COVID-19 Vaccine Hesitancy in Patients on Dialysis in Italy and France

Blanchi, Sophie; Torreggiani, Massimo; Chatrenet, Antoine; Fois, Antioco; Mazé, Béatrice; Njandjo, Linda; Bianco, Giovanna; Lepori, Nicola; Pili, Alessio; Michel, P.; Sileno, Giuseppe; Arazzi, Marta; Esposito, Vittoria; Pani, Antonello; Versino, Elisabetta; Esposito, Ciro; Fessi, H.; Cabiddu, Gianfranca; Piccoli, Giorgina Barbara

doi:10.1016/j.ekir.2021.08.030

Cited by 25 publications

(33 citation statements)

References 30 publications

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“…Regarding hesitancy of hemodialysis patients regarding SARS-CoV-2-vaccines, Garcia et al showed that one in five were reluctant to seek the COVID-19 vaccine even if the vaccine was considered safe for the general population [ 22 ]. A recent study from France and Italy showed that concerns about side effects and vaccine efficacy in dialysis patients were independent predictors for higher vaccine hesitancy [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Humoral immunogenicity and tolerability of heterologous ChAd/BNT compared with homologous BNT/BNT and ChAd/ChAd SARS-CoV-2 vaccination in hemodialysis patients

Haase

Lesny²,

Anderson

et al. 2022

J Nephrol

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Background After the reports of severe adverse reactions to the AstraZeneca ChAdOx1-S-nCoV-19 vaccine, patients who had received one dose of ChAdOx1-S-nCoV-19 vaccine were recommended a second dose of Pfizer’s BNT162b2 vaccine. In hemodialysis patients, we compared the humoral immunogenicity and tolerability of homologous vaccination with ChAdOx1-nCoV-19/ChAdOx1-nCoV-19 (ChAd/ChAd) and BNT162b2/BNT162b2 (BNT/BNT) with heterologous vaccination of first dose of ChAdOx1-nCoV-19 and a second dose with BNT162b2 (ChAd/BNT). Methods In a multicenter prospective observational study, SARS-CoV-2 spike-IgG antibody levels, Nucleocapsid-protein-IgG-antibodies, and vaccine tolerability were assessed 6 weeks after second SARS-CoV-2 vaccination in 137 hemodialysis patients and 24 immunocompetent medical personnel. Results In COVID-19-naïve hemodialysis patients, significantly higher median SARS-CoV-2-spike IgG levels were found after ChAd/BNT (N = 16) compared to BNT/BNT (N = 100) or ChAd/ChAd (N = 10) (1744 [25th–75th percentile 276–2840] BAU/mL versus 361 [25th–75th percentile 120–936] BAU/mL; p = 0.009; 1744 [25th–75th percentile 276–2840] BAU/mL versus 100 [25th–75th percentile 41–346] BAU/mL; p = 0.017, respectively). Vaccinated, COVID-19-naïve medical personnel had median SARS-CoV-2 spike-IgG levels of 650 (25th–75th percentile 217–1402) BAU/mL and vaccinated hemodialysis patients with prior COVID-19 7047 (25th–75th percentile 685–10,794) BAU/mL (N = 11). In multivariable regression analysis, heterologous vaccination (ChAd/BNT) of COVID-19-naïve hemodialysis patients was independently associated with SARS-CoV-2 spike-IgG levels. The first dose of ChAd and the second dose of BNT after the first vaccination with ChAd (heterologous vaccination, ChAd/BNT) were associated with more frequent but manageable side effects compared with homologous BNT. Conclusions Within the limitations of this study, heterologous vaccination with ChAd/BNT appears to induce stronger humoral immunity and more frequent but manageable side effects than homologous vaccination with BNT/BNT or with ChAd/ChAd in COVID-19-naïve hemodialysis patients. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Humoral immunogenicity and tolerability of heterologous ChAd/BNT compared with homologous BNT/BNT and ChAd/ChAd SARS-CoV-2 vaccination in hemodialysis patients

Haase

Lesny²,

Anderson

et al. 2022

J Nephrol

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“…Although Garcia et al found that age, gender, and educational level affect the intention of COVID-19 vaccination in an online survey conducted on MHD patients [ 14 ], our study did not confirm these findings. In another survey conducted on MHD patients, Blanchi et al stated that younger age was associated with vaccine hesitancy while hesitancy was not related to educational level and gender [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Given that one in three HD claimed prior personal contact with COVID-19 and one in four stated a close family member had antecedent infection, vaccine hesitancy in the high-risk dialysis population is alarming [ 10 ]. HD Patients have been reported to show high levels of vaccine hesitancy [ 11 , 12 ]. Vaccine hesitancy among these patients is not linked to their educational level, age, or gender, but rather to a lack of confidence in vaccine efficacy and safety concerns [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…HD Patients have been reported to show high levels of vaccine hesitancy [ 11 , 12 ]. Vaccine hesitancy among these patients is not linked to their educational level, age, or gender, but rather to a lack of confidence in vaccine efficacy and safety concerns [ 11 ]. Fortunately, the number of COVID-19 vaccination doses administered per 100 people in Egypt rose to 82 as of Jun 3, 2022 [ 13 ], however, data on HD patients are lacking.…”

Section: Introductionmentioning

confidence: 99%

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Acceptance of COVID-19 vaccination among maintenance hemodialysis patients: an Egyptian survey study

et al. 2022

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Background Coronavirus disease 2019 (COVID-19) is a contagious disease that is associated with significant morbidity and mortality especially among maintenance hemodialysis (MHD) patients. COVID-19 vaccination is important to decrease risk and severity of COVID-19 infection. However, vaccine hesitancy is a significant barrier to vaccination. Thus, the aim of this study was to investigate the vaccine acceptability among Egyptian MHD patients. Methods We conducted a paper-based survey on 237 MHD patients in 2 tertiary Egyptian hemodialysis (HD) centers. The survey consisted of a questionnaire that addressed demographic and clinical data, knowledge and attitudes towards COVID-19 infection and vaccines, beliefs regarding both conventional and COVID-19 vaccines, intention of COVID-19 vaccination together with motivators for and barriers against vaccination, sources of information regarding COVID-19 vaccines. Results According to intention to be vaccinated, the patients were divided into vaccine acceptant (VA), hesitant (VH), and resistant (VR) groups who comprised 58.3%, 26.5%, and 15.2%, respectively. Only occupational status and residency were significantly different between the three groups. In 60% of VA group, fear of infection was the main motivator for vaccination. Meanwhile, 40% of VH and VR groups reported that fear of serious side effects of vaccines was the main barrier against vaccination. Television was the primary information source (58.6%) about COVID-19 vaccination while only 18% of patients got their COVID-19 vaccine information from their nephrologists. Conclusions More than half of MHD patients accept to receive COVID-19 vaccine. Vaccine acceptability is not associated with age, gender, educational level, but rather with employment status and residency.

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“…Specific trust, such as trust in vaccines, the government, the health system, or professionals, has been sufficiently explored in the context of vaccine hesitancy in general [ 24 , 25 ], and specifically for COVID-19 vaccines (trust in vaccines [ 6 , 16 , 26 – 28 ], trust in government [ 20 , 22 , 26 , 29 , 30 ], trust in healthcare system or practitioners [ 16 , 31 – 33 ]). By contrast, generalized trust, i.e., a default expectation of goodwill from other people [ 34 ] that is often viewed as an important part of social capital [ 35 ], has not been sufficiently explored in the context of vaccine hesitancy.…”

Section: Introductionmentioning

confidence: 99%

Association between COVID-19 vaccine hesitancy and generalized trust, depression, generalized anxiety, and fear of COVID-19

Sekizawa

Hashimoto²,

Denda

et al. 2022

BMC Public Health

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Background Although numerous studies have been published on the predictors of COVID-19 vaccine hesitancy, some possible predictors remain underexplored. In this study, we explored the associations of unwillingness and indecisiveness regarding COVID-19 vaccination with generalized trust, mental health conditions such as depression and generalized anxiety, and fear of COVID-19. Methods Data of wave 1 (from October 27 till November 6, 2020) and wave 3 (from April 23 till May 6, 2021) of a longitudinal online study conducted in Japan were used for the analyses. Unvaccinated participants were asked at wave 3 about their willingness to be vaccinated, with possible responses of willing, unwilling, or undecided. These three responses were used as the outcome variable, and multinomial logistic regression analyses were conducted with willingness to be vaccinated as the reference group. Explanatory variables included generalized trust, depression, generalized anxiety, and fear of COVID-19 both at wave 1 and 3, and sociodemographic and health-related variables. Results Of the 11,846 valid respondents, 209 (1.8%) answered that they had already been vaccinated against COVID-19, 7089 (59.8%) responded that they were willing to be vaccinated, 3498 (29.5%) responded that they were undecided, and 1053 (8.9%) responded that they were unwilling to be vaccinated. After adjusting for covariates, we found that: (1) participants with lower levels of generalized trust at wave 1 and 3 were more likely to be undecided or unwilling at wave 3; (2) respondents with moderately severe or severe depression at wave 1 and 3 were more likely to be undecided at wave 3; (3) participants with moderate or severe levels of generalized anxiety at wave 3 but not at wave 1 were more likely to be unwilling at wave 3; and (4) respondents with high levels of fear of COVID-19 at wave 1 and 3 were less likely to be undecided and unwilling at wave 3. Conclusions Generalized trust, mental health conditions such as depression and generalized anxiety, and low level of fear of COVID-19 are associated with unwillingness or indecision regarding being vaccinated against COVID-19.

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COVID-19 Vaccine Hesitancy in Patients on Dialysis in Italy and France

Cited by 25 publications

References 30 publications

Humoral immunogenicity and tolerability of heterologous ChAd/BNT compared with homologous BNT/BNT and ChAd/ChAd SARS-CoV-2 vaccination in hemodialysis patients

Humoral immunogenicity and tolerability of heterologous ChAd/BNT compared with homologous BNT/BNT and ChAd/ChAd SARS-CoV-2 vaccination in hemodialysis patients

Acceptance of COVID-19 vaccination among maintenance hemodialysis patients: an Egyptian survey study

Association between COVID-19 vaccine hesitancy and generalized trust, depression, generalized anxiety, and fear of COVID-19

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