Safety profiles of homologous and heterologous regimens containing three major types of COVID-19 vaccine among people living with HIV.

BACKGROUND: Existing data on adverse effects (AEs) of homologous and heterologous COVID-19 vaccine regimens among people living with HIV (PLHIV) are limited. METHODS: A prospective cohort study was conducted among Thai PLHIV during 2021-2022. Vaccine types and AEs were collected using an online survey. RESULTS: Of the 398 vaccinated PLHIV, 92% had CD4 count ≥200 cells/µL and 96% were virologically suppressed at enrolment; 38% received two doses and 62% received three doses of COVID-19 vaccines. Inactivated, viral vector and mRNA were the most common vaccine types received as the first, second, and booster doses, respectively. For the first and second vaccine doses, the most common AEs were fever (15% and 11%) and injection site pain (11% and 11%). The mRNA vaccine significantly caused more overall AEs, injection pain, fatigue, and rashes than the other two types. For a booster dose, viral vector vaccine significantly caused more injection site pain and headache than the other two types. The majority of AEs of the first, second and booster doses spontaneously recovered without treatment. By multivariable analysis, receipt of viral vector or mRNA vaccine and age less than 40 years were independently associated with AEs of the primary series vaccines, while having AEs from the previous dose and female sex were independent factors associated with AEs of a booster vaccine. CONCLUSIONS: Our study suggested the safety of homologous and heterologous regimens containing the three types of COVID-19 vaccines among PLHIV and identified those who required close monitoring for vaccine AEs.