Are COVID-19 vaccines safe for people living with HIV?

Many of the COVID-19 vaccines studies have included a small number of people living with HIV in their trials. Despite limited data, available information suggests current WHO recommended COVID-19 vaccines (Pfizer/BioNtech, Oxford/AstraZeneca, Johnson&Johnson) are safe for people living with HIV. The currently available vaccine products are not live vaccines, they include genetic material from SARS-CoV-2 which cannot replicate. Therefore these vaccines are not expected to be less safe in people who are immunocompromised. In addition to this, no pharmacological interactions have been reported between COVID-19 vaccines and antiretroviral medications which people living with HIV should continue to take after vaccination to maintain health.

Recently, a debate in the scientific literature has led to broader concerns about a potential association observed more than a decade ago between adenovirus vector-based vaccines and an increased risk of acquiring HIV infection among men who received this type of vaccine[1]. This unexpected finding was detected in two HIV vaccine trials that used adenovirus vector containing products[2],[3]. The reason for this observed HIV risk remains uncertain, although several follow-up studies have suggested a possible interference in the HIV specific vaccine response or in the CD4 cell susceptibility to HIV infection induced by this kind of vaccine[4],[5]. However, a third study using another adenovirus vector-based vaccine, conducted more recently has not reported this finding[6]. Specific studies on this topic with COVID-19 vaccines are needed. Despite these potential concerns, it is important to highlight that the benefits of all authorized COVID-19 vaccines in a pandemic context currently outweigh the potential risks. WHO will continue to monitor the situation as new data become available and SAGE recommendations will be updated accordingly.