HIV-positive Russians have encountered an unexpected obstacle when trying to get vaccinated against Covid-19: some clinics in the country are refusing to vaccinate them on the grounds that the vaccine is contraindicated for people with this status.
The AIDS Center Foundation has received dozens of complaints about this situation and has reported it to the Ministry of Health, asking for clear recommendations for doctors in the department.
Andrey Ch., a 30-year-old HIV-positive Muscovite, tells the BBC that he is skeptical about the Covid-19 vaccine. However, he decided to get the vaccine because his own infectious disease specialist recommended it. “Given the situation in the country, that they are almost forcibly vaccinating, I decided that I would do it and let them back off,” he decided.
Andrey came to one of the Moscow polyclinics for vaccination. In the questionnaire about chronic diseases that everyone who wants to receive the vaccine fills out, he checked the box next to “HIV infection”. Seeing her, the doctor who examined the Muscovite said he would not give him the vaccine.
“He referred to a prescription. He said that one of the instructions said that people with HIV should be vaccinated with caution, and that he needed a certificate from my infectious disease specialist,” Andrey recalls.
According to him, a friend of his who is also HIV-positive faced a similar situation. He was also sent to get a certificate from an infectious disease specialist, even though there is no such protocol.
Neither the World Health Organization nor the Ministry of Health of Russia prohibits HIV-infected people from getting vaccinated, explains Yuri Poteshkin, a candidate of medical sciences and medical director of the “Atlas” clinic, according to the BBC. “In addition, HIV infection, even with comorbidities, is an indication for the most urgent vaccination, because with this diagnosis the risk of severe course and complications of Covid-19 is higher,” he explains.
According to the WHO, small groups of people with HIV status have participated in many studies of Covid-19 vaccines. Despite the limited data, “available information suggests that WHO licensed vaccines are safe for people with HIV,” the organization said.
The United Nations Joint Programme on HIV/AIDS (UNAIDS) has issued a special clarification on the safety of vaccination and the fact that people living with HIV should be among the priority groups for vaccination because of their vulnerability. But, as the BBC reports, the director of the fund “SPID.Center”, Sergey Abdurakhmanov, says that in recent months the fund has received dozens of requests regarding refusal of vaccination.
In India, special vaccination centers are being set up for patients with HIV status, transgender people and drug users over the age of 45.
According to him, many doctors still “confuse” HIV status with “immunodeficiency” (AIDS – Acquired Immunodeficiency Syndrome, which can develop in people with HIV). According to the latest Ministry of Health guidelines on Covid-19 vaccination, none of the four vaccines approved in Russia is contraindicated for people with HIV. The document states only that “patients with immunodeficiency may not develop an adequate immune response” when Sputnik or Sputnik Lite is administered.
Regarding “KoviVak” from the Chumakov Center, the recommendations indicate that this vaccine “is not contraindicated for people with immunosuppressive or immunodeficient conditions.
“Immunodeficiency and HIV infection are two different things. But many doctors believe that HIV infection means that a person’s immunity is severely weakened, and this is not true, to say the least. If a person undergoes special therapy, he/she is hardly different from normal people in terms of immunity,” says Abdurakhmanov.
After studying conflicting data on polyclinic websites, “SPID.Center” sent a letter to Health Minister Mikhail Murashko on June 30 (a copy of which is available at BBC). “The Foundation considers it necessary to send clarifications, in the form of an information letter, to health care institutions that provide vaccination against coronavirus infection, regarding the inadmissibility of refusing vaccination on the basis of HIV-positive status,” the appeal states.
In a few days, he will receive the second component of the vaccine.
At the time of this article’s publication, the Russian Ministry of Health had not responded to the AIDS Center’s request for clarification on recommendations for vaccination of people with HIV status. But after RBK reported the problem on July 6, a statement by Alexey Mazus, the Health Ministry’s chief external specialist on HIV infection, appeared on the ministry’s website. “HIV infection is not a contraindication to Covid-19 vaccination. The position of the Russian public health service on the necessity of vaccination of HIV-infected patients against Covid-19 is very clearly formulated – vaccination is recognized as the most important measure to ensure the protection of this category of patients and general social safety,” the statement said.
Alexander Gintsburg, the director of the Gamaleya Research Center for Epidemiology and Microbiology, who is also the developer of the “Sputnik” vaccine, commented on the problem. “We have not conducted any special studies, but if a person is in any remission and has a normal number of CD4+ cells (lymphocytes, a group of cells affected by HIV), then they are a normal person and should be vaccinated … This, I would say, is the ignorance of those who refuse, I will not be afraid to use this word,” he told RIA Novosti.
At the same time, Mazus noted in his comments that “profound immunodeficiency (CD4+ less than 50 cells/mcL)” makes it possible to classify a patient “as being at risk of a severe course of COVID-19”. “Vaccination should be a priority for this group,” he said.
Representatives of Rospotrebnadzor also spoke out against refusal to vaccinate people with HIV status. Vadim Pokrovsky, director of the Federal Research and Methodological Center for Combating and Preventing HIV Infection at the Central Research Institute of Epidemiology of Rospotrebnadzor, agreed that the Health Ministry’s recommendations should make a clearer distinction between HIV and “immunodeficiencies.” “HIV is only the late stage of HIV infection, especially since the majority of HIV patients are currently on antiretroviral therapy and typically have already restored their immunity or it has not been significantly reduced,” he told RIA Novosti. “Therefore, in my opinion, there is no reason to deny them help.”
With the participation of Olga Dyakonova.