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Vaccine. 2019 May 4. pii: S0264-410X(19)30568-7. doi: 10.1016/j.vaccine.2019.04.080. [Epub ahead of print]

Vaccine safety in HIV-infected adults within the Vaccine Safety Datalink Project.

Author information

1
Kaiser Permanente Southern California, USA. Electronic address: Rulin.C.Hechter@kp.org.
2
Kaiser Permanente Southern California, USA. Electronic address: Lei.X.Qian@kp.org.
3
Kaiser Permanente Southern California, USA. Electronic address: Sara.Y.Tartof@kp.org.
4
Kaiser Permanente Southern California, USA. Electronic address: Lina.S.Sy@kp.org.
5
Kaiser Permanente Northern California, USA. Electronic address: Nicola.Klein@kp.org.
6
Immunization Safety Office, Centers for Disease Control and Prevention, USA. Electronic address: eiw8@cdc.gov.
7
Kaiser Permanente Southern California, USA. Electronic address: Cheryl.M.Carlson@kp.org.
8
Kaiser Permanente Northwest, USA. Electronic address: Allison.Naleway@kpchr.org.
9
Marshfield Clinic Research Institute, USA. Electronic address: mclean.huong@marshfieldresearch.org.
10
Kaiser Permanente Southern California, USA. Electronic address: Steven.J.Jacobsen@kp.org.

Abstract

OBJECTIVES:

We evaluate safety of routine vaccination among adults infected with human immunodeficiency virus (HIV) in five healthcare organizations in the United States.

METHODS:

We conducted a retrospective cohort study of HIV-infected adults who received inactivated influenza vaccines, hepatitis B vaccines, pneumococcal vaccines, or tetanus, diphtheria, and acellular pertussis vaccines between 2002 and 2013. We conducted self-controlled case series analysis to estimate the relative risk (RR) for 11 pre-specified adverse events (AEs) requiring medical attention.

RESULTS:

Among 20,417 HIV-infected adults (90.2% male), a total of 137,674 vaccine doses were administered. Based on ICD-9 codes, we detected an increased risk of cellulitis and infection (RR: 1.18, 95% CI: 1.03-1.35) among all patients, and an increased risk of stroke/cerebrovascular diseases among patients with an HIV viral load >10,000 copies/ml (adjusted RR: 3.94, 95% CI: 1.32-11.72). Further analyses on chart confirmed cases of stroke/cerebrovascular diseases indicated no statistically significant increased risk (adjusted RR: 1.72, 95% CI: 0.41-7.24). There was no evidence of increased risk for other AEs following routine vaccination in HIV-infected adults.

CONCLUSIONS:

Routinely administered vaccines are generally safe for HIV-infected adults.

KEYWORDS:

HIV; Vaccine Safety Datalink; Vaccine safety

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