Will you help us end HIV stigma?
The UK was the first country to approve the use of a SARS-CoV-2 vaccine, Pfizer’s BioNTech COVID-19 vaccine, to prevent COVID-19 disease on 2nd December 2020. The AstraZeneca/Oxford vaccine was also approved for use in December 2020, with vaccinations beginning on 4th January 2021, and the Moderna vaccine on 8th January 2021 with first UK doses expected Spring 2021.
The patient information leaflets for the Pfizer/BioNTech, AstraZeneca/Oxford COVID-19 and Moderna vaccines all list immunodeficiency under the warnings and precautions for use, with Pfizer using HIV as an example, advising affected patients to tell their doctor/nurse/pharmacist before vaccination.
It is important to state that this is not based on concerns over safety. There is currently no evidence to suggest a higher risk of side effects in people with HIV. The guidance is mainly based on the fact that there are limited data for people with immune deficiency and/or HIV.
It is possible that people with HIV will produce a weaker response to the COVID-19 vaccines, but the vaccines are still expected to be protective, and are recommended.
The Department of Health guidance is clear that people with HIV, regardless of CD4 count, should have a COVID-19 vaccine. None of the currently available COVID-19 vaccines is live so the vaccines cannot cause COVID-19.
People will receive the vaccine in strict order of priority based on their age, health, occupation, whether they live in a care or residential home and who they live with. Vaccines will be offered strictly based on these priorities. There is no way to jump the queue, and you will be contacted when your vaccine is due.
There are 9 priority groups: those in priority group 1 will get the vaccine first, followed by each in turn up until priority 9. After that the vaccine will be offered to everyone else (that is all the people not in priority groups 1-9). Most people living with HIV will be offered a vaccine as part of group six (the 'at-risk group'). If your GP is not aware that you are living with HIV, and there is no other reason why you would be in the at risk-group, then you may not be offered a vaccine until later. This means it might be a good idea for you to tell your GP about your HIV status if you haven't.
We advise that the people at higher risk may include:
People with a CD4 count less than 50
People with a serious HIV-related illness (e.g. an opportunistic infection) in the last 6 months
People with a CD4 count between 50 and 200 with other issues that increase the risk of getting very sick, such as:- Detectable viral load- Low nadir CD4 (the lowest CD4 before starting HIV treatment)- Other medical conditions associated with increased risk of severe COVID (such as asthma, COPD, diabetes, heart disease, kidney disease, liver disease, Parkinson’s disease, multiple sclerosis, motor neurone disease, conditions or drugs that suppress the immune system (e.g. steroid treatment), severe obesity.
People with ‘multi-morbidity’ meaning that they have other health conditions that may increase the risk of getting very sick.
More information about shielding and being at high risk is available here from the Scottish Government.
We recommend that you take the vaccine when offered. If the vaccine is for your own health, then this is always still your choice. You do not have to have the vaccine.
Please talk to your doctor if you have any worries or concerns. Or if you are not sure about having the vaccine.
If you are offered the vaccine because of your job, not having the vaccine might affect the work you can do.
In the future, some countries might want travellers to be vaccinated.
No. It will take many months to vaccinate everyone and it remains important to continue to wash your hands regularly, to wear a mask and to follow your local guidance about social distancing.