‐based study suggests that there are significant differences in terms of prioritizing PLWH, the types of vaccines used, vaccination coverage, and the development and implementation of a vaccination programmes within the region. Regardless of heterogenicity and existing barriers within the region, systematic vaccination in PLWH should have the highest priority, especially in those with severe immunodeficiency, risk factors, and in the elderly, aiming for prompt and high vaccination coverage.

Letter to the Editor: Complementary dose of COVID-19 vaccination may prevent SARS-CoV-2 breakthrough infection among previously vaccinated HIV positive persons

“…This underlines the importance of prompt and timely vaccination of HIV positive persons against SARS-CoV-2 infection (6). Nevertheless, until now many countries did not prioritize this group of patients in national vaccination strategies (7).…”

Progressive Worsening of Neurological Manifestations in HIV-Associated Opportunistic Central Nervous System (CNS) Infection Patients After COVID-19 Vaccinations: A Possible Co-Incidence Causality

“…The increased risk of morbidity and mortality due to COVID-19 in PLWHA was also reported despite the successful HIV treatment, suggesting immune deficiency as the culprit [ 12 ]. Therefore, there are national and international consensuses regarding the necessity of COVID-19 vaccinations in PLWHA, despite the limited data on the efficacy and safety of the vaccines in these subpopulations [ 13 ]. In some countries, including Indonesia, it is necessary for people with certain medical conditions, including PLWHA whose HIV infection status has been known, to have a physician’s recommendation for COVID-19 vaccination in spite of the safety claim from the WHO and CDC for COVID-19 vaccinations in PLWHA [ 4 , 14 ].…”

Clinical characteristics and factors associated with ICU mortality during the first year of the SARS-Cov-2 pandemic in Romania

“…During the first weeks, the national vaccination strategy targeted healthcare providers and individuals at high risk of complications following SARS-CoV-2 infection. Vaccination for the general population was available after 15 Normal distribution for continuous variables was evaluated through histograms, QQ-plots and the Shapiro-Wilk test. Student's test (for parametric) or Mann-Whitney Utest (for nonparametric) were used as appropriate for comparisons of continuous variables.…”

“…Furthermore, neither the vaccine availability nor access to ICU beds are the same worldwide. In this context, it is essential to identify ICU mortality predictors to target the population at risk more precisely and implement life-saving measures 15 …”

“…In this context, it is essential to identify ICU mortality predictors to target the population at risk more precisely and implement lifesaving measures. 15 The main objective of this study was to describe the clinical characteristics of patients admitted to Romanian ICUs with SARS-CoV-2 infection. The secondary objective was to evaluate the factors associated with ICU mortality in the SARS-CoV-2 Romanian ICU cohort.…”