COVID-19 Booster Vaccine Hesitancy among Hemodialysis Patients in Saudi Arabia Using the Health Belief Model: A Multi-Centre Experience

Abstract

Objective: Vaccination hesitance for the COVID-19 booster dosage among hemodialysis patients is an important barrier in reducing morbidity and mortality linked to COVID-19 infection. Hence, this study aimed to explore the predictors of the third (booster) dose of COVID-19 vaccine intention among CKD patients on hemodialysis from the Kingdom of Saudi Arabia (KSA). Methods: This study was a multi-center cross-sectional study conducted at four dialysis centers in KSA from 13 February 2022 to 21 June 2022. The data was collected by the nephrologist in charge of the unit using a structured study questionnaire, which consisted of four parts; socio-demographic and clinical variables, questions about COVID-19 infection and subjective assessment of health state, COVID-19 booster dose vaccination intention and confidence in vaccines and preferences, and a health belief model. The study population consisted of 179 hemodialysis patients. Results: Participants in the study had conflicting health beliefs about their vulnerability to COVID-19 infection and the severity of the COVID-19 infection. Study participants expressed positive health beliefs about the advantages of the COVID-19 booster dose, and reported less perceived obstacles in receiving the vaccine. The influence of cues on action among the study population was high. A total of 140 (78.2%) hemodialysis patients expressed their intention to receive the COVID-19 booster dose. Patients who reported poor health in the self-rating of their health status had a substantially higher definite intention to take the COVID-19 booster dose, according to the chi-square test (11.16, df = 3, p = 0.01). There was a significant association between the constructs in the HBM model and COVID-19 vaccine (booster) intention. Marital status (OR = 1.67, CI 1.07–2.58) was found to be the strongest predictors of a definite intention to receive a COVID-19 booster dose. Confidence in the locally manufactured vaccine (OR = 0.33, CI 0.17–0.60), education (OR = 0.62, CI 0.41–0.93), and rating of health status (OR = 0.43 CI 0.25–0.74) were the strongest significant correlates of having no definite intention to take the COVID-19 vaccination. Conclusions: HBM constructs were found to be significantly associated with vaccination intention, which can be considered while planning policies to promote COVID-19 booster vaccination among hemodialysis patients. The study results could be utilized in drafting policies to improve COVID-19 booster dose vaccination uptake among hemodialysis population.

Perceptions and Information-Seeking Behavior Regarding COVID-19 Vaccination Among Patients With Chronic Kidney Disease in 2023: A Cross-Sectional Survey

“…This finding is consistent with both quantitative and qualitative data from studies that have shown that people living with CKD, including patients on dialysis and kidney transplant recipients, are quite concerned or feel vulnerable about contracting COVID-19. 40 - 42 We also found differences in this perceived risk by sex, with the female sex being associated with expressing more concern about contracting COVID-19, which coincides with findings from various populations in the literature. 43 - 46 In addition, those who expressed concern about contracting SARS-CoV-2 were more likely to have sought out information about COVID-19, in the last 12 months.…”

“…Surveys administered among patients undergoing hemodialysis in Saudi Arabia, Italy, and France also found that that many respondents expressed positive perceptions regarding the benefits or effectiveness of the COVID-19 vaccines despite the high level of concern about contracting COVID-19. 42 , 46 …”

Evolving impact of the COVID-19 pandemic in chronic dialysis recipients over the course of pandemic waves and COVID-19 vaccination rollout: a French national study

“…Several studies have reported an association between COVID-19 vaccination and lower risks of COVID-19-related hospitalization or death, 6,7 but due to waning vaccine immunity over time, researchers have emphasized the need for additional booster campaigns, particularly for vulnerable populations such as CDR. To date, only Alobaidi et al 9 reported that 22% of hemodialysis patients had reluctance to take up the COVID-19 booster vaccine. Our study indicates that booster campaigns did not achieve the same level of coverage as that observed for the two initial doses, with even worse coverage in the matched-control group.…”

“…Indeed, a recent systematic review examining the relationships between Health Belief Model constructs and COVID-19 vaccination intention included 109 studies but only 13 articles explored booster vaccines, 8 and only 1 of these 13 articles explored the booster vaccine hesitancy in hemodialysis patients. 8,9 Such findings led us to undertake investigations on vaccination coverage for booster doses. Another challenging consequence of the COVID-19 pandemic for CDR was the reduction in kidney transplant activity.…”