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Are People on Dialysis Especially Wary of the COVID-19 Vaccine?

— Some patients said they believed it was better to get a natural infection versus a vaccine

Last Updated April 16, 2021
MedpageToday

Younger people on dialysis may be particularly vaccine-hesitant, a researcher reported.

In a survey analysis conducted across 150 U.S. dialysis facilities, 22% of all dialysis patients (n=943) said they were hesitant to receive the COVID-19 vaccine, reported Pablo Garcia, MD, of Stanford University in California.

"Vaccine hesitancy is lower among patients on dialysis who participated in this survey than is reported in the general population," Garcia pointed out during a presentation of the late-breaking findings at the virtual National Kidney Foundation Spring Clinical meeting.

Still, more than a third of dialysis patients, ages 18 to 44, said they were reluctant to receive the COVID-19 vaccine even when it was deemed safe and effective for the general population. However, vaccine hesitancy overall lessened among older patients, as those ages 80 and older were the most willing to receive the vaccine.

A total of 29% of the younger dialysis patients said they wouldn't be keen on accepting the vaccine even if it were required by their school, employer, or residential area. This sentiment was also held by 22% of patients between the ages of 45-64, but only 13% of those 80 and older.

Of those who completed the survey, more than half said they had concerns about the vaccine's side effects, and 19% said they were concerned about its efficacy. Interestingly, 17% said they didn't think they needed the COVID-19 vaccine at all, and 8% said they believed it was better to get a natural infection than a vaccine. In addition, 5% responded that they didn't believe COVID-19 was a "real problem" and 4% said the vaccine was a conspiracy.

Factors that seemed to ameliorate some concerns about the vaccine were having it offered at dialysis facilities, personally knowing someone who died from the virus, and willingness to receive the flu vaccine.

"I think that perhaps we will see a change and more people will be willing to accept in general," Garcia suggested, adding that dialysis centers received vaccine-delivery supplies in the past few months, potentially making patients more willing to get their jabs.

Garcia and colleagues also found that Black patients (OR 1.5, 95% CI 1.0-2.3) and women (OR 1.4, 95% CI 1.0-1.9) were more likely to express concerns about the vaccine. Other groups who tended to express more vaccine hesitancy included younger patients, Asian Pacific Islander or Native American patients, and those with lower education attainment.

According to the findings, the number one source of information about the COVID-19 vaccine came from television news, which nearly 80% of the patients said they watched. Dialysis staff, including nurses and technicians, was the second largest source of vaccine information, followed by friends and family, social media, and nephrologists. Younger dialysis patients were more likely to get their vaccine news through social media, including Facebook, Twitter, and Instagram.

The online survey was offered in English and Spanish across dialysis centers in the Northeast, South, Midwest, and Western U.S. regions from January through February 2021.

The majority of patients were ages 45-64 (40%) and 65-79 (37%), and a little over half of respondents were male. The participants were fairly evenly split between white (30%), Black (30%), and Hispanic (24%) patients.

A total of 59% of patients said they had a family member or close acquaintance who was COVID-19-positive, and 15% said they knew someone close to them who died from the virus.

Overall, 85% said they either received or were planning to get the flu vaccine.

  • author['full_name']

    Kristen Monaco is a senior staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, she’s worked at the company since 2015.

Disclosures

Garcia disclosed no relevant relationships with industry.

Primary Source

National Kidney Foundation

Garcia P, et al "SARS-CoV-2 vaccine acceptability in patients on dialysis: a nationwide survey" NKF 2021; Abstract 329.