Effectiveness of Messenger RNA Vaccines against SARS-CoV-2 Infection in Hemodialysis Patients: A Case–Control Study

Abstract

Patients with end-stage kidney disease (ESKD) are at increased risk for SARS-CoV-2 infection and its complications compared with the general population. Several studies evaluated the effectiveness of COVID-19 vaccines in the dialysis population but showed mixed results. The aim of this study was to determine the effectiveness of COVID-19 mRNA vaccines against confirmed SARS-CoV-2 infection in hemodialysis (HD) patients in the State of Qatar. We included all adult ESKD patients on chronic HD who had at least one SARS-CoV-2 PCR test done after the introduction of the COVID-19 mRNA vaccines on 24 December 2020. Vaccinated patients who were only tested before receiving any dose of their COVID-19 vaccine or within 14 days after receiving the first vaccine dose were excluded from the study. We used a test-negative case–control design to determine the effectiveness of the COVID-19 vaccination. Sixty-eight patients had positive SARS-CoV-2 PCR tests (cases), while 714 patients had negative tests (controls). Ninety-one percent of patients received the COVID-19 mRNA vaccine. Compared with the controls, the cases were more likely to be older (62 ± 14 vs. 57 ± 15, p = 0.02), on dialysis for more than one year (84% vs. 72%, p = 0.03), unvaccinated (46% vs. 5%, p < 0.0001), and symptomatic (54% vs. 21%, p < 0.0001). The effectiveness of receiving two doses of COVID-19 mRNA vaccines against confirmed SARS-CoV-2 infection was 94.7% (95% CI: 89.9–97.2) in our HD population. The findings of this study support the importance of using the COVID-19 mRNA vaccine in chronic HD patients to prevent SARS-CoV-2 infection in such a high-risk population.

From past to present: Exploring COVID-19 in Qatar’s hemodialysis population across Omicron dominant and pre-Omicron periods

“…Recent studies have shown that the booster dose of SARS-CoV-2 vaccines, especially mRNA-based vaccines, has proven to be relatively effective in providing protection against Omicron infection within the general population [ 40 – 42 ] (despite the vaccine evasion mentioned above). This benefit also extends to patients with kidney disease [ 43 – 46 ]. Notably, almost 50% of our patients received the third vaccine dose, which could partially account for the milder disease course observed compared to previous variants.…”

COVID-19 and patients on renal replacement therapy: Perspective from the State of Qatar

“…The effectiveness of mRNA vaccines against SARS-CoV-2 infection was estimated at 94.7% ≥ 14 days after the second dose. 16 On the other hand, vaccine effectiveness in kidney transplant recipients in Qatar against SARS-CoV-2 was estimated at 46.6% (95% CI: 0.0-73.7%) ≥ 14 days after the second dose and vaccine effectiveness against any severe, critical, or fatal COVID-19 disease was estimated at 72.3%. 17 …”