Vaccine acceptance improves for patients on dialysis, but physician encouragement is key
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Although survey results from January 2021 showed 85% of patients on dialysis were willing to get a COVID-19 vaccine, a speaker said work is still needed to increase the vaccination rate, with physicians playing an essential role.
“A lot of research is going into how to get patients to be more accepting of the vaccine and how to reach out to them. I know a lot of people participating in this conference have done amazing outreach,” Shuchi Anand, MD, MS, director of the Center for Tubulointerstitial Kidney Disease and assistant professor of medicine at Stanford University, said during her presentation at the virtual Innovations in Dialysis: Expediting Advances Symposium. “That’s all [important] effort, but what I understand from reading the literature on this topic is that physicians remain the most trusted authorities or givers of information about vaccination. Patients want a personal conversation where they relay their concerns and a physician addresses them. That seems to be the best strategy for vaccination.”
Geographic divide in vaccine hesitancy
According to Anand, the survey that her group designed was administered around the time that the general population in the United States expressed vaccine hesitancy, with 40% of individuals stating they were not going to get vaccinated. This was, she said, despite efficacy data that had been released on the MRNA vaccines. Of the 1,500 patients on dialysis who completed the survey at the time, Anand said most were comfortable with vaccination. While this was “great news for patients and providers,” she highlighted the geographic divide that exists in terms of vaccine acceptability, with patients on the West coast and East coast more likely to view the vaccine favorably compared with those in the South.
According to Anand, this is further evidenced by data that show that although more than 85% of patients in California were completely vaccinated, only 50% to 60% of patients in Tennessee had accepted the vaccine.
Suggesting this viewpoint is “probably informed by community norms that are still hesitant about vaccination,” she said work is needed to ensure patients continue to get vaccinated.
“I know that now [the news is focusing on] a booster and third shot potentially, but there’s still a lot of work to be done to reach the patients who haven’t even gotten a single shot.”
Delta variant, re-framing vaccination conversations
Addressing the high rates of AKI that frequently accompany COVID-19, as well as the newly emerging delta variant, Anand contended it is important to understand that SARS-COV-2 will most likely continue to present a threat to patients on dialysis and transplant recipients.
“We have to work toward thinking of strategies that deal with it at every front in terms of renal protective measures but also as protecting the health of patients who have significant kidney disease,” she said. “Just like the delta variant points out, there will be chinks in our armor throughout, so we’ll have to study and have processes where we can have real-time data and information out to our patients on how best to protect themselves.”
One “great potential avenue of learning how to counsel our patients and how to be receptive to their concerns,” according to Anand, is through partnerships between nephrologists and mental health professionals.
“When we start to put vaccination in the context of ‘public health only’ so that people who are hesitant or have questions feel like they’re being outcast, that’s probably the wrong way to encourage people,” she said. “We need to have a more receptive conversation. All of us can learn from psychologists and psychiatrists on how to do that. We need to work on understanding viewpoints and perspectives so that we can relay our information in a way that is heard instead of two sides talking at each other.”
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Anand S. Panel session I: COVID-19 and the kidney. Presented at: Innovations in Dialysis: Expediting Advances Symposium; Aug. 22-24, 2021 (virtual meeting).
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