People with suppressed HIV respond well to mRNA vaccines, but individuals with a low CD4 count may not be adequately protected.
People living with HIV generally respond well to COVID-19 vaccines—especially if they receive booster shots—thereby dramatically reducing their risk of severe illness and death, according to several recent studies. But those with poorly controlled HIV or advanced immune suppression may not fare as well, underlining the importance of antiretroviral treatment.
As previously reported, early studies of COVID vaccine response among HIV-positive people found that those with well-controlled HIV and an adequate CD4 count could achieve SARS-CoV-2 antibody levels and T-cell responses comparable to those of HIV-negative people, though they might need additional doses to achieve full protection.
Now, with another year’s worth of data, people with HIV can generally feel confident that COVID vaccines, as well as prior SARS-CoV-2 infection, provide good protection. But those with unsuppressed HIV or a low CD4 count—along with older individuals and those with underlying health conditions—may have slower, weaker or less durable immune responses and could potentially benefit from additional precautions.