Kidney transplant recipients’ attitudes toward COVID‐19 vaccination and barriers and enablers to vaccine acceptance

Abstract

Objective To identify barriers and enablers to COVID‐19 vaccination in renal transplant recipients who are undecided about vaccination. Methods An online survey was distributed to 876 adult kidney transplant recipients at a tertiary referral service, who had not been vaccinated against COVID‐19. The survey assessed willingness to be vaccinated, attitudes toward COVID‐19 vaccines, and barriers and enablers to proceeding with vaccination. Results The survey response rate was 54% (473/876). Three hundred and forty‐six (73.1%) participants planned to receive vaccination (yes group), 105 (22.2%) were undecided, and 22 (4.7%) refused vaccination. The undecided group were younger but were not different in other demographic characteristics to the yes group. The undecided group were less positive toward (34.29% vs. 91.3%, p < .001) and more concerned about (93.3% vs. 25.1%, p < .001) vaccination than the yes group. Their concerns related to vaccine safety (including harm to their transplant), poor efficacy, and a lack of rigorous testing in transplant recipients. Undecided recipients had received less vaccine‐specific information from medical specialists than the yes group. Most undecided participants (95.1%) were willing to proceed with vaccination with appropriate supports. The most desired supports were information and a recommendation to proceed with vaccination from their treating transplant specialist and team. Conclusion(s) Concerns about vaccine safety (including harm to transplant), poor vaccine efficacy, and lack of rigorous testing were barriers to vaccine uptake. Most undecided recipients would proceed with vaccination with specific recommendations and vaccine information provided by their transplant specialist/team. These simple interventions can be readily implemented to optimize vaccine uptake.

Effect of age and rural residency on perceptions about SARS‐CoV‐2 pandemic and vaccination in kidney transplant recipients

“…This leaves a significant proportion of the population unprotected and vulnerable to this pandemic. A survey of 473 Australian kidney transplant patients done slightly before ours showed that 73.1% patients planned to receive the vaccine 27 . On the other hand, a survey of 1308 solid organ transplant recipients in the United States in November 2020 showed that almost half were unwilling or unsure about the vaccine 28 .…”

“…A survey of 473 Australian kidney transplant patients done slightly before ours showed that 73.1% patients planned to receive the vaccine. 27 On the other hand, a survey of 1308 solid organ transplant recipients in the United States in November 2020 showed that almost half were unwilling or unsure about the vaccine. 28 Our study, performed after more information and guidance was available about transplant patients, indicates some progress has been made.…”

Meta-analysis of immunologic response after COVID-19 mRNA vaccination in solid organ transplant recipients

“…Indeed, kidney transplant recipients (KTR) are poorly protected by SARS-CoV-2 mRNA vaccines [2] , thus prevention SOTRs from COVID 19 infection remain a difficult challenge. Owning to ineligibility in clinical trials [3] , the efficacy and safety of SARS-CoV-2 mRNA vaccines are currently limited in this fragile population, further decrease adherence to vaccination schemes [ 4 , 5 ]. Given the accumulated data available for safety and immunogenicity of mRNA vaccine [ 6 , 7 ], there is an urgent need to develop recommendations and guidelines for better delivery of COVID-19 vaccines in SOTRs.…”

COVID-19 Vaccination in Kidney Transplant Candidates and Recipients

“…Yet, resistance to accept vaccination may persist. An online survey on 473 kidney transplant recipients showed that 346 (73.1%) participants planned to receive vaccination, but 105 (22.2%) were undecided, and 22 (4.7%) refused vaccination [97]. Thus, many KTRs are not vaccinated against COVID-19 and are at increased risk for infection.…”