COVID-19 vaccine hesitancy and behaviours among people living with HIV in British Columbia

Objectives: Immunocompromised individuals face heightened risks from vaccine-preventable diseases, including People Living with HIV (PLHIV), who are further vulnerable due to socio-economic and comorbidity factors, as underscored by the recent COVID-19 pandemic. This study employed a scoping review to identify barriers and facilitators to vaccination in immunocompromised individuals. It also includes a cross-sectional study focused on COVID-19 vaccines in PLHIV to highlight socio-economic and health-related factors influencing vaccine uptake and hesitancy. Methods: The scoping review was guided by the Joanna Briggs Institute’s framework encompassing studies published between January 1974 and July 25, 2022, in academic databases and grey-literature sources. Subsequently, a 34-item anonymous survey was distributed to PLHIV via e-newsletters through HIV/AIDS-related organisations in British Columbia. The survey, conducted between November 2022 and January 2023, collected information on socio-demographics, COVID-19-vulnerability factors, HIV indicators, and vaccine hesitancy scores using the validated adult Vaccine Hesitancy Scale. Descriptive (means and frequencies) and inferential statistics, including ANOVA and Binary logistic regression, were conducted to detect factors associated with COVID-19 vaccine hesitancy and vaccine uptake. Significant level (p<0.05). Results: Seventy-six publications were included in the scoping review, with vaccine uptake ranging from 5.6% to 96.7%. Barriers to vaccine uptake included concerns about adverse effects, lack of physician recommendations, and younger age, while facilitators included older age, perceived disease vulnerability, higher education, prior vaccination history, and longer immunosuppression duration. iv From the cross-sectional study, out of 276 respondents (mean age 29.93±7.548), nearly 40% received three vaccine doses or more, and 82.2% at least one dose. Predictors of COVID-19 vaccine uptake included age [aOR=1.063], bachelor's degree [aOR=0.216], family/friends with COVID-19 [aOR=3.678], HIV viral load >500copies [aOR=0.197], belief in vaccine importance [aOR=0.514], trust in Health Canada's information [aOR=0.494], and concerns about vaccine adverse effects [aOR=0.349]. Conclusions: My study highlights that immunocompromised individuals' vaccination behaviours are influenced by health-related factors, such as concerns about vaccine safety and reliance on physicians’ recommendations due to limited vaccine knowledge. These insights are pivotal in formulating effective public health policies and interventions that address safety concerns and knowledge gaps to support informed vaccination decisions, ultimately fostering vaccine uptake and maintaining an up-to-date vaccination status.Dentistry, Faculty ofGraduat