Availability and prioritisation of COVID-19 vaccines among patients with advanced chronic kidney disease and kidney failure during the height of the pandemic: a global survey by the International Society of Nephrology

• Published in: BMJ open Vol. 12; no. 12; p. e065112
• Main Authors: Wijewickrama, Eranga S, Abdul Hafidz, Muhammad Iqbal, Robinson, Bruce M, Johnson, David W, Liew, Adrian, Dreyer, Gavin, Caskey, Fergus J, Bello, Aminu K, Zaidi, Deenaz, Damster, Sandrine, Salaro, Silvia, Luyckx, Valerie Ann, Bajpai, Divya
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 30.12.2022; BMJ Publishing Group
• Series: Original research
• Subjects: Advocacy; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 Vaccines; Epidemiology; Hemodialysis; Humans; Kidney diseases; Kidney Failure, Chronic - therapy; Leadership; Mortality; Nephrology; Pandemics; Questionnaires; Regions; Renal Dialysis; Renal Insufficiency, Chronic - epidemiology; Renal Insufficiency, Chronic - therapy; Response rates; Severe acute respiratory syndrome coronavirus 2; Surveys and Questionnaires; Middle East; Africa; East Asia; North America; Western Europe; Russia; Latin America; South Asia; COVID-19; dialysis; epidemiology; health policy; renal transplantation
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2022-065112

Patients with advanced chronic kidney disease (CKD) or kidney failure receiving replacement therapy (KFRT) are highly vulnerable to COVID-19 infection, morbidity and mortality. Vaccination is effective, but access differs around the world. We aimed to ascertain the availability, readiness and prioritisation of COVID-19 vaccines for this group of patients globally. Collaborators from the International Society of Nephrology (ISN), Dialysis Outcomes and Practice Patterns Study and ISN-Global Kidney Health Atlas developed an online survey that was administered electronically to key nephrology leaders in 174 countries between 2 July and 4 August 2021. Survey responses were received from 99 of 174 countries from all 10 ISN regions, among which 88/174 (50%) were complete. At least one vaccine was available in 96/99 (97%) countries. In 71% of the countries surveyed, patients on dialysis were prioritised for vaccination, followed by patients living with a kidney transplant (KT) (62%) and stage 4/5 CKD (51%). Healthcare workers were the most common high priority group for vaccination. At least 50% of patients receiving in-centre haemodialysis, peritoneal dialysis or KT were estimated to have completed vaccination at the time of the survey in 55%, 64% and 51% of countries, respectively. At least 50% of patients in all three patient groups had been vaccinated in >70% of high-income countries and in 100% of respondent countries in Western Europe.The most common barriers to vaccination of patients were vaccine hesitancy (74%), vaccine shortages (61%) and mass vaccine distribution challenges (48%). These were reported more in low-income and lower middle-income countries compared with high-income countries. Patients with advanced CKD or KFRT were prioritised in COVID-19 vaccination in most countries. Multiple barriers led to substantial variability in the successful achievement of COVID-19 vaccination across the world, with high-income countries achieving the most access and success.