Targeted Coordination Is Crucial in Boosting Pneumococcal Vaccine Coverage

Targeted patient strategies and greater coordination across all care levels are key in boosting pneumococcal vaccine coverage among people living with HIV (PLWH), according to a study published in Vaccine: X.¹ By addressing both individual and health-system factors, researchers believe coordination between primary care and additional health care arenas can bolster vaccine adherence across all populations and immunizations.

“Vaccines are especially important for people with chronic health conditions like HIV, which can make it harder to fight off vaccine-preventable diseases like pneumococcal disease or the flu,” wrote the Minority HIV/AIDS Fund.² “HIV can also make it more likely that you’ll have serious complications from those diseases, which is why getting recommended vaccines is an important part of your overall HIV medical care.”

HIV, or the human immunodeficiency virus, is a condition that impacts patients’ ability to fight viruses and diseases. It is spread by certain bodily fluids and makes the value of vaccination significantly more heightened when compared with patients who do not have HIV.³

READ MORE: The Pharmacist’s Expertise in Managing Pneumococcal Diseases, Vaccines

However, according to another study published in Vaccines, many global vaccination guidelines for PLWH are heterogenous, meaning not all vaccines are necessarily recommended for all patients who have reported an HIV diagnosis.⁴ With the unique and at-risk positioning PLWH are placed in regarding immunization, this population can become a key focus when exploring vaccine coverage across large cohorts of patients.

Pneumococcal Disease Risk Among PLWH

For pneumococcal diseases among PLWH, the risks are significant and force these patients to keep close attention to their pneumococcal vaccine schedules. According to aidsmap, severe pneumococcal disease rates were up to 50 times higher in adults living with HIV. Furthermore, rates were still 7 times higher when PLWH were taking HIV medication.⁵

While PLWH must be aware of various risks that impact their mortality and overall quality of life, pneumococcal diseases may just be 1 factor among many others. This leads researchers and health care providers to step in, educate, and promote the importance of pneumococcal vaccination in this population. Researchers of the current study aimed to better understand pneumococcal vaccine coverage among this population.

“Globally, there is little research on adults with HIV infection regarding vaccine coverage, adherence, and factors that influence it,” wrote authors of the study.¹ “For this reason, this study set 2 objectives: to determine vaccination coverage and to describe and identify the clinical and social characteristics associated with administration of the second pneumococcal vaccine dose in people diagnosed with HIV in Andalusia who received the first dose between January 1, 2014, and March 31, 2022.”

Pneumococcal Vaccine Coverage in PLWH

They conducted a retrospective cohort of adults living with HIV vaccinated against pneumococcus bacteria in the Andalusian Public Health System of Spain. Data were extracted from this population between January 1, 2014, and March 31, 2023.

In the context of this study, vaccine coverage was explored through patients’ time from first to second dose of the pneumococcal vaccine. All observations were then considered “censored” if a patient was lost during the follow-up time after their first dose. On top of their time to second dose, researchers also recorded participants’ age, sex, hospital follow-up destination, and clinical stage of illness.

The final analysis included 4938 participants (mean age, 41.7 years; 83.9% men). In the first year following patients’ first pneumococcal vaccine dose, coverage only reached 37.2%. By the end of the study’s follow-up period, those rates reached 80% of the population, still falling significantly behind the recommended 95% threshold.

“People living with HIV are at higher risk of bacterial pneumonia and invasive pneumococcal disease, which are associated with increased morbidity and mortality compared with the general population,” they continued.¹ “This [study] shows that coverage is low, does not meet recommended standards, and requires further attention to identify the possible causes behind these low numbers.”

Especially among PLWH, these rates are considerably low. Furthermore, researchers related these findings to the overall pneumococcal vaccination rates of the general population in Spain, which were also significantly lacking. While further efforts in boosting coverage are needed, further attention toward PLWH is also necessary.

Going forward, researchers suggested a targeted approach among this population, employing the expertise of providers on all care levels. However, despite the pharmacist’s vaccine expertise, as well as the knowledge levels of other infectious disease specialists, researchers believe primary care can be significantly more utilized to boost vaccine rates.

“There is considerable room for improvement in overall coverage, highlighting the need to strengthen coordination across care levels and promote primary care involvement in immunization,” they concluded.¹

READ MORE: Pneumococcal Resource Center

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REFERENCES

1. Heredia-Ruiz MR, Jiménez-Murillo JL, Lopez-Gigosos R, et al. Pneumococcal vaccine coverage and factors linked to second-dose administration in HIV patients in Andalusia (Spain), 2014–2022. Vaccine X. 2025;28:100769-100769. https://doi.org/10.1016/j.jvacx.2025.100769

2. Vaccines and people with HIV. Minority HIV/AIDS Fund. December 12, 2025. Accessed December 19, 2025. https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/immunizations-recommended-for-people-living-with-hiv

3. About HIV. CDC. January 14, 2025. Accessed December 19, 2025. https://www.cdc.gov/hiv/about/index.html

4. De Vito A, Colpani A, Trunfio M, et al. Living with HIV and getting vaccinated: a narrative review. Vaccines. 2023;11(5):896. https://doi.org/10.3390/vaccines11050896

5. Stanford A. Pneumococcal disease and HIV. August 2023. Accessed December 19, 2025. https://www.aidsmap.com/about-hiv/pneumococcal-disease-and-hiv