The impact of vaccination on incidence and outcomes of SARS-CoV-2 infection in patients with kidney failure in Scotland

TY - JOUR

T1 - The impact of vaccination on incidence and outcomes of SARS-CoV-2 infection in patients with kidney failure in Scotland

AU - Bell, Samira

AU - Campbell, Jacqueline

AU - Lambourg, Emilie

AU - Watters, Chrissie

AU - O'Neill, Martin

AU - Almond, Alison

AU - Buck, Katharine

AU - Carr, Edward J.

AU - Clark, Laura

AU - Cousland, Zoe

AU - Findlay, Mark

AU - Joss, Nicola

AU - Metcalfe, Wendy

AU - Petrie, Michaela

AU - Spalding, Elaine

AU - Traynor, Jamie P.

AU - Sanu, Vinod

AU - Thomson, Peter

AU - Methven, Shona

AU - Mark, Patrick B.

AU - The Scottish Renal Registry (SRR)

N1 - Copyright © 2022 by the American Society of Nephrology.

PY - 2022/3/31

Y1 - 2022/3/31

N2 - Background Patients with kidney failure requiring KRT are at high risk of complications and death following SARS-CoV-2 infection, with variable antibody responses to vaccination reported. We investigated the effects of COVID-19 vaccination on the incidence of infection, hospitalization, and death from COVID-19 infection. Methods The study design was an observational data linkage cohort study. Multiple health care datasets were linked to ascertain all SARS-CoV-2 testing, vaccination, hospitalization, and mortality data for all patients treated with KRT in Scotland from the start of the pandemic over a period of 20 months. Descriptive statistics, survival analyses, and vaccine effectiveness were calculated. Results As of September 19, 2021, 93% (n55281) of the established KRT population in Scotland had received two doses of an approved SARS-CoV-2 vaccine. Over the study period, there were 814 cases of SARS-CoV-2 infection (15.1% of the KRT population). Vaccine effectiveness rates against infection and hospitalization were 33% (95% CI, 0 to 52) and 38% (95% CI, 0 to 57), respectively. Within 28 days of a SARS-CoV-2–positive PCR test, 9.2% of fully vaccinated individuals died (7% patients on dialysis and 10% kidney transplant recipients). This compares to,0.1% of the vaccinated general Scottish population admitted to the hospital or dying due to COVID-19 during that period. Conclusions These data demonstrate that a primary vaccine course of two doses has limited effect on COVID-19 infection and its complications in patients with KRT. Adjunctive strategies to reduce risk of both COVID-19 infection and its complications in this population are urgently required.

AB - Background Patients with kidney failure requiring KRT are at high risk of complications and death following SARS-CoV-2 infection, with variable antibody responses to vaccination reported. We investigated the effects of COVID-19 vaccination on the incidence of infection, hospitalization, and death from COVID-19 infection. Methods The study design was an observational data linkage cohort study. Multiple health care datasets were linked to ascertain all SARS-CoV-2 testing, vaccination, hospitalization, and mortality data for all patients treated with KRT in Scotland from the start of the pandemic over a period of 20 months. Descriptive statistics, survival analyses, and vaccine effectiveness were calculated. Results As of September 19, 2021, 93% (n55281) of the established KRT population in Scotland had received two doses of an approved SARS-CoV-2 vaccine. Over the study period, there were 814 cases of SARS-CoV-2 infection (15.1% of the KRT population). Vaccine effectiveness rates against infection and hospitalization were 33% (95% CI, 0 to 52) and 38% (95% CI, 0 to 57), respectively. Within 28 days of a SARS-CoV-2–positive PCR test, 9.2% of fully vaccinated individuals died (7% patients on dialysis and 10% kidney transplant recipients). This compares to,0.1% of the vaccinated general Scottish population admitted to the hospital or dying due to COVID-19 during that period. Conclusions These data demonstrate that a primary vaccine course of two doses has limited effect on COVID-19 infection and its complications in patients with KRT. Adjunctive strategies to reduce risk of both COVID-19 infection and its complications in this population are urgently required.

KW - clinical epidemiology

KW - vaccination

KW - COVID-19

KW - dialysis

KW - transplantation

KW - kidney replacement therapy

UR - https://www.scopus.com/pages/publications/85128000976

U2 - 10.1681/ASN.2022010046

DO - 10.1681/ASN.2022010046

M3 - Article

C2 - 35110363

SN - 1046-6673

VL - 33

SP - 677

EP - 686

JO - Journal of the American Society of Nephrology

JF - Journal of the American Society of Nephrology

IS - 4

ER -