Assessment of pneumococcal and hepatitis B vaccination coverage in people living with HIV: Adherence to GeSIDA quality indicators.

OBJECTIVE

To assess compliance with GeSIDA pneumococcal and HBV vaccination indicators among people living with HIV (PLWH) followed at a Spanish hospital and identify clinical and organizational factors associated with complete vaccination coverage.

METHODS

Retrospective study including 198 adult PLWH from the Infectious Diseases Unit at Hospital Clínico Universitario San Juan. We analysed pneumococcal and HBV vaccination coverage, Preventive Medicine (MPRE) referral and attendance, demographic variables (age, sex, nationality), clinical parameters (baseline and referral CD4 count, viral load, ART, ACRG3 complexity), and organizational factors using univariate analysis and multivariate logistic regression.

RESULTS

Complete vaccination coverage was 60.8% for pneumococcus (108/178 eligible patients) and 72.6% for HBV (114/157 eligible). Missed vaccination opportunities reached 23.7% for pneumococcus (unvaccinated) and 27.4% for HBV. Univariate analysis showed significant associations between complete vaccination and MPRE referral (p < 0.001 both vaccines), MPRE attendance (p < 0.001), and time since HIV diagnosis (p = 0.030 HBV). Multivariate analysis identified no independent significant variables for pneumococcal vaccination; HBV showed complete separation due to MPRE attendance.

CONCLUSIONS

Although better than previous studies, vaccination coverage remains below GeSIDA standards. MPRE referral and attendance represent the main organizational barriers. Targeted interventions to optimize care pathways are needed to improve vaccine protection in this vulnerable population.