HIV-Specific vs Universal Immunization Coverage in US Children with HIV: A Multi-Site Study

Area of Science:

• Pediatric Infectious Diseases
• Immunology
• Public Health

Background:

• Children living with HIV (CLWH) have unique immunization needs due to increased risk of vaccine-preventable diseases.
• Adherence to specific immunization schedules for CLWH in the US is not well understood.
• This study assesses immunization coverage for HIV-specific and universal vaccines in pediatric HIV clinics.

Purpose of the Study:

• To evaluate the coverage rates of HIV-specific and universal vaccines among children living with HIV (CLWH) in the US.
• To identify factors associated with vaccine coverage in this population.
• To inform strategies for improving immunization adherence in CLWH.

Main Methods:

• Retrospective, cross-sectional study of 238 CLWH (0-18 years) across six US pediatric HIV clinics.
• Evaluation of coverage for universal vaccines and HIV-specific vaccines (e.g., PPSV23, MenACWY).
• Statistical analysis using prevalence ratios to assess associations between coverage and demographic/HIV-related factors.

Main Results:

• HIV-specific vaccine coverage was significantly lower than universal vaccines (e.g., PPSV23 at 25.7%, MenACWY at 46.2%).
• Older age (7-12 years) was associated with lower PPSV23 coverage compared to younger children (0-6 years).
• Receiving primary care at an HIV clinic and having Medicaid were associated with higher coverage for certain vaccines (PPSV23, MenACWY).

Conclusions:

• Significant gaps exist in adhering to recommended HIV-specific immunizations for CLWH.
• Integrated HIV and primary care services show promise for improving vaccine uptake.
• Enhanced clinical decision support systems may be crucial for improving immunization coverage in CLWH.