Vaccination coverage among individuals receiving HIV pre-exposure prophylaxis (PrEP): A systematic review and meta-analysis

Objective: This study aimed to assess vaccination coverage among individuals receiving HIV pre-exposure pro- phylaxis (PrEP). Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed, Scopus, and Web of Science were searched from January 2011 to March 2026. Studies assessing vaccination coverage among individuals receiving PrEP within routine care were included. Random-effects meta-analyses were per- formed for each vaccine, and subgroup analyses were conducted when adequate data were available. Results: Twenty-four studies including 13,087 individuals were analysed. Vaccination coverage was highest for HBV (73.00%, 95% CI [59.00, 88.00]), followed by Monkeypox (61.00%, 95% CI [40.00, 83.00]) and HAV (59.00%, 95% CI [48.00, 71.00]), and lowest for HPV (43.00%, 95% CI [34.00, 52.00]). Evidence on other vaccines was limited. High heterogeneity was observed across studies, and vaccination status was frequently self- reported (63.00%). No consistent geographical pattern emerged. Conclusions: Vaccination coverage among individuals receiving PrEP remains relatively low across most key vaccines, highlighting missed opportunities for prevention. Strengthening the integration of vaccination within PrEP care pathways and enhancing proactive provider engagement are key priorities. Future efforts should focus on high-quality primary studies, standardized methodologies, evaluation of targeted interventions, and economic evidence to better inform policy decisions.