The COVID-19 vaccine does not interfere with antiretroviral medication or cause adverse side effects people living with HIV, provided a person’s immune system is intact, meaning that they are not suffering from any other ailments or infections.

This is according to Dr Lerato Masemola, a general practitioner based in Johannesburg.

“Taking the vaccine while experiencing any symptoms of flu or illness may result in a more severe illness due to an already activated immune response to the current undiagnosed infection,” she said.

However, she added that it is important to avoid becoming overly anxious about the vaccine, especially based on fake news that is being proliferated by some people.

“Being concerned about vaccines is understandable, but panic states can mimic chest pains and shortness of breath, which can also be side effects post-vaccination.”

Masemola advised people who were unsure about getting vaccinated due to their concerns about their immune systems to seek further medical advice from their healthcare providers.

Same benefits for people living with HIV

According to a report by the Joint United Nations Programme on HIV/AIDS (UNAIDS), the COVID-19 vaccine holds the same benefits for people who are living with HIV, as they do for all individuals and communities – the prevention of severe illness and potentially reduced transmission of the virus.

“Advocacy is needed so that no one is left behind and so that the national vaccination programs do not exclude people from key populations who may have limited access to health services. Based on recent data, people living with HIV, regardless of their CD4 count, appear to be at an increased risk of severe outcomes and death due to COVID-19 compared to other people.”

The UNAIDS report shows how COVID-19 lockdowns and other restrictions have disrupted HIV testing and in many countries this has led to steep drops in HIV diagnoses, referrals to care services and HIV treatment initiations.

Fewer HIV diagnoses

In KwaZulu-Natal, for example, there was a 48% drop in HIV testing after the first national lockdown was imposed in April 2020. There were also fewer new HIV diagnoses and a marked drop in treatment initiation. This occurred as 28 000 HIV community healthcare workers were moved from HIV testing to COVID-19 symptom screening.

“People living with HIV should continue to take effective antiretroviral therapy. Even after vaccination, people should continue to take preventive measures against the virus, such as physical distancing, regular hand washing and wearing face coverings,” said Masemola.

“I tested positive for the coronavirus in December, and it was the hardest thing I have ever had to cope with. I spent 10 days in quarantine and still didn’t feel better, my breathing was getting worse, and I didn’t have an appetite throughout. I was advised by the hospital to quarantine for an additional 10 days. I spent the whole month and the first few weeks of the new year recovering,” said Nonhlanhla Madonsela (25), from Pretoria.

Urging others to get the shot

Madonsela has been living with HIV for six years, and was diagnosed with asthma in February this year while she still had long COVID-19.

“That’s why I am so eager to get vaccinated and encourage my other friends and members of my community to register. The doctor at the hospital told me that my immune system, as a person living with HIV, fights the virus differently than other people – it may be weaker at times and the symptoms may last longer for me, as they did with the long COVID-19 infection. So, providing those extra antibodies of support through the vaccine is a decision I don’t regret.”

Madonsela said she is aware that the vaccine will not protect her from contracting the virus again, nor is it a guarantee that she won’t be hospitalised, but she is confident that her immune system will be strengthened against the virus.

Booster shot

According to the Interim Guidance for Covid-19 and Person’s living with HIV, people who are living with HIV are at an increased risk for severe outcomes from COVID-19, compared to people who do not have HIV. The guide notes that they should be included in the category of high-risk medical conditions when developing vaccine priority.

“People living with HIV were included in clinical trials of the two mRNA vaccines. At this time, the safety and efficacy in this specific subgroup have not been fully reported. People living with HIV, who are well controlled on antiretroviral therapy, typically respond well to licensed vaccines. Confidentiality about their underlying condition should be preserved when administering vaccines to people with HIV,” the guide said.

The US Centre for Disease Control and Prevention has recommended that immunocompromised people who received the Pfizer vaccines should receive a third dose to improve their chances of developing an adequate antibody response.

“The recommendation applies to people who are receiving immunosuppressive treatment for cancer and to people with HIV with low CD4 counts or detectable HIV viral load. The recommendation does not apply to recipients of the Johnson & Johnson single-dose vaccine, as there is not sufficient data to make a recommendation yet.”

Other countries in Europe, such as France, have begun the rollout of the third COVID-19 vaccine booster shot.

Madonsela said she would be willing to take a third jab to boost her immune system against the virus. She believes South Africa should continue the discussion around making vaccines mandatory to ensure the safety of people with compromised immune systems. – Health-e News