Abstract
Objective: Patients with advanced chronic kidney disease (CKD) or kidney failure receiving replacement therapy (K.F.R.T.) 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 prioritization of COVID-19 vaccines for this group of patients globally.
Setting and participants: 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 2nd July and 4th August 2021.
Results: 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 prioritized for vaccination, followed by patients living with a kidney transplant (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-center hemodialysis, peritoneal dialysis, or K.T. 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 and low-middle-income countries compared to high-income countries.
Conclusion: Patients with advanced CKD or K.F.R.T. were prioritized 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.
Setting and participants: 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 2nd July and 4th August 2021.
Results: 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 prioritized for vaccination, followed by patients living with a kidney transplant (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-center hemodialysis, peritoneal dialysis, or K.T. 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 and low-middle-income countries compared to high-income countries.
Conclusion: Patients with advanced CKD or K.F.R.T. were prioritized 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.
| Original language | English |
|---|---|
| Article number | e065112 |
| Number of pages | 10 |
| Journal | BMJ Open |
| Volume | 12 |
| DOIs | |
| Publication status | Published - 30 Dec 2022 |
