{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T22:45:54Z","timestamp":1776638754052,"version":"3.51.2"},"reference-count":53,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T00:00:00Z","timestamp":1733184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Capital\u2019s Funds for Health Improvement and Research","award":["2024-1-1203"],"award-info":[{"award-number":["2024-1-1203"]}]},{"name":"Capital\u2019s Funds for Health Improvement and Research","award":["DFL20221601"],"award-info":[{"award-number":["DFL20221601"]}]},{"name":"Capital\u2019s Funds for Health Improvement and Research","award":["leaders-03-21"],"award-info":[{"award-number":["leaders-03-21"]}]},{"name":"Dengfeng Talent Support Program of Beijing Municipal Administration of Hospitals","award":["2024-1-1203"],"award-info":[{"award-number":["2024-1-1203"]}]},{"name":"Dengfeng Talent Support Program of Beijing Municipal Administration of Hospitals","award":["DFL20221601"],"award-info":[{"award-number":["DFL20221601"]}]},{"name":"Dengfeng Talent Support Program of Beijing Municipal Administration of Hospitals","award":["leaders-03-21"],"award-info":[{"award-number":["leaders-03-21"]}]},{"name":"High-level Public Health Technical Personnel Construction Project","award":["2024-1-1203"],"award-info":[{"award-number":["2024-1-1203"]}]},{"name":"High-level Public Health Technical Personnel Construction Project","award":["DFL20221601"],"award-info":[{"award-number":["DFL20221601"]}]},{"name":"High-level Public Health Technical Personnel Construction Project","award":["leaders-03-21"],"award-info":[{"award-number":["leaders-03-21"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Objectives: Accumulating evidence has confirmed the efficacy and safety of COVID-19 vaccines against SARS-CoV-2 infection. However, the effect of COVID-19 vaccination on immuno-virological parameters in people with HIV (PWH) is uncertain. Methods: A total of 372 PWH treated at Beijing Ditan Hospital were included. Unvaccinated PWH were matched 1:3 with vaccinated PWH using a propensity score matching algorithm. Differences in immuno-virological markers between the matched groups were analyzed. The Wilcoxon signed rank test was used to test for changes in CD4 and CD8 counts and HIV viral load over two months around vaccination. In addition, we investigated the long-term changes in HIV-related markers in different vaccination dose groups and in the entire vaccinated population. Results: Vaccinated PWH had a higher CD4\/CD8 ratio (0.64 (0.49, 0.78) vs. 0.80 (0.56, 1.03), p = 0.037) than unvaccinated PWH within a two-month window after the third dose. There were 337 PWH who received COVID-19 vaccination, and 73.9% (n = 249) received three doses of vaccine. We observed a transient increase in CD4 count and CD4\/CD8 ratio within a two-month window after vaccination, especially after the second dose (CD4 count: 583.5 (428.5, 706.8) vs. 618.0 (452.0, 744.0), p = 0.018; CD4\/CD8 ratio: 0.70 (0.50, 0.91) vs. 0.71 (0.53, 0.96), p &lt; 0.001)) and the third dose (CD4 count: 575.5 (435.5, 717.0) vs. 577.5 (440.8, 754.8), p = 0.001; CD4\/CD8 ratio: 0.70 (0.52, 0.93) vs. 0.79 (0.53, 1.00), p &lt; 0.001)). Recent CD4 counts and CD4\/CD8 ratios were lower than after COVID-19 but remained higher than before COVID-19 in vaccinated PWH. In addition, COVID-19 vaccination had no negative effect on HIV viral load. Conclusions: A transient increase in CD4 count and CD4\/CD8 ratio was observed after COVID-19 vaccination. However, the enhanced cellular immune response induced by vaccination may diminish over time and return to normal levels. There is no adverse effect of vaccination on HIV viral load.<\/jats:p>","DOI":"10.3390\/vaccines12121365","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T04:01:29Z","timestamp":1733198489000},"page":"1365","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["COVID-19 Vaccination and Transient Increase in CD4\/CD8 Cell Counts in People with HIV: Evidence from China"],"prefix":"10.3390","volume":"12","author":[{"given":"Yanyan","family":"Li","sequence":"first","affiliation":[{"name":"Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China"},{"name":"National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingying","family":"Lin","sequence":"additional","affiliation":[{"name":"Center of Integrative Medicine, Peking University Ditan Teaching Hospital, Beijing 100015, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4873-0119","authenticated-orcid":false,"given":"Yunyun","family":"Yi","sequence":"additional","affiliation":[{"name":"Tuberculosis Prevention and Control Key Laboratory, Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5499-8756","authenticated-orcid":false,"given":"Na","family":"Zhu","sequence":"additional","affiliation":[{"name":"Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China"},{"name":"National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyu","family":"Cui","sequence":"additional","affiliation":[{"name":"Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China"},{"name":"National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China"},{"name":"National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China"},{"name":"Center of Integrative Medicine, Peking University Ditan Teaching Hospital, Beijing 100015, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1038\/s41579-023-00878-2","article-title":"The evolution of SARS-CoV-2","volume":"21","author":"Markov","year":"2023","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"677","DOI":"10.3949\/ccjm.90a.22102","article-title":"COVID-19: A management update","volume":"90","author":"Bash","year":"2023","journal-title":"Cleve. Clin. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1093\/bmb\/ldac031","article-title":"COVID-19 infection in people living with HIV","volume":"147","author":"Brolly","year":"2023","journal-title":"Br. Med. Bull."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/QCO.0000000000000898","article-title":"Estimating the global impact of coronavirus disease 2019 on people living with HIV","volume":"36","author":"Thornhill","year":"2023","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1038\/s41392-023-01724-w","article-title":"Strategies for the development and approval of COVID-19 vaccines and therapeutics in the post-pandemic period","volume":"8","author":"Ao","year":"2023","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/COH.0000000000000790","article-title":"The effect of HIV on COVID-19 vaccine responses","volume":"18","author":"Levy","year":"2023","journal-title":"Curr. Opin. HIV AIDS"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1038\/s41467-022-28825-4","article-title":"The indirect effect of mRNA-based COVID-19 vaccination on healthcare workers\u2019 unvaccinated household members","volume":"13","author":"Salo","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1001\/jama.2022.17985","article-title":"Incidence of Severe COVID-19 Illness Following Vaccination and Booster With BNT162b2, mRNA-1273, and Ad26.COV2.S Vaccines","volume":"328","author":"Kelly","year":"2022","journal-title":"JAMA"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.ijid.2021.10.021","article-title":"Transient increase in plasma HIV RNA after COVID-19 vaccination with mRNA-1272","volume":"113","author":"Bozzi","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1016\/j.cmi.2021.07.031","article-title":"Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in people living with HIV-1","volume":"27","author":"Levy","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1089\/vim.2022.0182","article-title":"Does COVID-19 Vaccination with BNT162b2 Influence HIV-Related Immunological and Virological Markers? Data from 235 Persons Living with HIV at Cotugno Hospital, Naples, Italy: Immune Response After Second and Third Doses, and Influence on Immunovirological Markers","volume":"36","author":"Fusco","year":"2023","journal-title":"Viral Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"107065","DOI":"10.1016\/j.ijid.2024.107065","article-title":"SARS-CoV-2 mRNA vaccination and short-term changes in viral load and CD4\/CD8 T-cell counts in people living with HIV","volume":"144","author":"Vergori","year":"2024","journal-title":"Int. J. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.arthro.2021.06.037","article-title":"Best Practice Guidelines for Propensity Score Methods in Medical Research: Consideration on Theory, Implementation, and Reporting. A Review","volume":"38","author":"Chen","year":"2022","journal-title":"Arthroscopy"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1001\/jama.2021.8565","article-title":"Effect of 2 Inactivated SARS-CoV-2 Vaccines on Symptomatic COVID-19 Infection in Adults: A Randomized Clinical Trial","volume":"326","author":"Zhang","year":"2021","journal-title":"JAMA"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Hua, Q., Zhang, H., Yao, P., Xu, N., Sun, Y., Lu, H., Xu, F., Liao, Y., Yang, J., and Mao, H. (2022). Immunogenicity and immune-persistence of the CoronaVac or Covilo inactivated COVID-19 Vaccine: A 6-month population-based cohort study. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.939311"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/S1473-3099(20)30843-4","article-title":"Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18\u201359 years: A randomised, double-blind, placebo-controlled, phase 1\/2 clinical trial","volume":"21","author":"Zhang","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.ijid.2021.11.009","article-title":"Real-world effectiveness of COVID-19 vaccines: A literature review and meta-analysis","volume":"114","author":"Zheng","year":"2022","journal-title":"Int. J. Infect. Dis."},{"key":"ref_18","unstructured":"CDC (2023, March 28). COVID-19 Vaccines for People Who Are Moderately or Severely Immunocompromised, Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/vaccines\/recommendations\/immuno.html."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e2507","DOI":"10.1002\/rmv.2507","article-title":"Safety and efficacy of COVID-19 vaccines: A systematic review and meta-analysis of controlled and randomized clinical trials","volume":"34","author":"Beladiya","year":"2024","journal-title":"Rev. Med. Virol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1097\/QAD.0000000000003579","article-title":"Immunogenicity, effectiveness, and safety of SARS-CoV-2 vaccination in people with HIV","volume":"37","author":"Griffin","year":"2023","journal-title":"AIDS."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/s100960100470","article-title":"Effect of pneumococcal vaccine on plasma HIV-1 RNA of stable patients undergoing effective highly active antiretroviral therapy","volume":"20","author":"Negredo","year":"2001","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1016\/S0264-410X(99)00389-8","article-title":"Increasing the number of hepatitis B vaccine injections augments anti-HBs response rate in HIV-infected patients. Effects on HIV-1 viral load","volume":"18","author":"Rey","year":"2000","journal-title":"Vaccine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1086\/315260","article-title":"Effect of influenza vaccination on viral replication and immune response in persons infected with human immunodeficiency virus receiving potent antiretroviral therapy","volume":"181","author":"Wong","year":"2000","journal-title":"J. Infect. Dis."},{"key":"ref_24","first-page":"184","article-title":"The immune response to SARS-CoV-2 in people with HIV","volume":"21","author":"Burgers","year":"2024","journal-title":"Cell Mol. Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1038\/s41562-023-01733-3","article-title":"A systematic review and meta-analysis of the global prevalence and determinants of COVID-19 vaccine acceptance and uptake in people living with HIV","volume":"8","author":"Sulaiman","year":"2024","journal-title":"Nat. Hum. Behav."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2242","DOI":"10.1007\/s10461-022-03577-w","article-title":"Intention to Receive a COVID-19 Vaccine by HIV Status Among a Population-Based Sample of Women and Gender Diverse Individuals in British Columbia, Canada","volume":"26","author":"Kaida","year":"2022","journal-title":"AIDS Behav."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1007\/s10461-024-04351-w","article-title":"COVID-19 Vaccine Acceptance and Hesitancy among People Living with HIV: Review and Meta-Analysis","volume":"28","author":"Pereira","year":"2024","journal-title":"AIDS Behav."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Yi, Y., Han, X., Cui, X., Wang, P., Wang, X., Liu, H., Wang, Y., Zhu, N., Li, Y., and Lin, Y. (2023). Safety and Immunogenicity of the Inactivated COVID-19 Vaccine Booster in People Living with HIV in China. Vaccines, 11.","DOI":"10.3390\/vaccines11061019"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Datwani, S., Kalikawe, R., Waterworth, R., Mwimanzi, F.M., Liang, R., Sang, Y., and Lapointe, H.R. (2024). T-Cell Responses to COVID-19 Vaccines and Breakthrough Infection in People Living with HIV Receiving Antiretroviral Therapy. Viruses, 16.","DOI":"10.1101\/2024.03.08.24304006"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e474","DOI":"10.1016\/S2352-3018(21)00103-X","article-title":"Safety and immunogenicity of the ChAdOx1 nCoV-19 (AZD1222) vaccine against SARS-CoV-2 in HIV infection: A single-arm substudy of a phase 2\/3 clinical trial","volume":"8","author":"Frater","year":"2021","journal-title":"Lancet HIV"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e552","DOI":"10.1093\/cid\/ciac238","article-title":"Humoral and Cellular Immune Response Elicited by mRNA Vaccination Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in People Living with Human Immunodeficiency Virus Receiving Antiretroviral Therapy Based on Current CD4 T-Lymphocyte Count","volume":"75","author":"Antinori","year":"2022","journal-title":"Clin. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1093\/cid\/ciab648","article-title":"The BNT162b2 mRNA Vaccine Elicits Robust Humoral and Cellular Immune Responses in People Living with Human Immunodeficiency Virus (HIV)","volume":"74","author":"Woldemeskel","year":"2022","journal-title":"Clin. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1111\/hiv.13188","article-title":"Qualitative assessment of anti-SARS-CoV-2 spike protein immunogenicity (QUASI) after COVID-19 vaccination in older people living with HIV","volume":"23","author":"Tuan","year":"2022","journal-title":"HIV Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e157031","DOI":"10.1172\/jci.insight.157031","article-title":"Durability of ChAdOx1 nCoV-19 vaccination in people living with HIV","volume":"7","author":"Ogbe","year":"2022","journal-title":"JCI Insight"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"abm0829","DOI":"10.1126\/science.abm0829","article-title":"mRNA vaccines induce durable immune memory to SARS-CoV-2 and variants of concern","volume":"374","author":"Goel","year":"2021","journal-title":"Science"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e069989","DOI":"10.1136\/bmj-2022-069989","article-title":"Effectiveness of heterologous and homologous COVID-19 vaccine regimens: Living systematic review with network meta-analysis","volume":"377","author":"Au","year":"2022","journal-title":"BMJ"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1016\/S1473-3099(22)00409-1","article-title":"Duration of effectiveness of vaccination against COVID-19 caused by the omicron variant","volume":"22","author":"Higdon","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2130","DOI":"10.3201\/eid2810.220691","article-title":"Three-Dose Primary Series of Inactivated COVID-19 Vaccine for Persons Living with HIV, Hong Kong","volume":"28","author":"Chan","year":"2022","journal-title":"Emerg. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.ijid.2022.10.005","article-title":"Immunogenicity and efficacy of COVID-19 vaccines in people living with HIV: A systematic review and meta-analysis","volume":"124","author":"Yin","year":"2022","journal-title":"Int. J. Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1093\/infdis\/jiac229","article-title":"People With Human Immunodeficiency Virus Receiving Suppressive Antiretroviral Therapy Show Typical Antibody Durability After Dual Coronavirus Disease 2019 Vaccination and Strong Third Dose Responses","volume":"227","author":"Lapointe","year":"2023","journal-title":"J. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"4922","DOI":"10.1038\/s41467-022-32263-7","article-title":"Immunogenicity to COVID-19 mRNA vaccine third dose in people living with HIV","volume":"13","author":"Vergori","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1038\/s41590-022-01184-4","article-title":"SARS-CoV-2 antigen exposure history shapes phenotypes and specificity of memory CD8+ T cells","volume":"23","author":"Minervina","year":"2022","journal-title":"Nat. Immunol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e2215934","DOI":"10.1001\/jamanetworkopen.2022.15934","article-title":"Analysis of Postvaccination Breakthrough COVID-19 Infections Among Adults with HIV in the United States","volume":"5","author":"Coburn","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"100898","DOI":"10.1016\/j.xcrm.2022.100898","article-title":"Impact of SARS-CoV-2 exposure history on the T cell and IgG response","volume":"4","author":"Keeton","year":"2023","journal-title":"Cell Rep. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"107915","DOI":"10.1016\/j.isci.2023.107915","article-title":"Immunogenicity of COVID-19 vaccines and their effect on HIV reservoir in older people with HIV","volume":"26","author":"Matveev","year":"2023","journal-title":"iScience"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1152\/physrev.00020.2018","article-title":"Cellular Senescence: Aging, Cancer, and Injury","volume":"99","author":"Calcinotto","year":"2019","journal-title":"Physiol. Rev."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Brauning, A., Rae, M., Zhu, G., Fulton, E., Admasu, T.D., Stolzing, A., and Sharma, A. (2022). Aging of the Immune System: Focus on Natural Killer Cells Phenotype and Functions. Cells, 11.","DOI":"10.3390\/cells11061017"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1038\/s41591-020-0968-3","article-title":"Extrapulmonary manifestations of COVID-19","volume":"26","author":"Gupta","year":"2020","journal-title":"Nat. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1007\/s12016-022-08921-5","article-title":"Risk and Protective Factors for COVID-19 Morbidity, Severity, and Mortality","volume":"64","author":"Zhang","year":"2023","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"6716","DOI":"10.3748\/wjg.v28.i47.6716","article-title":"Liver injury in COVID-19: A minireview","volume":"28","author":"Hu","year":"2022","journal-title":"World J. Gastroenterol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1056\/NEJMsb2408466","article-title":"Long Covid Defined","volume":"391","author":"Ely","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1038\/d41586-023-01371-9","article-title":"Are repeat COVID infections dangerous? What the science says","volume":"616","author":"Willyard","year":"2023","journal-title":"Nature."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2183","DOI":"10.1007\/s10461-024-04344-9","article-title":"COVID-19 Vaccine Hesitancy Among People Living with HIV: A Systematic Review and Meta-Analysis","volume":"28","author":"Liu","year":"2024","journal-title":"AIDS Behav."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/12\/12\/1365\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:45:28Z","timestamp":1760114728000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/12\/12\/1365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,3]]},"references-count":53,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["vaccines12121365"],"URL":"https:\/\/doi.org\/10.3390\/vaccines12121365","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,3]]}}}