Uptake and adverse reactions of COVID-19 vaccination among people living with HIV in China: a case–control study

Figures & data

Table 1. Characteristics of PLHIV stratified by COVID-19 vaccination status (N = 1618)

Variables		COVID-19 vaccination		Univariable	Multivariable
	Overall	Received	Did not receive	P-value	aOR (95% CI)	P-value
Total	1618(100.0%)	527(32.6%)	1091(67.4%)
Sociodemographic information
Gender				0.788
Male	1541(95.2%)	503(95.4%)	1038(95.1%)		-
Female	77(4.8%)	24(4.6%)	53(4.9%)		-
Age (years)				0.043
18–29	511(31.6%)	186(35.3%)	325(29.8%)		Ref
30–39	742(45.9%)	240(45.5%)	502(46.0%)		0.69(0.48–0.99)	0.044
40–49	262(16.2%)	76(14.4%)	186(17.0%)		0.55(0.33–0.92)	0.023
≥50	103(6.4%)	25(4.7%)	78(7.1%)		0.36(0.17–0.76)	0.009
BMI				0.238
<18.5	129(8.0%)	39(7.4%)	90(8.2%)		-
18.5–24	1038(64.2%)	327(62.0%)	711(65.2%)		-
≥24	451(27.9%)	161(30.6%)	290(26.6%)		-
Marital status				<0.001
Married	288(17.8%)	108(20.5%)	180(16.5%)		Ref
Unmarried	1147(70.9%)	352(66.8%)	795(72.9%)		0.43(0.28–0.66)	<0.001
Divorced or widowed	171(10.6%)	57(10.8%)	114(10.4%)		1.25(0.72–2.15)	0.430
Other	12(0.7%)	10(1.9%)	2(0.2%)		1.68(0.38–11.93)	0.536
Educational level				<0.001
Junior high school or primary school	217(13.4%)	37(7.0%)	180(16.5%)		Ref
High school	319(19.7%)	82(15.6%)	237(21.7%)		1.51(0.86–2.68)	0.151
College	975(60.3%)	338(64.1%)	637(58.4%)		2.16(1.30–3.67)	0.004
Postgraduate	107(6.6%)	70(13.3%)	37(3.4%)		8.38(3.89–18.48)	<0.001
Occupation				<0.001
Other	897(55.4%)	140(26.6%)	757(69.4%)		Ref
Urban functional security workers	349(21.6%)	193(36.6%)	156(14.3%)		6.21(4.35–8.92)	<0.001
Medical workers	126(7.8%)	88(16.7%)	38(3.5%)		8.50(5.05–15.52)	<0.001
Unemployed	95(5.9%)	15(2.8%)	80(7.3%)		1.57(0.76–3.07)	0.203
International transportation workers	75(4.6%)	30(5.7%)	45(4.1%)		3.63(1.93–6.74)	<0.001
Entry quarantine site workers	52(3.2%)	40(7.6%)	12(1.1%)		13.58(6.30–31.15)	<0.001
Cold chain workers	24(1.5%)	21(4.0%)	3(0.3%)		30.41(8.89–145.70)	<0.001
Received influenza or pneumonia vaccine in the past 3 years				<0.001
Yes	167(10.3%)	101(19.2%)	66(6.0%)		5.40(3.36–8.77)	<0.001
No	1451(89.7%)	426(80.8%)	1025(94.0%)		Ref
HIV treatment
Time of HIV diagnosis				0.628
≤5 years	1045(64.6%)	336(63.8%)	709(65.0%)		-
>5 years	573(35.4%)	191(36.2%)	382(35.0%)		-
On ART				0.293
Yes	1570(97.0%)	508(96.4%)	1062(97.3%)		-
No	48(3.0%)	19(3.6%)	29(2.7%)		-
ART duration				0.245
≤5 years	1112(70.8%)	350(68.9%)	762(71.8%)		-
>5 years	458(29.2%)	158(31.1%)	300(28.2%)		-
Latest HIV viral load (copies/ml)				0.042
<50	1121(69.3%)	387(73.4%)	734(67.3%)		Ref
≥50	189(11.7%)	54(10.2%)	135(12.4%)		1.30(0.81–2.07)	0.268
Not sure	308(19.0%)	86(16.3%)	222(20.3%)		1.60(1.03–2.47)	0.034
Latest CD4+ T cell count (cells/μl)				<0.001
<200	59(3.6%)	15(2.8%)	44(4.0%)		Ref
200–500	481(29.7%)	172(32.6%)	309(28.3%)		1.40(0.57–3.60)	0.474
>500	776(48.0%)	291(55.2%)	485(44.5%)		1.85(0.76–4.73)	0.189
Not sure	302(18.7%)	49(9.3%)	253(23.2%)		0.55(0.21–1.48)	0.225
Comorbidities				<0.001
Yes	469(29.0%)	68(12.9%)	401(36.8%)		0.33(0.22–0.47)	<0.001
No	1149(71.0%)	459(87.1%)	690(63.2%)		Ref
View on COVID-19 vaccination				<0.001
Believing in effectiveness of vaccines
Yes	568(35.1%)	258(49.0%)	310(28.4%)		3.01(2.20–4.12)	<0.001
No	1050(64.9%)	269(51.0%)	781(71.6%)		Ref
Concerning about adverse reactions of vaccines				<0.001
Yes	672(41.5%)	107(20.3%)	565(51.8%)		0.31(0.22–0.44)	<0.001
No	946(58.5%)	420(79.7%)	526(48.2%)		Ref
Concerning about negative impact of vaccine on the progression of HIV/AIDS				<0.001
Yes	758(46.8%)	112(21.3%)	646(59.2%)		0.36(0.26–0.50)	<0.001
No	860(53.2%)	415(78.7%)	445(40.8%)		Ref
Concerning about negative impact of vaccine on effectiveness of ART				<0.001
Yes	891(55.1%)	199(37.8%)	692(63.4%)		0.61(0.44–0.85)	0.003
No	727(44.9%)	328(62.2%)	399(36.6%)		Ref
Concerning about disclosure of HIV infection status				<0.001
Yes	635(39.2%)	121(23.0%)	514(47.1%)		0.69(0.49–0.96)	0.030
No	983(60.8%)	406(77.0%)	577(52.9%)		Ref
Consultation
Consulted HIV specialists				0.113
Yes	531(32.8%)	187(35.5%)	344(31.5%)		-
No	1087(67.2%)	340(64.5%)	747(68.5%)		-
Consulted outpatient doctors				0.318
Yes	139(8.6%)	40(7.6%)	99(9.1%)		-
No	1479(91.4%)	487(92.4%)	992(90.9%)		-
Consulted CBOs				0.593
Yes	366(22.6%)	115(21.8%)	251(23.0%)		-
No	1252(77.4%)	412(78.2%)	840(77.0%)		-
Consulted sex partners/friends/family				0.088
Yes	113(7.0%)	45(8.5%)	68(6.2%)		1.71(0.98–2.95)	0.058
No	1505(93.0%)	482(91.5%)	1023(93.8%)		Ref
Discussed with other PLHIV				0.245
Yes	335(20.7%)	118(22.4%)	217(19.9%)		-
No	1283(79.3%)	409(77.6%)	874(80.1%)		-
Receiving media information regarding COVID-19 vaccine				<0.001
Yes	471(29.1%)	207(39.3%)	264(24.2%)		2.23(1.61–3.11)	<0.001
No	1147(70.9%)	320(60.7%)	827(75.8%)		Ref

PLHIV, people living with HIV; aOR, adjusted odds ratio; CI, confidence interval; BMI, body-mass index.

Other, other occupations at low risk for COVID-19 transmission.

Urban functional security workers include government personnel, public security officers, armed police, firefighters, community workers, media staff, guarantee urban water, electricity, heating, coal, gas, logistics, elderly care, sanitation, funeral, and communication personnel.

ART, antiretroviral therapy.

Comorbidities include hyperlipidemia, liver disease, kidney disease, hypertension, allergic rhinitis, allergic dermatitis, respiratory diseases, diabetes, cardiovascular diseases.

CBOs, community-based organizations.

Table 2. Characteristics of PLHIV stratified by adverse reactions after COVID-19 vaccination (N = 527)

Variables		Adverse reactions		Univariable	Multivariable
	Overall	Yes	No	P-value	aOR (95% CI)	P-value
Total	527(100.0%)	155(29.4%)	372(70.6%)
Gender				0.177
Male	503(95.4%)	145(93.5%)	358(96.2%)		Ref
Female	24(4.6%)	10(6.5%)	14(3.8%)		1.81(0.76–4.17)	0.168
Age				0.353
18–29	186(35.3%)	46(29.7%)	140(37.6%)		Ref
30–39	240(45.5%)	78(50.3%)	162(43.5%)		1.49(0.97–2.30)	0.071
40–49	76(14.4%)	24(15.5%)	52(14.0%)		1.37(0.75–2.46)	0.299
≥50	25(4.7%)	7(4.5%)	18(4.8%)		1.19(0.44–2.93)	0.715
BMI				0.245
<18.5	39(7.4%)	7(4.5%)	32(8.6%)		-
18.5–24	327(62.0%)	101(65.2%)	226(60.8%)		-
≥24	161(30.6%)	47(30.3%)	114(30.6%)		-
Received influenza or pneumonia vaccine inthe past 3 years				0.511
Yes	426(80.8%)	128(82.6%)	298(80.1%)		-
No	101(19.2%)	27(17.4%)	74(19.9%)		-
Time of HIV diagnosis				0.120
≤5 year	336(63.8%)	91(58.7%)	245(65.9%)		-
>5 year	191(36.2%)	64(41.3%)	127(34.1%)		-
On ART				0.216
Yes	508(96.4%)	147(94.8%)	361(97.0%)		-
No	19(3.6%)	8(5.2%)	11(3.0%)		-
ART duration				0.184
≤5 years	350(68.9%)	95(64.6%)	255(70.6%)		-
>5 years	158(31.1%)	52(35.4%)	106(29.4%)		-
Latest HIV viral load (copies/ml)				0.661
<50	387(73.4%)	118(76.1%)	269(72.3%)		-
≥50	54(10.2%)	14(9.0%)	40(10.8%)		-
Not sure	86(16.3%)	23(14.8%)	63(16.9%)
Latest CD4+ T cell count (cells/μl)				0.309
<200	15(2.8%)	3(1.9%)	12(3.2%)
200–500	172(32.6%)	43(27.7%)	129(34.7%)		-
>500	291(55.2%)	92(59.4%)	199(53.5%)		-
Not sure	49(9.3%)	17(11.0%)	32(8.6%)		-
Comorbidities				0.392
Yes	68(12.9%)	23(14.8%)	45(12.1%)		-
No	459(87.1%)	132(85.2%)	327(87.9%)		-

PLHIV, people living with HIV; aOR, adjusted odds ratio; CI, confidence interval; BMI, body-mass index.

ART, antiretroviral therapy.

Comorbidities include hyperlipidemia, liver disease, kidney disease, hypertension, allergic rhinitis, allergic dermatitis, respiratory diseases, diabetes, cardiovascular diseases.

Figure 1. Adverse reactions among PLHIV after vaccination. The X-axis is the proportion of adverse reactions. The Y-axis is the specific adverse reactions. PLHIV, people living with HIV. Color shaded regions indicate whether participants have adverse reactions (dark blue = yes, light blue = no).