For HIV, Factors Associated With Influenza Vaccination Are Identified

Nationally, younger adults and racial minorities are less likely to receive influenza vaccination than non-Hispanic, White adults. Consistent with these statistics, during the 2015-2016 season, most people living with HIV (PLWH) in Delaware’s Cristiana Care Health System who declined influenza vaccination were male, Black, and
45 to 66 years old.

To determine factors that influence vaccination among PLWH, health system researchers compared patient characteristics between influenza vaccine recipients and non‑recipients as recorded in their electronic medical records (EMRs) from October 2020 through March 2021. 

All PLWH aged at least 18 years old in the system in Wilmington met the eligibility criteria for entry into the study, and patient reports of vaccination not included in the EMR required confirmation. Influenza vaccination was reported for 86% (667 of 780) of PLWH in the study population.  

Comparisons between vaccinated and unvaccinated PLWH were done by using Wilcoxon rank sum tests for continuous variables and chi-squared tests for categorical variables. A multivariable logistic regression model including age, sex, race, insurance, poverty level, HIV status, and virologic suppression was used to predict vaccine uptake.

After unadjusted data analysis, older age, lower HIV viral load, and virologic suppression were associated with influenza vaccination to a statistically significant degree. However, after logistic regression modeling, only older age was significantly associated with influenza vaccination (p < 0.01).

The researchers concluded that, although older age was associated with influenza vaccination in the adjusted analysis, the number of unvaccinated patients was small, confidence intervals were wide, and associations were therefore weak. As a result, “Larger studies are needed to further investigate factors associated with vaccine receipt amongst PLWH,” according to presenting author Deborah Kahal, MD, MPH.

—Ellen Kurek


Kahal DA, Wharton B, James C, Caplan R, Arlene BK. People living with HIV during the COVID-19 pandemic: who did (or did not) receive annual influenza vaccination? Paper presented at: IDWeek 2021; September 29-October 3, 2021; Virtual.