BHIVA statement on HIV positive people and access to COVID vaccines
9 December 2020. Related: COVID-19: HIV and COVID-19 coinfection, COVID-19: vaccine research.
Simon Collins, HIV i-Base
On 9 November 2020, BHIVA published information about access to the new UK approval of the Pfizer/BioNTech vaccine against COVID-19 and the implications for people living with HIV. [1, 2]
It outlines that there is no reason for HIV positive people to be at any increased risk from the vaccine, although future research will need to check that immune responses are as strong.
Access to the vaccine across the UK will be based on criteria from a panel of independent experts (the JCVI). These are detailed in the Green Book. [3]
The vaccines will be available free and although vaccination is recommended, it is also voluntary.
Access to vaccines for HIV positive people
BHIVA emphasie that “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 nine priority groups: those in priority group one will get the vaccine first, followed by each group in order. After that the vaccine will be offered to everyone else (that is all the people not in priority groups 1-9). See Table 1 below,
HIV positive people (with uncomplicated infection) are included in priority group 6.
Some HIV positive people with complications that make them more vulnerable can be recommended for group 4. These people need to be added to a central NHS list by their HIV clinic.
BHIVA suggest that the following factors could be used for access to group 4,
- 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.
Table 1: Criteria for access to COVID-19 vaccines by priority group
| Priority group | Risk group |
| 1 | Residents in a care home for older adults. Staff working in care homes for older adults. |
| 2 | All those 80 years of age and over. Frontline Health and social care workers. |
| 3 | All those 75 years of age and over. |
| 4 | All those 70 years of age and over. Clinically extremely vulnerable individuals (not including pregnant women and those under 16 years of age). * |
| 5 | All those 65 years of age and over. |
| 6 | Adults aged 16 to 65 years in an at-risk group (Table 3). ** |
| 7 | All those 60 years of age and over |
| 8 | All those 55 years of age and over |
| 9 | All those 50 years of age and over |
* HIV can be included in group 4 if their heatlh is vulnerable.
** HIV is included in Table 3.
References
- BHIVA. SARS-CoV-2 vaccine advice for adults living with HIV: British HIV Association (BHIVA) & Terrence Higgins Trust (THT) guidance. (9 November 2020).
https://www.bhiva.org/SARS-CoV-2-vaccine-advice-for-adults-living-with-HIV - BHIVA. SARS-CoV-2 vaccine advice for adults living with HIV: British HIV Association (BHIVA) & Terrence Higgins Trust (THT) guidance. Plain English version. (9 November 2020).
https://www.bhiva.org/SARS-CoV-2-vaccine-advice-for-adults-living-with-HIV-plain-english-version - Gov.UK. COVID-19: the green book, chapter 14a.
https://www.gov.uk/government/publications/covid-19-the-green-book-chapter-14a