SARS-CoV-2 Vaccine Acceptability in Patients on Hemodialysis: A Nationwide Survey

Abstract

BackgroundPatients on dialysis are at increased risk for COVID-19–related complications. However, a substantial fraction of patients on dialysis belong to groups more likely to be hesitant about vaccination.MethodsWith the goal of identifying strategies to increase COVID-19 vaccine uptake among patients on hemodialysis, we conducted a nationwide vaccine acceptability survey, partnering with a dialysis network to distribute an anonymized English and Spanish language online survey in 150 randomly selected facilities in the United States. We used logistic regression to evaluate characteristics of vaccine-hesitant persons.ResultsA total of 1515 (14% of eligible) patients responded; 20% of all responders, 29% of patients aged 18–44 years, and 29% of Black responders reported being hesitant to seek the COVID-19 vaccine, even if the vaccine was considered safe for the general population. Odds of vaccine hesitancy were higher among patients aged 18–44 years versus those 45–64 years (odds ratio [OR], 1.5; 95% confidence interval [95% CI], 1.0 to 2.3), Black patients versus non-Hispanic White patients (OR, 1.9; 95% CI, 1.3 to 2.7), Native Americans or Pacific Islanders versus non-Hispanic White patients (OR, 2.0; 95% CI, 1.1 to 3.7), and women versus men (OR, 1.6; 95% CI, 1.2 to 2.0). About half (53%) of patients who were vaccine hesitant expressed concerns about side effects. Responders’ main information sources about COVID-19 vaccines were television news and dialysis staff (68% and 38%, respectively).ConclusionsA substantial proportion of patients receiving in-center hemodialysis in the United States are hesitant about seeking COVID-19 vaccination. Facilitating uptake requires outreach to younger patients, women, and Black, Native American, or Pacific Islander patients, and addressing concerns about side effects.

Results of an Academic Dialysis Program-Wide SARS-CoV-2 Vaccination Effort

“…Patients that refused vaccine during the initial mobile vaccination clinics were more likely to be younger, female, and lack evidence of prior influenza vaccination. These findings are consistent with prior studies in the general public and dialysis patients (5,6,7). We hypothesized that prior infection with SARS-CoV-2 would reduce vaccine acceptance based on patient belief in natural immunity.…”

“…In these studies, various factors were found to be associated with vaccine hesitancy including: younger age, African American race, lower attained education level and lower influenza vaccination rates (5). A more recent national survey of dialysis patients suggested vaccine acceptance rates could reach as high as 81% under ideal conditions (7). In that survey, similar factors were associated with vaccine hesitancy in the dialysis population as seen in the general population.…”

Safety and Tolerability of the BNT162b2 mRNA COVID-19 Vaccine in Dialyzed Patients. COViNEPH Project

“…In a nationwide vaccine acceptability survey performed in 150 dialysis units in the United States a significant proportion of hemodialyzed (HD) patients hesitate to vaccinate against COVID-19 for fear of potential side effects. Hesitancy among people overall may have recently increased, at least for the short term, because of concerns over rare thrombotic events among people who receive certain types of COVID-19 vaccine [ 3 , 4 ]. BNT162b2 mRNA vaccine against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) approved for use in the US and Europe was shown to have a favorable safety profile, and its reactogenicity was generally mild or moderate [ 5 ].…”

Do University Students Adhere to WHO Guidelines on Proper Use of Face Masks during the COVID-19 Pandemic?—Analysis and Comparison of Medical and Non-Medical Students

“…Until now, hundreds of articles in worldwide journals have been published using this methodology [7][8][9][10][11]. Moreover, with the COVID-19 pandemic, researchers have been using online questionnaires even more frequently due to contact restrictions, lack of face-to-face contact and no possibility to travel [12][13][14][15][16][17][18]. A similar methodology was employed by Machida et al [19] in their paper about the incorrect use of face masks during the COVID-19 pandemic.…”