COVID-19 and HIV

Most people living with HIV do not need to take any extra precautions just because of HIV. We advise following national advice

  • Staying at home, except for specific reasons such as exercise or essential shopping
  • Working from home if possible
  • Meeting only one person outside your household and meeting them outside in the open air where the risk of COVID-19 transmission is lower
  • Wearing a face mask
  • Washing your hands regularly for at least 20 seconds

If you have HIV but are not on medication for it, or have a low CD4 count (less than 200) then we recommend following the government advice very carefully.

If you have an extremely low CD4 count or have recently had a severe infection, we will contact you with further advice.

You might have other health reasons why should be careful, for example:

  • Diabetes
  • Heart disease
  • Lung disease
  • If you are overweight

You might have other health conditions that make you extremely vulnerable, for example:

  • If you have had an organ transplant
  • If you have severe kidney disease, or are on dialysis
  • If you are being treated for cancer with chemotherapy or radiotherapy
  • If you take other medication that suppresses your immune system

Remember that there are benefits to your general wellbeing and physical health in going out and getting regular daily exercise as well as in keeping in contact (safely) with other people

Leaving your home to get care and treatment is also important for your health. During the November lockdown, you should continue to attend medical appointments. It is a good idea to make sure that your treatment is working, your immune system is strong and that you have a good supply of medication.

It is especially important to get the flu vaccine this year, and to make sure you are up to date with other recommended vaccines by checking with your GP

  • Flu vaccine (every year)
  • Pneumococcal vaccine

HIV and the COVID-19 vaccine

All of the COVID-19 vaccines are considered safe and effective for people living with HIV

The patient information leaflets for the three COVID-19 vaccines all list a ‘weakened immune system’ under the warnings. The leaflets advise affected patients to tell their doctor, nurse or pharmacist before vaccination.

However, this advice in the patient information leaflets is not based on concerns about safety. There is currently no evidence for more side effects in people with HIV. The guidance is there mainly because there is not yet very much research information about people with immune deficiency and/or HIV.

With some vaccines, people with HIV can produce a weaker response. We do not yet know if this is the case for the COVID-19 vaccines but they are expected to be protective in people with HIV and are recommended. The Department of Health recommends COVID-19 vaccination for all people with HIV, regardless of their CD4 count.

All currently approved vaccines are thought to be safe for people with suppressed immune systems.

Is there any interplay between COVID-19 vaccine and HIV drugs?

No. HIV drugs do not affect the effectiveness of COVID-19 vaccines and COVID-19 vaccines do not affect how well HIV drugs work either. If you have had side effects or an allergic reaction to particular HIV drugs in the past, that does not mean you will get side effects from the COVID-19 vaccines.

There is no evidence that HIV drugs, taken as HIV treatment or prevention (PrEP) can be used to prevent or treat COVID-19. Some studies are looking into using HIV drugs to prevent COVID-19 but there are no results yet and no good evidence to suggest they will be effective.

Who will get the vaccine?

People will receive the vaccine in strict order of priority based on their age, health, occupation, whether they live in a care or residential home and who they live with. Vaccines will be offered strictly based on these priorities. There is no way to jump the queue, and you will be contacted when your vaccine is due.

There are 9 priority groups: those in priority group 1 will get the vaccine first, followed by each in turn up until priority 9. After that the vaccine will be offered to everyone else (that is all the people not in priority groups 1-9).

Everyone with HIV is automatically in priority group 6 so you will get the vaccine earlier than many people. If your clinic thinks you are at higher risk you can be put into priority group 4, and get the vaccine sooner, but you will need to be added to a central NHS list to be put into priority group 4 - please contact your HIV clinic if you think this applies to you. We advise that the people at higher risk may include:

  • People with a CD4 count less than 50
  • People with a serious HIV-related illness (like an opportunistic infection) in the last 6 months
  • People with a CD4 count between 50 and 200 with other issues that increase the risk of getting very sick
  • People with ‘multi-morbidity’ meaning that they have other health conditions that may increase the risk of getting very sick.

Will I have to have the vaccine?

No, nobody has to have the vaccine. However, we strongly recommend that everyone who is offered the vaccine accepts it. Although vaccine development has been very fast, it has been to the same high standards as any other vaccine trial and includes very careful monitoring of side effects. If anything changes we will update this guidance.

Where can I get the vaccine?

Currently vaccines are being offered in some hospitals, some pharmacies and in local vaccination centres run by GPs. Vaccines are not available in your local HIV clinic. You need to be registered with a GP in order to get a vaccination. Most people living with HIV are in priority group 6 which, for many people, means they are eligible for vaccination before other people of their age. However, if your GP does not know that you are HIV positive, you will not be offered the vaccination early. We have asked the national vaccine team to clarify how people who are not registered with a GP will be able to get the vaccine. We will update you on this and on any new plans to make the vaccine made more widely available from different places.

Does having the vaccine mean I can stop following social distancing rules?

No. It will take many months to vaccinate everyone and it remains important to continue to wash your hands regularly, to wear a mask and to follow your local guidance about social distancing.

Find out more - British HIV Association

Frequently asked questions from i-base