In:
Journal of the American Society of Nephrology, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. 4 ( 2022-04), p. 677-686
Abstract:
Patients with kidney failure requiring KRT are at high risk of poor outcomes following SARS-CoV-2 infection, with variable antibody responses to vaccination reported. Ninety-three percent of patients on KRT in Scotland received a SARS-CoV-2 vaccine. The effectiveness of two vaccine doses was only 33% (95% CI, 0 to 52) against SARS-CoV-2 infection and 38% (95% CI, 0 to 57) against hospitalization in patients requiring KRT. Within 28 days of a positive SARS-CoV-2 PCR test, 9.2% of fully vaccinated patients died (7% patients on dialysis and 10% transplant recipients). These data suggest that a primary vaccine course of two doses does not provide adequate protection in patients receiving KRT and highlight the urgent need for adjunctive strategies to reduce risk of both SARS-CoV-2 infection and its complications. Background Patients with kidney failure requiring KRT are at high risk of complications and death following SARS-CoV-2 infection, with variable antibody responses to vaccination reported. We investigated the effects of COVID-19 vaccination on the incidence of infection, hospitalization, and death from COVID-19 infection. Methods The study design was an observational data linkage cohort study. Multiple health care datasets were linked to ascertain all SARS-CoV-2 testing, vaccination, hospitalization, and mortality data for all patients treated with KRT in Scotland from the start of the pandemic over a period of 20 months. Descriptive statistics, survival analyses, and vaccine effectiveness were calculated. Results As of September 19, 2021, 93% ( n =5281) of the established KRT population in Scotland had received two doses of an approved SARS-CoV-2 vaccine. Over the study period, there were 814 cases of SARS-CoV-2 infection (15.1% of the KRT population). Vaccine effectiveness rates against infection and hospitalization were 33% (95% CI, 0 to 52) and 38% (95% CI, 0 to 57), respectively. Within 28 days of a SARS-CoV-2–positive PCR test, 9.2% of fully vaccinated individuals died (7% patients on dialysis and 10% kidney transplant recipients). This compares to 〈 0.1% of the vaccinated general Scottish population admitted to the hospital or dying due to COVID-19 during that period. Conclusions These data demonstrate that a primary vaccine course of two doses has limited effect on COVID-19 infection and its complications in patients with KRT. Adjunctive strategies to reduce risk of both COVID-19 infection and its complications in this population are urgently required.
Type of Medium:
Online Resource
ISSN:
1046-6673
,
1533-3450
DOI:
10.1681/ASN.2022010046
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
2029124-3
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