Multiple studies have found that people with kidney failure who are on dialysis have weaker antibody responses after receiving COVID-19 vaccination than the general population, but new research suggests that their immune responses are still capable of protecting them against SARS-CoV-2 infection and severe COVID-19. The findings have been published in the journal JASN.
Matthew Oliver, MD, MHS (Sunnybrook Health Science Centre, University of Toronto, Ontario Health) and colleagues analysed health records for 13,759 people who received maintenance dialysis between December 21, 2020 and June 30, 2021; 17% were unvaccinated, while 83 percent had received at least one mRNA COVID-19 vaccine dose.
The research looked at the whole population of people on maintenance dialysis in Ontario, Canada’s most populous province. Patients getting both home dialysis and in-center hemodialysis made up the diverse population.
During the research period, Dr. Oliver and his team discovered 663 SARS-CoV-2 infections, 323 hospitalizations, and 94 fatalities. Those who had received one COVID-19 vaccine dose were 41% less likely to become infected with SARS-CoV-2 and 46% less likely to develop severe COVID-19 that required hospitalisation or resulted in death, compared to those who had not been vaccinated, and those who had received two doses were 69 percent and 83 percent less likely to become infected or experience severe disease, respectively, than those who had not been vaccinated. The risk of hospitalization in the unvaccinated group was 52% and the mortality rate was 16%, whereas the risk of hospitalization in the 2-dose group was 30% and the mortality rate was 10%.
There were no significant variations in vaccination efficacy between age groups, dialysis modes, or vaccine types (Pfizer-BioNTech or Moderna).
“Governments and health care providers prioritized patients on maintenance dialysis for early COVID-19 vaccination in many countries, including the U.S and Canada. This strategy was correct and important because our results show that 2 doses of an mRNA vaccine significantly protected this population, preventing many hospitalizations and deaths and reducing the burdens on patients, families, and the health care system,” said Dr. Oliver. “The effectiveness of the vaccines was less than that seen in studies in the general population but still provided substantial protection.” It is now recommended that all adults and teenagers, especially those who are immunocompromised, receive a third dose of COVID-19 vaccine to ensure an optimal immune response.