2393. Factors Associated with Time to COVID-19 Vaccination among People with HIV

BACKGROUND: The COVID-19 pandemic has significantly impacted at-risk populations, including people with HIV/AIDS (PWHA). Several reports indicate a higher risk of SARS-CoV-2 infection and mortality in PWHA compared to the general population. Despite an effective vaccine, PWHA with low CD4 count develop a weak immune response and are at risk of severe breakthrough infections. Vaccination gaps have been identified amongst PWHA, but factors associated with time to mRNA COVID-19 vaccine initiation and first booster have not been studied. METHODS: PWHA age ≥ 18 years, in HIV care at an urban clinic, and who completed the primary series of COVID-19 vaccines were invited to complete an online survey. Socio-demographic and clinical characteristics and COVID-19 vaccination motivators were assessed and complemented by a review of medical records. Statements on motivators to vaccination were rated on a 5-point Likert scale treated as ordinal data (minimum score 19, maximum 95). Factors associated with time to first COVID-19 vaccine and first booster were analyzed by the Kaplan-Meier method. RESULTS: A total of 129 patients enrolled; 83% (108/129) received the COVID-19 booster. Mean age was 50.3 (±10.9) years; 26.4% were female; 54.3% were Black, and 34.1% were White; 91.5% were non-Hispanic. The mean nadir CD4 count throughout their care was 309.4 (±245.6) cells/mm3. The mean time to first COVID-19 vaccine dose was 2.8 (±1.8) months from December 2020 (Pfizer-BioNTech vaccine approval), and time to first booster was 9.9 (±3.8) months from the date of the first vaccine. Factors associated with quicker uptake of the first dose included being ≥ 51 years of age (p=0.001), White race (p=0.027), male sex (p=0.023), and gay/lesbian identity (p=0.014) (Fig 1). Factors associated with quicker uptake of the first booster included being ≥ 51 years of age (p < 0.000) and a COVID-19 motivators’ survey score > 69 (p=0.017) (Fig 2). Figure 1. [Figure: see text] Kaplan-Meier Curves for Time to COVID-19 First Dose Vaccination Among People Living with HIV/AIDS Receiving HIV Care through Penn Medicine. Figure 2. [Figure: see text] Kaplan-Meier Curves for Time to COVID-19 First Booster Vaccination Among People Living with HIV/AIDS Receiving HIV Care through Penn Medicine. CONCLUSION: We found high rates of COVID-19 booster vaccination among PWHA. White and male patients got vaccinated quicker in the early phase of the pandemic; however, race and age-based inequities resolved in the later phase of the pandemic. Motivation to vaccination emerged as a facilitator for uptake of booster vaccines. DISCLOSURES: All Authors: No reported disclosures