Background and objective:
Immunisation of patients with altered immunity is indicated to prevent diseases for which they are considered to have an increased vulnerability. Adapted vaccination protocols have been implemented through Preventive Medicine departments since 2013 according to national and regional guidelines in the Valencian Community. This study aims to evaluate the success of high risk patient vaccination through existing clinical pathways by assessing the vaccination protocol in people infected with HIV.

Methods:
We conducted a descriptive retrospective study in the Valencian Health System (VHS). People 18 years or older with an HIV diagnosis (ICD-9 042, V08; ICD-10 Z21, B20) and microbiological confirmation were included. People with less than 14 months between diagnosis and death, withdrawal from the VHS or data extraction date were excluded. Adequate vaccination was assessed through: vaccination protocol initiation success, successful initiation within 6 months of diagnosis and success in protocol completion. Global, antipneumococcal, antimeningococcal, papillomavirus (3 doses) and shingles (2 doses) vaccination coverages were calculated. For global coverage, we assumed that people with sequential antipneumococcal vaccination and 2 antimeningococcal doses (menC+menACWY or 2 MenACWY doses) were fully vaccinated.

Result:
10610 people with an HIV diagnosis were included (22.9% women). Mean age and mean age (SD) at diagnosis were 56.6 (13.1) and 41.7 (10.9) years. 30.5% were foreign, of which 78.4% were non-EU citizens. 39.9% of people had initiated a vaccination protocol, of which 28.8% did so within 6 months of diagnosis and 27.4% were fully vaccinated. 511 people had not received any vaccine in their lifetime. Vaccination coverages were: global 11.3%, antipneumococcal 35.2%, antimeningococcal 14.1%, papillomavirus 16.3% and shingles 3.1% (vaccination strategy since December 2021).

Conclusion:
Current vaccination coverages and patient engagement in the vaccination protocol are suboptimal. While more research is needed on underlying factors, data-based active inclusion strategies may improve the studied indicators.