Real-World Effectiveness of COVID-19 Vaccine and Identification of SARS-CoV-2 Variants among People Living with HIV on Highly Active Antiretroviral Therapy in Central Kerala of India—An Ambi-Directional Cohort Study
Joe Thomas,
Priyanka Rajmohan,
Ponnu Jose,
Radhika Kannan,
Rosmi Jose,
Unnikrishnan Uttumadathil Gopinathan,
Lucy Raphael,
Nithya M. Baiju,
Swathi Krishna,
Teny Attokaran,
Jubina Bency A. T,
Aiswarya Venugopal,
Soorya Sheela,
Akhila Kallempadam,
Lee Jose,
Susheela J. Innah,
Pulikkottil Raphael Varghese,
Alex George
Affiliations
Joe Thomas
Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Priyanka Rajmohan
Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Ponnu Jose
Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Radhika Kannan
Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Rosmi Jose
Department of Microbiology, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Unnikrishnan Uttumadathil Gopinathan
Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Lucy Raphael
Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Nithya M. Baiju
Department of Transfusion Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Swathi Krishna
KEM Hospital Research Centre, Pune 412216, Maharashtra, India
Teny Attokaran
Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Jubina Bency A. T
Department of Community Medicine, PK DAS Medical College, Vaniyamkulam 679522, Kerala, India
Aiswarya Venugopal
Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Soorya Sheela
Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Akhila Kallempadam
Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Lee Jose
Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Susheela J. Innah
Department of Transfusion Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Pulikkottil Raphael Varghese
Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Alex George
Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India
Background: Vaccine effectiveness for first-generation coronavirus disease (COVID-19) vaccines among People Living with HIV (PLHIV) in India remains unexplored. This study entails the estimation of the real-world effectiveness of COVID-19 vaccines (AZD1222/Covishield, BBV152/Covaxin) among PLHIV and the identification of variants of SARS-CoV-2 among those infected with COVID-19. Methods: An ambi-directional cohort study was conducted among 925 PLHIV above 18 years of age in two districts of central Kerala, India, from February 2022 to March 2023. Selected PLHIV were recruited as Participant Liaison Officers (PLOs) for the follow-up on the study participants. At enrolment, basic details, baseline CD4 count, and a Nasopharyngeal (NP) swab for RT-PCR were collected. In the follow-up phase, NP swabs were collected from subjects with COVID-19 symptoms. Positive subjects had a CD4 count and genomic sequencing performed. Results: The mean age of the participants was 46.93 ± 11.00 years. The majority, 819 (93.6%), of participants had received at least one dose of any vaccine, while 56 (6.4%) were unvaccinated. A total of 649 (79.24%) participants were vaccinated with Covishield and 169 (20.63%) with Covaxin. In the vaccinated group, 158 (19.3%) reported COVID-19 infection. Vaccine Effectiveness (VE) for one dose of any vaccine was 43.2% (95% CI: 11.8–64.5), p = 0.015. The effectiveness of full vaccination with Covishied was 63.8% (95% CI: 39.3–79.2), p 350 had greater protection from COVID-19, at 53.4% (95% CI: 19.6–75.3) p = 0.004. The incident cases were sub-variants of Omicron (BA.2, BA.2.38, BA.2.10). Conclusions: Full vaccination with Covishield and Covaxin was effective against COVID-19 infection among PLHIV on treatment; albeit, that of Covaxin was higher. A gap of 4 to 6 weeks between the two doses of COVID-19 vaccine was found to have higher VE among PLHIV.