As COVID-19 vaccination exposure increases, fewer dialysis patients have severe infections
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Although patients on dialysis show a low immunological response to COVID-19 vaccines, they benefit from the general population getting vaccinated, according to data published in the Clinical Journal of the American Society of Nephrology.
Further, investigators wrote that herd immunity may be the best way to protect patients on dialysis from COVID-19 infections.
“In this work, we sought to characterize COVID-19 dynamics in dialysis patients at the population scale by using the general population incidence over time and space as a reflection of SARS-CoV-2 spread,” Khalil El Karoui, MD, PhD, of the Assistance Publique–Hôpitaux de Paris Henri Mondor Hospital in France, and colleagues wrote.
In a population-level cohort study, researchers analyzed patients on dialysis with severe COVID-19 infections reported in the French kidney failure REIN registry between March 11, 2020, and April 29, 2021. They collected data on vaccine exposure from weekly national surveys that began in January 2021. All information about the general population’s COVID-19 infections and vaccine exposure were acquired from the national inpatient surveillance system .
Researchers used three Bayesian multivariable spatiotemporal models to evaluate the correlation between vaccine exposure and severe COVID-19 infections in patients on dialysis. Additionally, the models assessed previous COVID-19 hospitalizations to predict subsequent COVID-19 hospitalizations at different time points.
Analyses revealed that during the first wave of the pandemic, patients on dialysis reported similar COVID-19-related hospitalizations to the general population. However, as vaccines became available during the second and third waves, patients on dialysis reported a lower incidence of these hospitalizations than the general population.
According to the researchers, adding vaccination coverages in patients on and off dialysis to equations showed that overall vaccination correlated with a lower risk of COVID-19-related hospitalization in patients on dialysis.
"Our findings suggest that both individual and herd vaccine-induced immunity may yield a protective effect against severe forms of COVID-19 in dialysis patients," Karoui said in a press release.
In an editorial on the study, associate professors of medicine from the University of Ottawa Gregory L. Hundemer, MD, MPH, and Manish M. Sood, MD, MS, FASN, wrote, “Maximizing vaccination rates among not only patients on dialysis (where mRNA vaccines are clearly preferred) but also the general population to provide herd immunity must remain a top priority. Given the attenuated initial immunologic response combined with rapidly waning immunity over several months postvaccination, booster doses of COVID-19 vaccines will likely be critical for this population to prevent breakthrough cases.”
Reference:
- Growing understanding of the clinical and serologic effects of COVID-19 vaccines in patients undergoing long-term dialysis. https://cjasn.asnjournals.org/content/early/2022/02/10/CJN.00320122. Published Feb. 10, 2022. Accessed Feb. 14, 2022.
- New data on the effects of COVID-19 vaccination in patients on dialysis. https://medicalxpress.com/news/2022-02-effects-covid-vaccination-patients-dialysis.html. Published Feb. 10, 2022. Accessed Feb. 14, 2022.
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