Many of the studies of COVID-19 vaccines initially limited their recruitment to participants who did not have other medical conditions. After early studies showed that the vaccines were safe in the wider population, people with HIV have begun to take part in studies. This includes each of the four vaccines whose successful efficacy results have been publicly announced.
Nonetheless, relatively small numbers of people with HIV have been involved so far and the length of time they have been in the studies is relatively short. For this reason, specific data on people with HIV has not yet been released from most of the studies.
- The Pfizer study has recruited at least 196 people with HIV, but they were not included in the analysis published in the New England Journal of Medicine or the data which has led to approval by regulators in the US and UK.
- The Moderna study has recruited 176 people with HIV. One person who received the placebo and none who received the vaccine developed COVID-19. No unusual safety concerns were reported in people with HIV.
- The Oxford/AstraZeneca studies have recruited 160 people with HIV in the UK and South Africa, but they were not included in the main data set published in The Lancet. You can read about one HIV-positive study participant’s experience here.
- The Janssen (Johnson & Johnson) vaccine study has involved the largest number of people with HIV so far: 1218 people or 2.8% of all participants. The study was conducted in the United States, South Africa and six Latin American countries. There were two cases of COVID-19 in people with HIV receiving the vaccine and four in people with HIV receiving the placebo. However, due to the small numbers of cases, this difference is not statistically significant and we cannot draw any conclusions about efficacy specifically in people with HIV.
People living with HIV have also been recruited to studies of vaccines by Novavax and Sanofi/GlaxoSmithKline.
When data from these studies are made available, we will report them on aidsmap.com.
“There is no reason to think these vaccines will be less safe for people with HIV,” say the British HIV Association (BHIVA). “Both include some of the genetic material from SARS-CoV-2 (the virus that causes COVID-19) but not the whole virus. This means they are not live vaccines and so are no less safe in people with damaged immune systems.”
Their statement referred specifically to the Pfizer and Oxford/AstraZeneca vaccines, but this is also the case for the Moderna and Janssen vaccines, and almost all COVID-19 vaccines being tested.
BHIVA continues: “It is possible that people with HIV might not respond as well to the vaccine. This means that the vaccine might trigger a weaker response in people with HIV. We will monitor any new evidence as it is released and will update this advice if and when needed.”
The US Centers for Disease Control and Prevention (CDC) advises that "mRNA COVID-19 vaccines may be administered to people with underlying medical conditions provided they have not had a severe allergic reaction to any of the ingredients in the vaccine". They note that people with HIV might be at increased risk for severe COVID-19 and can receive a COVID-19 vaccine. "However, they should be aware of the limited safety data... People living with HIV were included in clinical trials, though safety data specific to this group are not yet available at this time."
A December 2020 special edition of aidsmapLIVE answered viewers' questions about COVID-19 vaccines: click here to watch the programme.