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COVID Immunizations in PLWH

  • 1.  COVID Immunizations in PLWH

    Posted 12-09-2020 22:29
    I'm getting inquiries from patients about the safety of either of the 2 potential COVID 19 vaccinations.

    I'm having a difficult time identifying any resources for this topic.

    Recommendations would be greatly appreciated.

    John Phoenix
    Las Vegas NV

  • 2.  RE: COVID Immunizations in PLWH

    Posted 12-10-2020 16:46
    This was just posted today earlier today on FDA site:
    Fda remove preview
    View this on Fda >

    Christopher Link, MD
    Boise, ID

  • 3.  RE: COVID Immunizations in PLWH

    Posted 12-10-2020 18:12
    My recommendation at this time is based on page 46 of the "Vaccines and Related Biological Products Advisory Committee Meeting" - December 10, 2020, FDA Briefing Document. Under section 8.2. 'Unknown Benefits/Data Gaps', 'Effectiveness in certain populations at high-risk of severe COVID-19':

    Although the proportion of participants at high risk of severe COVID-19 is adequate for the overall evaluation of safety in the available follow-up period, the subset of certain groups such as immunocompromised individuals (e.g., those with HIV/AIDS) is too small to evaluate efficacy outcomes.

    My recommendation for my providers is:
    While the safety data is compelling enough to conclude, via a risk vs benefit analysis, that PLWH with multiple comorbidities should be advised to seek a vaccine, the efficacy data in a risk/benefit analysis for PLWH with a suppressed viral load and a strong CD4 and CD4/CD8 ratio with otherwise no additional comorbidities (or very few comorbidities that are well controlled) be advised at this time to await further clinical data supporting this vaccination in this patient population.

    Christopher Wust
    Byron GA

  • 4.  RE: COVID Immunizations in PLWH

    Posted 12-11-2020 17:19
    While i do agree there is not adequate data to conclusively say what the efficacy of the vaccine will be in special populations like people with HIV the very high overall efficacy suggest this is highly likely. To give an analogy we are using the new biologics available for cancer and rheumatologic conditions without any HIV specific data. Overall we assume they will be effective. At this time I believe it is prudent to go with that assumption and until there is data giving us an idea of the efficacy in the HIV positive population.  From experience, one thing I would say is that even when that time come we should not be surprised to see different studies with different point estimates on account of the differences in immune function intrinsic within this population.

    Leonard Sowah
    Baltimore MD

  • 5.  RE: COVID Immunizations in PLWH

    Posted 12-10-2020 19:13
    Dr. Buchbinder wrote an article on this - I need to find it or you can google it.

    Sara Back
    North Central Bronx Hospital
    New York NY