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SARS-CoV-2 Vaccine Effectiveness & Breakthrough Infections During Maintenance Dialysis

Patients on maintenance dialysis were better protected from COVID-19 when they had received SARS-CoV-2 vaccination, a study shows, with decreased risk of diagnosis, hospitalization, and death. When vaccinees had low anti-spike immunoglobulin G levels, COVID-19–related outcomes tended to be worse.

The retrospective, observational study included adult patients without a COVID-19 history receiving maintenance dialysis through a national dialysis provider and treated between Feb. 1 and Dec. 18, 2021, with follow-up through Jan. 17, 2022. The outcomes based on vaccination status were SARS-CoV-2 infections and a composite of hospitalization or death following COVID-19.

The results showed the following: “Of 16,213 patients receiving dialysis during the study period, 12,278 (76%) were fully vaccinated, 589 (4%) were partially vaccinated, and 3,346 (21%) were unvaccinated by the end of follow-up. Of 1,225 COVID-19 cases identified, 550 (45%) occurred in unvaccinated patients, and 891 (73%) occurred during the Delta variant–dominant period. Between the pre-Delta period and the Delta-dominant period, vaccine effectiveness rates against a severe COVID-19–related event (hospitalization or death) were 84% and 70%, respectively. In the subset of 3,202 vaccinated patients with at least one anti-spike immunoglobulin G (IgG) assessment, lower anti-spike IgG levels were associated with higher case rates per 10,000 days and higher adjusted hazard ratios for infection and COVID-19–related hospitalization or death.”

Source: American Journal of Kidney Diseases