COVID -19 Vaccination in Patients with End Stage Kidney Disease. Early Results for an mRNA Vaccine in a Vulnerable Population

Abstract

Patients with end stage kidney disease receiving dialysis treatment are at increased risk of COVID-19 infection. These patients have also higher rates of complications and mortality. The vulnerability may in part be explained by the profound changes in the immune system that are associated with impaired renal function. At the time of approval of the first vaccine for COVID-19, the BNT162b2 mRNA vaccine, there was no information on the efficacy and safety of the vaccine in dialysis patients. Preliminary reports on outcomes with the vaccine in the dialysis population have been published recently and the results are, in general, encouraging. However, these results indicate a lower response rate, a longer time to mount antibody response, lower antibody levels and possibly higher rate of COVID-19 breakthrough infection in the dialysis population. These results raise several questions that await further data to be reported. Meanwhile the dialysis patient’s population may still need special attention. Lessons learnt in this special population may also be applicable for other vulnerable patient groups.