Cent Eur J Public Health 2026, 34(1):16-21 | DOI: 10.21101/cejph.a8674

Vaccination coverage against COVID-19 among people living with HIV infection in the Czech Republic

Lukáš Fleischhans1, Barbora Králíčková1, Marek Malý2, Ladislav Machala3, David Jilich1
1 Department of Infectious Diseases, First Faculty of Medicine, Charles University, University Hospital Bulovka, Prague, Czech Republic
2 National Institute of Public Health, Prague, Czech Republic
3 Department of Infectious Diseases, Third Faculty of Medicine, Charles University, University Hospital Bulovka, Prague, Czech Republic

Objectives: The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected hundreds of millions of individuals globally. Vaccination has become a promptly effective preventive procedure. People living with HIV (PLHIV) are in increased risk of many infections including COVID-19. We aimed to analyse the first phase of vaccination (January 2021–June 2022) in the Czech Republic in PLHIV focusing on vaccination coverage, vaccine hesitancy and breakthrough infections.

Methods: In this single-centre, open-label, prospective study we have enrolled 1,758 PLHIV with median age of 42.5 years and median CD4+ T cells count (cluster of differentiation) 800/µL.

Results: Vaccination coverage was 84.7% and first booster dose was received by 71.7% of those who completed vaccination. Only 78 individuals (4.4%) have actively rejected vaccination. The most frequent vaccination scheme (60.3%) was Comirnaty vaccine plus booster of the same vaccine. There was a significant difference between vaccinated and unvaccinated individuals in age, CD4+ count, CD4/CD8 ratio, virological suppression on antiretroviral therapy (ART) duration of HIV and level of education (p < 0.001). Prevalence of breakthrough infection was seen in 21.4%. There was no significant difference among individual vaccines (p = 0.715). Individuals with breakthrough infections were statistically younger (p = 0.001) with some risk factors in 25.1%.

Conclusion: In this prospective study we have seen higher vaccination coverage against COVID-19 in PLHIV in the Czech Republic in comparison with the general Czech population. Hesitancy, resulting in rejection of vaccination, was lower in our cohort as regards affinity to the HIV clinic, and breakthrough infections were noticed and occurred particularly in younger age groups.

Keywords: HIV, COVID-19, vaccination, hesitancy, breakthrough infections

Received: June 6, 2025; Revised: December 14, 2025; Accepted: December 14, 2025; Published: March 31, 2026  Show citation

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Fleischhans L, Králíčková B, Malý M, Machala L, Jilich D. Vaccination coverage against COVID-19 among people living with HIV infection in the Czech Republic. Cent Eur J Public Health. 2026;34(1):16-21. doi: 10.21101/cejph.a8674.
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