As exposure to COVID-19 vaccination increases, fewer dialysis patients have serious infections
As exposure to COVID-19 vaccination increases, fewer dialysis patients have serious infections

As exposure to COVID-19 vaccination increases, fewer dialysis patients have serious infections

February 17, 2022

2 min read

Karoui reports employment with INSERM U955; research funding from Amgen, Otsuka and Sanofi; and fees from Alexion, AstraZeneca and Otsuka. Sood reports speaker fees from AstraZeneca; sits in the editorial office of American Journal of Kidney Disease, Canadian Journal of Cardiology and Clinical Journal of American Society of Nephrology; acts as deputy editor of Canadian Journal of Kidney Disease and Health; and serves as a member of the American Society of Nephrology Highlights End Stage Renal Disease Team. Hundemer does not report any relevant financial information.

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Although dialysis patients show a low immunological response to COVID-19 vaccines, they have the advantage of being vaccinated in the general population, according to data published in Clinical Journal of American Society of Nephrology.

Additionally, investigators wrote that herd immunity may be the best way to protect patients on dialysis from COVID-19 infections.

“In this work, we have sought to characterize the COVID-19 dynamics of dialysis patients on 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, Ph.D.D, from 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 11 March 2020 and 29 April 2021. They collected data on vaccine exposure from weekly national studies, which began in January 2021. All data on the general COVID-19 infections and vaccine exposure of the population were retrieved from the national 24-hour monitoring system.

Researchers used three Bayesian multivariable spatiotemporal models to evaluate the association between vaccine exposure and severe COVID-19 infections in patients on dialysis. In addition, the models assessed previous COVID-19 admissions to predict subsequent COVID-19 admissions at different times.

Analyzes revealed that during the first wave of the pandemic, dialysis patients reported similar COVID-19-related admissions to the general population. However, as vaccines became available during the second and third waves, patients on dialysis reported a lower incidence of these admissions than the general population.

According to the researchers, the addition of vaccination coverage in patients on and off dialysis to equations showed that the overall vaccination correlated with a lower risk of COVID-19-related hospitalization in patients on dialysis.

“Our results suggest that both individual and herd vaccine-induced immunity may provide 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. HundemerMD, MPH, and Manish M. SoodMD, MS, FASN, wrote: “Maximizing the vaccination rate among not only dialysis patients (where mRNA vaccines are clearly preferred) but also the general population to grant flock immunity must remain a top priority. Given the weakened initial immunological response combined with rapidly declining immunity over several months after vaccination, booster doses of COVID-19 vaccines are likely to be critical for this population to prevent breakthrough cases. “


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