COVID-19 Vaccination in Immunoglobulin A Nephropathy

Lim, Cynthia Ciwei; Choo, Jason; Tan, Chieh Suai

doi:10.1053/j.ajkd.2021.07.001

Cited by 17 publications

(13 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Large population-based investigations are necessary to prove causation. A single-centre study focused on IgA nephropathy found that among 89 patients with a pre-existing disease no disease flare was recorded [ 73 ]. The EMA is closely monitoring the occurrence of glomerulonephritis and nephrotic syndrome.…”

Section: Introductionmentioning

confidence: 99%

Perspective on COVID-19 vaccination in patients with immune-mediated kidney diseases: consensus statements from the ERA-IWG and EUVAS

Stevens

Frangou

Smıth

et al. 2022

Nephrology Dialysis Transplantation

View full text Add to dashboard Cite

Patients with immune-mediated kidney diseases are at increased risk of severe COVID-19. The international rollout of COVID-19 vaccines has provided varying degrees of protection and enabled the understanding of vaccine efficacy and safety. The immune response to COVID-19 vaccines is lower in most patients with immune-mediated kidney diseases; either related to immunosuppression or to co-morbidities and complications caused by the underlying disease. Humoral vaccine response, measured by the presence of antibodies, is impaired or absent in patients receiving rituximab, mycophenolate mofetil (MMF), higher doses of glucocorticoids and likely other immunosuppressants, such as cyclophosphamide. Timing between the use of these agents and administration of vaccines associate with the level of immune response: with rituximab, vaccine response can only be expected once B cells start to recover and patients with transient discontinuation of MMF mount a humoral response more frequently. The emergence of new COVID-19 variants and waning of vaccine induced immunity highlight the value of booster dose and need to develop mutant proof vaccines. COVID-19 vaccines are safe, exhibiting a very low risk of de novo or relapsing immune-mediated kidney disease. Population-based studies will determine whether this is causal or co-incidental. Such cases respond to standard management, including the use of immunosuppression. The IWG and EUVAS recommend that patients with immune-mediated kidney diseases follow national guidance on vaccination. Booster doses based on antibody measurements could be considered.

show abstract

Section: Introductionmentioning

confidence: 99%

Perspective on COVID-19 vaccination in patients with immune-mediated kidney diseases: consensus statements from the ERA-IWG and EUVAS

Stevens

Frangou

Smıth

et al. 2022

Nephrology Dialysis Transplantation

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…Furthermore, among a previously reported cohort of 88 patients with known IgA nephropathy who received at least one dose of mRNA based SARS-CoV-2 vaccine, none had developed gross hematuria. 23 Strengths of this study are the inclusion of all biopsy-proven glomerulonephritis cases diagnosed in Switzerland, which allowed to calculate true incidence rates, and the use of an unambiguous primary outcome (biopsy-proven glomerulonephritis) that limited the potential for bias. By linking the second study to the epidemiological analysis, we were able to specifically approach potential participants and achieved a considerable inclusion rate (>50% of all Swiss patients with histologically confirmed glomerulonephritis during the study period).…”

Section: Discussionmentioning

confidence: 99%

Incidence of Glomerulonephritis after SARS-CoV-2 mRNA Vaccination

Diebold

Locher

Boide

et al. 2022

Preprint

View full text Add to dashboard Cite

Numerous cases of glomerulonephritis manifesting shortly after SARS-CoV-2 vaccination have been reported, but causality remains unproven. We studied the association between mRNA-based SARS-CoV-2 vaccination and new-onset glomerulonephritis using a nationwide retrospective cohort and case-cohort design. Data from all Swiss pathology institutes processing native kidney biopsies served to calculate incidence of IgA nephropathy, pauci-immune necrotizing glomerulonephritis, minimal change disease and membranous nephropathy. The observed incidence during the vaccination campaign (Jan to Aug 2021) was not different from the expected incidence based on the years 2015 to 2019 (incidence rate ratio 0.86, 95%-credible interval 0.73–1.02) and did not cross the upper boundary of the 95% credible interval for any month. Among 111 patients aged >18 years with newly diagnosed glomerulonephritis between January and August 2021, 38.7% had received at least one vaccine dose before biopsy, compared to 39.5% of the general Swiss population matched for age and calendar-time. The estimated risk ratio for the development of new-onset biopsy-proven glomerulonephritis was 0.97 (95% CI 0.66–1.42, P=0.95) in vaccinated vs. unvaccinated individuals. Patients with glomerulonephritis manifesting within 4 weeks after vaccine did not differ clinically from the rest of the cohort. Results were consistent across all types of glomerulonephritis with the possible exception of minimal change disease. In conclusion, vaccination against SARS-CoV-2 was not associated with new-onset glomerulonephritis in these two complementary studies. Most temporal associations between SARS-CoV-2 vaccination and glomerulonephritis are likely coincidental.

show abstract

“…Thus, leading expert opinion had empirically recommended COVID-19 vaccination for patients with immune-mediated kidney diseases [ 8 ], despite limited published data regarding vaccine efficacy in glomerulonephritides treated with immunosuppressants [ 9 ]. However, the lack of trial safety data in glomerulonephritides and reports of IgA nephropathy flares after vaccination that emerged in early 2021 [ 10 , 11 , 12 ] have led to calls for nephrologists to advocate COVID-19 vaccination but counsel patients regarding a small risk of relapsing disease for up to one month after the second dose and to monitor for symptoms suggestive of relapse [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

A Descriptive Evaluation of Health Literacy and Determinants of COVID-19 Vaccine Acceptance among Patients with IgA Nephropathy with High Vaccine Uptake

Lim

Mok²,

Leeu³

et al. 2022

Glomerular Dis

Self Cite

View full text Add to dashboard Cite

Aims: Shared decision-making regarding COVID-19 vaccination in IgA nephropathy involves the ability to handle health information regarding potential benefits and risk of flare, but few studies have evaluated health literacy in the context of vaccination. We aimed to evaluate the health literacy and COVID-19 vaccination uptake and acceptance in IgA nephropathy. Methods: Single-center cross-sectional study of 126 consecutive patients with IgA nephropathy. Health literacy was assessed using the HLS-EU-47 questionnaire. Determinants of vaccine acceptance such as contextual influences, individual and group influences, and vaccine-specific issues were adapted from the World Health Organization framework. Results: Forty-eight patients (38.1%) with IgAN nephropathy completed the survey between June and August 2021. The participants’ median age was 40.5 (31.6, 52.8) years with median disease duration of 2.8 (1.3, 4.3) years. The median general health literacy index was 31.74 (29.88, 35.82) with significantly greater difficulty in the competency of appraising health information and in the domain of disease prevention (p<0.001). Forty-five patients (93.8%) received at least one dose of COVID-19 vaccine between January and August 2021. Among the 3 unvaccinated patients, 2 intended to receive the vaccination while and 1 did not intend to get vaccinated. There was a high level of trust and belief that their government and healthcare providers had their best interests at heart and that the healthcare providers were honest about the vaccine’s risk and benefits, although 31.2% did not understand how the vaccine works and 22.9% believed that there were other ways to prevent infection. Most thought there was adequate safety information, were confident in the system for tracking adverse events and had no issues with access to the vaccine. Conclusion: Participants with IgA nephropathy had high health literacy scores and low vaccine hesitancy. The determinants for vaccine acceptance can guide efforts to optimize vaccination coverage.

show abstract

COVID-19 Vaccination in Immunoglobulin A Nephropathy

Cited by 17 publications

References 4 publications

Perspective on COVID-19 vaccination in patients with immune-mediated kidney diseases: consensus statements from the ERA-IWG and EUVAS

Perspective on COVID-19 vaccination in patients with immune-mediated kidney diseases: consensus statements from the ERA-IWG and EUVAS

Incidence of Glomerulonephritis after SARS-CoV-2 mRNA Vaccination

A Descriptive Evaluation of Health Literacy and Determinants of COVID-19 Vaccine Acceptance among Patients with IgA Nephropathy with High Vaccine Uptake

Contact Info

Product

Resources

About