Factors Contributing to Pneumococcal, COVID-19, and Influenza Vaccine Uptake Among People Living With HIV in Belgium: A Retrospective Study.

Publication date: Sep 01, 2025

Despite antiretroviral therapy, people living with HIV (PLWH) remain vulnerable to vaccine-preventable diseases. Although vaccination is strongly recommended, data on vaccine uptake among PLWH in Belgium remain scarce. This study aims to assess pneumococcal, COVID-19, and influenza vaccine coverage in PLWH in Belgium and identify factors associated with vaccine uptake. We conducted a retrospective study using the data from the HIV database of the Liege University Hospital in Belgium from 2017 to 2022. We evaluated vaccine coverage and collected demographic, clinical, and biological data to assess factors associated with vaccine uptake. Vaccine adherence was characterized as follows: partial adherence: receipt of at least one of the recommended vaccines during the study period and complete vaccination: pneumococcal vaccination, full COVID-19 primary vaccination, and annual influenza vaccination throughout the study period. Among 791 participants, 89. 1% received at least 1 dose of COVID-19 vaccine. Sixty-eight percent received at least 1 dose of influenza vaccine, but only 10. 1% were vaccinated annually. Pneumococcal vaccine coverage was only 37. 8%. Complete vaccine adherence was correlated with age (adjusted odds ratio [aOR]: 1. 02, P = .024). Partial vaccine adherence was associated with age (aOR: 2. 66, P = .026) and number of consultations (aOR: 1. 23, P = .0002) and negatively associated with intravenous drug use (aOR: 0. 15, P = .015). While COVID-19 vaccine uptake was high, vaccination coverage for influenza and pneumococcal disease remains insufficient. Age, healthcare encounters, and drug use were key factors influencing vaccine uptake. Targeted interventions and vaccine reminders should be conducted to increase vaccination rates.

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