Answering the call to action: rapid implementation of an in-center hemodialysis SARS-CoV-2 vaccination program

Abstract

in Singapore, with a 20-station inpatient dialysis center, a large renal inpatient service, and a renal transplant program. Universal masking and visitor screening were implemented 4 ; symptomatic patients were segregated in a dedicated dialysis room, with staff using personal protective equipment. All symptomatic inpatients were tested for SARS-CoV-2 and common RVIs via multiplex polymerase chain reaction.The incidence of HA-RVI during the pandemic dramatically decreased to 0.5 cases per 1000 admissions (1 case, 2186 admissions), compared with 21.7 cases per 1000 admissions (70 cases, 3223 admissions) over the previous 2 years (incidence rate ratio, 0.02; 95% confidence interval, 0.001-0.13; P < 0.001). Notably, zero episodes of HA-RVI were recorded from February to December 2020 (Figure 1). There was no significant difference in the proportion of inpatients tested for common RVIs (26.5%, 581 of 2186 admissions tested during the pandemic; vs. 28.8%, 929 of 3223 admissions tested prepandemic; odds ratio, 0.89; 95% confidence interval, 0.77-1.08; P ¼ 0.07). Despite managing $1600 COVID-19 cases, there was no nosocomial acquisition. Infection prevention measures introduced for COVID-19 mitigate HA-RVI among renal inpatients and should be continued postpandemic. ACKNOWLEDGMENTSAs this study utilized aggregated anonymized data collected as part of routine surveillance, waiver of informed consent was obtained from our hospital's institutional review board. AUTHOR CONTRIBUTIONSWLE conceived and designed the study. WLE and EPC analyzed the data. WLE, CST, and IV drafted the manuscript. CST and IV supervised. 1. Thaunat O, Legeai C, Anglicheau D, et al. French nationwide Registry of Solid Organ Transplant Recipients with COVID-19. IMPact of the COVID-19 epidemic on the moRTAlity of kidney transplant recipients and candidates in a French Nationwide registry sTudy (IMPORTANT). Kidney Int. 2020;98: 1568-1577. 2. Torreggiani M, Fessi H, Piccoli GB. On the need to better protect hemodialysis patients: a comment on "IMPact of the COVID-19 epidemic on the moRTAlity of kidney transplant recipients and candidates in a French Nationwide registry sTudy (IMPORTANT).

SARS-CoV-2 in dialysis patients and the impact of vaccination

“…Like our vaccine programme, other hospitals have also implemented similar programmes. A team at Imperial College Healthcare NHS trust offered approximately 1500 ICHD patients their first dose of the SARS-CoV-2 vaccine within 16 days of dialysis patients being included in the vaccine priority schedule [ 20 ].…”

Improved Immune Response to the Third COVID-19 mRNA Vaccine Dose in Hemodialysis Patients

“… 3 , 4 , 5 , 6 , 7 As patients undergoing hemodialysis (HD) are at a high risk for COVID-19 severity and death, they have been prioritized in vaccination programs worldwide. 8 , 9 …”

“…[3][4][5][6][7] As patients undergoing hemodialysis (HD) are at a high risk for COVID-19 severity and death, they have been prioritized in vaccination programs worldwide. 8,9 To the best of our knowledge, there are no reports comparing humoral immunity after the third vaccination in hundreds of patients undergoing HD and healthy controls.…”

Impact of the COVID-19 pandemic on patients with chronic kidney disease

“…During dialysis, the patients were vaccinated simultaneously. A total of 1500 cases of vaccinations were completed within 16 days, reducing the risk of infection at other vaccination centers [54] . This indicates that hemodialysis patients could be given priority for a unified vaccination.…”