Factors Associated with Vaccination Adequacy in People Living with HIV: A Cross-Sectional Study

Abstract

People living with HIV (PLHIV) are at greater risk of illness and death from vaccine-preventable diseases. This study aimed to identify the predictors associated with the recommended vaccination schedule for this group. This was a single-center cross-sectional study conducted in a large Brazilian municipality, evaluating the vaccination statuses of 645 PLHIV for nine immunizers. The primary outcome was the adequacy of the vaccination schedule. The vaccination status was assessed for the diphtheria/tetanus, hepatitis B, hepatitis A, measles/mumps/rubella, yellow fever, 13- and 23-valent pneumococcal, meningococcal C, and HPV vaccines. Those who had received all of the recommended vaccinations in accordance with the schedule established by the government at the time of the assessment, without any delays, were classified as having received an “adequate schedule”. The independent variables included sociodemographic, clinical–epidemiological, and social vulnerability factors, analyzed by multiple logistic regression with adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs). Only 47 individuals (7.3%) had an adequate vaccination schedule for all vaccines. The vaccines with the highest adequacy rate were diphtheria and tetanus (533; 82.6%), and the one with the lowest rate was measles/mumps/rubella (MMR) (243; 37.7%). The main predictors of a complete vaccination schedule were the age group, place of clinical follow-up, and where they received their last doses of vaccines. Educational interventions for PLHIV and health professionals are needed to improve the vaccination coverage in this group.