Study: Two COVID-19 vaccine doses insufficient in patients with kidney replacement therapy
Click Here to Manage Email Alerts
Two doses of a COVID-19 vaccine have a limited impact on COVID-19 infection in patients with kidney replacement therapy, according to data published in the Journal of the American Society of Nephrology.
Further, researchers said strategies are urgently needed to reduce the risk and impact of COVID-19 infection in this population.
“There are an increasing number of studies demonstrating lack of serological response to two doses of COVID-19 vaccine in patients on dialysis and with a kidney transplant. It is, however, unclear how this translates to patient outcomes,” Samira Bell, FRCP, MD, chair of Scottish Renal Registry of Public Health in Scotland and the senior clinical lecturer and consultant nephrologist at the University of Dundee in Scotland, told Healio. “We sought to examine the effect of two doses of COVID-19 vaccines in patients on dialysis and with a transplant in Scotland by using linkage of real-world datasets for the entire Scottish population of patients. Our aim was to establish the effect of two doses of COVID-19 vaccine on rates of infection and patient outcomes, such as death and hospitalization.”
In an observational data linkage cohort study, researchers assessed all patients treated with kidney replacement therapy (KRT) in Scotland from March 1, 2020, to Oct. 19, 2021. Several health care datasets provided all SARS-CoV-2 testing, vaccination, hospitalization and mortality for the patients.
By Sept. 19, 2021, 93% of the KRT population in Scotland received two doses of a COVID-19 vaccine. A total of 814 cases of COVID-19 infections occurred in the study population, and researchers found vaccine effectiveness against infection and hospitalization was 33% and 38%, respectively. Analyses revealed that 9.2% of fully vaccinated patients died within 28 days of testing positive for COVID-19; 7% were patients on dialysis and 10% were kidney transplant patients. To put the numbers into perspective, researchers noted that less than 0.1% of the vaccinated general Scottish population were admitted to the hospital or died due to COVID-19 during the same time period.
“We were disappointed that outcomes were still poor for these patient groups despite two doses of vaccine, but we were unfortunately not surprised as our findings reflect what we were observing in clinical practice at that time,” Bell told Healio.
According to the researchers, limitations of the study included a small population which kept them from being able to determine vaccine effectiveness against death or to separate by vaccine type.
“Our work shows that whilst outcomes following two doses of COVID-19 vaccine are improved, there is still a 9% risk of death following infection in these patient group,” Bell told Healio. “This highlights the urgent need for a third dose of vaccine and so, I would urge any patients on dialysis or with a kidney transplant to ensure they have had a third dose plus or minus a fourth dose if eligible.”
Collapse
Click Here to Manage Email Alerts