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

  1. Brendan T. Bowman
  2. Benjamin J. Lobo
  3. Binu Sharma
  4. Jennie Z. Ma

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Abstract

Patients with End Stage Kidney Disease requiring dialysis are exceedingly vulnerable to SARS-CoV-2 infection with high hospitalization rates and mortality. Despite this risk, little is known about real world dialysis patient SARS-CoV-2 vaccination acceptance. Surveys of the general population suggest significant vaccine hesitancy and high potential for refusal. From January 27 th to March 12 th 2021, the University of Virginia (UVA) Health System, in partnership with the Virginia Department of Health / Blue Ridge Health District (BRHD) provided on-site mobile vaccination clinics at 12 UVA dialysis sites. We conducted a cross-sectional study to evaluate vaccine acceptance and evaluate factors associated with refusal. Of 859 dialysis patients with complete vaccination data, 80% received at least one dose of vaccine and 87% of these vaccinations were provided by the UVA/BRHD partnership. The overall patient refusal rate was low at 14%. Patients refusing SARS-CoV-2 vaccine were more likely to be female, younger and missing a documented flu vaccination during the 2020-2021 season. Attributes such as race or prior infection with SARS-CoV-2 were not significantly associated with vaccine refusal. In conclusion, dialysis patients in our program were surprisingly likely to accept vaccination for SARS-CoV-2. Identifying attributes associated with refusal may help target populations at high risk of vaccine refusal.

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  1. ScreenIT

    SciScore for 10.1101/2021.05.07.21256841: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The research proposal was evaluated by the UVA Institutional Review Board for Health Sciences Research and found to be exempt from IRB review / not human subjects research (tracking #23147)
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has several limitations. Given that the census of our program differs significantly from the national profile with a higher proportion of black patients and a lower census of latinx patients, some of our findings here may not directly translate to the national dialysis population. Also, unlike pre-vaccination surveys, we were not able to definitively obtain patient elements such as income and education level. Proxies for these were used, but may not be reliable. Additionally, due to limitations on data collection, unmeasured confounding factors may also have impacted our results. Finally, we were not able to directly verify receipt of the two-shot series in all patients obtaining vaccine outside of our mobile vaccine clinics (pharmacies, primary care offices, etc.). This may have caused underestimation of the proportion of patients fully vaccinated. In summary, we present the results of an early dialysis program-wide vaccination effort. In our program, it appears that real-world vaccine acceptance is higher than early estimates in the general population and align with more recent surveys of the dialysis population. This data is encouraging. Patients at high risk of refusal share common attributes and likely can be identified for additional interventions to address vaccine hesitancy.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  2. Version published to 10.1101/2021.05.07.21256841v1 on medRxiv