Work needed to increase COVID-19 vaccine acceptance in patients with CKD
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Patients with chronic kidney disease who resided in the inner-city expressed similar hesitancy to the COVID-19 vaccine as patients who attended family medicine clinics in the same area, according to a study presented here.
The primary concern, for both groups, was related to the safety of the vaccine.
“An intensive education program regarding COVID-19 vaccines for our high-risk CKD patients must understand our population’s beliefs and concerns with safety in order to gain vaccine acceptance, as their attitudes seem to reflect the general population in our inner-city environment and are not unique to the patient with CKD,” Lauren Gruffi, of SUNY Downstate Health Sciences University in Brooklyn, told Healio Nephrology.
Gruffi said she was motivated to conduct this research to both explore barriers to vaccination and to identify the best approaches to increase vaccine acceptance through education and vaccine messaging campaigns.
“Studies have demonstrated that CKD is a significant risk factor for severe SARS-Cov-2 infection, and preventative measures are paramount for CKD populations; it is my hope that this research addresses issues surrounding vaccine hesitancy and helps inform communication of preventative measures to high-risk patients similar to those in our population.”
For the study, Gruffi and colleagues conducted telephone surveys of patients from CKD and family medicine clinics. Attitudes toward the vaccine were assessed through a variety of questions, including the following questionnaires: multidimensional health locus of control (MHLC), perceived stress scale (PSS) and beliefs in medicine (BMQ).
“In order for this patient population to accept the vaccine, it is imperative that we understand and respect our population’s beliefs and concerns with safety,” Gruffi explained of the questionnaire choice. “The multidimensional health locus of control (MHLC) research on patients’ relative loci of control provides meaningful information about their attitudes toward themselves, physicians and others, and it is helpful for understanding what makes individuals more or less likely to accept a COVID-19 vaccine. Locus of control has been demonstrated to be a useful construct to predict and explain health-related behaviors, and therefore it is an important tool for predicting vaccination uptake among certain groups.”
Survey results pointed toward vaccine hesitancy. Most respondents in both groups answered “no” to the question of whether they would get a vaccine (61% in CKD group vs. 58% in family medicine group), with both highlighting safety concerns as the primary reason (79% of all participants who would decline). Gruffi noted that family medicine patients were more likely to believe that COVID-19 is preventable and that the United States has more cases due to more testing.
Additional findings revealed that men and individuals with lower perceived stress were also more willing to get the vaccine, while patients who believed that alternative medicine could cure COVID-19 were less likely to answer “yes” to the vaccine.
Regarding the questionnaires, patients with CKD appeared to have more belief in the necessity of medicine and of their health depending on medications than the family medicine patients, though patients with CKD were less likely to assign locus of control to doctors. Refusal of the vaccine was not, however, related to locus of control or beliefs in medicine.
“There are certainly limitations in the usefulness of MHLC sub-scores in our population and its association with willingness to accept a COVID-19 vaccine,” Gruffi said. “First, when analyzing our entire study population, we did not find significant correlations among different MHLC sub-scores and gender, race or clinic setting; therefore, it may be difficult to apply learnings from the study beyond the individual. However, it is possible that if we were to increase our study size, we would find more statistically significant associations that would help inform COVID-19 vaccination messaging toward certain groups of people.
“Despite these limitations, MHLC is a useful tool for interpreting health-related behaviors, and it can both help understand vaccine hesitancy in our study population and inform education and messaging toward vaccination campaigns.”
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Gruffi L, et al. Abstract #210. Presented at: National Kidney Foundation Spring Clinical Meetings (virtual meeting); April 6-10, 2021.
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