Fauci, ASN panelists encourage patients with CKD to get COVID-19 booster vaccine
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Panelists opened 2021 ASN Kidney Week by discussing the impact that the COVID-19 virus can have on chronic kidney disease, in addition to how vaccinating vulnerable populations is the best way to end the pandemic.
Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases at the NIH, explained how underlying conditions such as CKD are associated with an increased risk for “severe COVID-19 illness.”
“We know now from studies that have been conducted during this outbreak of something about the pathophysiology of COVID-19-associated acute kidney disease, where more than 25% of patients who are hospitalized with COVID-19 have developed AKI,” Fauci said at the meeting. “A number of studies that we have performed here, and others in other counties, make it very clear of the extraordinary benefit of booster shots for getting maximal degree of protection.”
Not only is kidney disease a potential outcome of long COVID, but patients who already have kidney disease are at a higher risk for being infected with the virus.
Susan Weiss, PhD, professor of microbiology at the University of Pennsylvania, detailed the origin of COVID-19 and how the delta-variant came to be. As the virus mutates, the need for wide-spread vaccinations increases, but Weiss is optimistic that the dominance of the delta variant is a sign that the spike-protein may reach a point where it stops mutating. Until then, vaccines are imperative to prevent infection.
“Data shows that for all patients, boosters are beneficial; that immunity, at least based on the spike protein, wanes over time,” Jeffrey Silberzweig, MD, chief medical officer at The Rogosin Institute, said at the meeting. “The data for patients who are on dialysis is that they don’t mount as strong an antibody response to the vaccines to start with, and that it doesn’t appear to be as long-lasting. Boosters are definitely indicated for all patients with CKD and certainly for those on dialysis, not only because of the immunity, but also because of the increased risk of exposure [from having] to go to dialysis three times a week.”
Ashish Jha, MD, MPH, dean of the school of public health at Brown University, spoke about the increased risk that patients with kidney disease face in the pandemic, but also highlighted other vulnerable populations. As the U.S. and other countries collect COVID-19 supplies, Africa is being excluded due to what Jha called “vaccine nationalism.”
“We can’t get through this pandemic until we have the whole world vaccinated,” Jha said. “We have to focus on people with chronic diseases, people who are vulnerable, people with cardiovascular disease, people with CKD; particularly people who are high risk. If we begin there, even if we don’t get everybody vaccinated, immediately we’re going to dramatically lower mortality and suffering from this virus.”
Amitava Banerjee, MD, PhD, from the Institute of Health Informatics Research at the University College London, also emphasized the importance of the booster COVID-19 vaccine. “CKD is acting as a risk factor as a disease and as an outcome from infection with SARS-COV-2,” Banerjee said at the meeting. “The key take-homes are infection suppression is best and that we need to improve vaccination and manage underlying chronic disease.”
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Fauci AS, et al. Joint ASN-NAM Plenary: ASN President's Address, COVID-19 Panel. Presented at: ASN Kidney Week. Nov. 4-7, 2021 (virtual meeting).
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