Safety and efficacy of coronavirus disease-19 vaccines in chronic kidney disease patients under maintenance hemodialysis: A systematic review.

Abstract

Background and aimsPatients on maintenance dialysis are a high‐risk, immune‐compromised population with 15%–25% coronavirus disease (COVID‐19) mortality rate that has been underrepresented in COVID‐19 vaccination clinical trials. The aim of study was to review of those studies to determine the safety and efficacy of the COVID‐19 vaccination in chronic kidney disease (CKD) patients receiving maintenance hemodialysis systematically.MethodsThe effectiveness was assessed by looking at the humoral and cellular responses. The humoral response is defined as de novo IgG‐ or IgA‐anti‐SpikeS1 antibody positivity. The establishment of de novo T‐cell immunity after immunization was used to measure cellular response. Adverse results were also reported of the included studies to analyze the safety of COVID‐19 vaccines. Eight previous works were included in our study.ResultsTwo doses of COVID‐19 vaccines were shown to be effective with seroconversion rate of humoral response ranging from 81% to 97% among eight studies. The T‐cell response was shown 67% and 100% in two studies. COVID‐19 vaccines did not have notable adverse events and hence can be considered safe.ConclusionAlthough a single dosage has not shown to improve humoral immune response in most hemodialysis trials, a double dose has been reported to improve seroconversion rate and humoral immune response. Further research are required to observe if hemodialysis patients generate effective T‐cell responses.