Researchers recommend kidney transplant recipients continue getting COVID-19 vaccinations
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Although COVID-19 vaccines lower the risk of infection among kidney transplant recipients, breakthrough infections can occur, and researchers recommend patients continue to receive boosters when available.
“The SARS-CoV-2 messenger RNA (mRNA) vaccines have shown high clinical efficacy in preventing COVID-19 in the immunocompetent population,” Ivan Zahradka, MD, from the Institute for Clinical and Experimental Medicine in the Czech Republic, and colleagues wrote. They added, “However, data about the effectiveness of SARS-CoV-2 vaccines are conflicting, and to what extent the two doses of an mRNA vaccine protect [kidney transplant recipients] KTRs from COVID-19 is unclear.”
In a retrospective observational cohort study, researchers examined data for 2,101 kidney transplant recipients from the department of nephrology at the Institute for Clinical and Experimental Medicine from Feb. 17 to May 16, 2021. Researchers considered the incidence of COVID-19 infections in vaccinated KTRs compared with non-vaccinated KTRs the primary outcome of the study. All data were taken from the Institute for Clinical and Experimental Medicine’s registry.
Researchers ended follow-ups when patients became infected with COVID-19, when patients were censored (death or return to long-term dialysis) or when the study period concluded. At the end of the follow-up, patients were categorized into two subgroups of vaccinated and unvaccinated patients.
Using multivariable Poisson regression, researchers identified the unadjusted incidence rate ratios in both groups.
Among the 2,101 patients, 346 did not receive full vaccination until the end of the study period and 246 did not achieve full vaccination at all. A total of 33 vaccinated patients and 79 unvaccinated patients reported COVID-19 infections during the study period. Similarly, eight vaccinated patients and 10 unvaccinated patients died during the study period due to COVID-19 infections.
Researchers determined the incidence rate in the vaccinated group was 0.474 per 1,000 person-days and the incidence rate in the unvaccinated group was 1.370 per 1,000 person-days.
“The association between two doses of mRNA SARS-CoV-2 vaccines and lowered risk for infection shown in our study provides much needed real-world evidence. However, despite the effectiveness in kidney transplant recipients, there were still breakthrough infections, and indirect comparisons suggest lower effectiveness compared with the general population,” Zahradka and colleagues wrote. “Thus, we believe that the current recommendations for additional booster doses based on laboratory immune-monitoring studies are also supported by our clinical report. Kidney transplant recipients should continue to be prioritized for booster doses in vaccination programs.”
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