Although patients on dialysis are at increased risk for severe COVID-19-related complications, a substantial percentage are hesitant to obtain a SARS-CoV-2 vaccination, according to new nationwide survey results presented during the virtual National Kidney Foundation 2021 Spring Clinical Meetings.

A total of 943 patients from 135 facilities within a large dialysis network responded to an anonymized survey administered in English or Spanish via tablet or smartphone during January 8 to February 11, 2021. In all, 22% of respondents and 34% of those aged 18-44 years reported that they would likely not seek a COVID-19 vaccine even if the vaccine were proven safe and effective for the general population, Pablo Garcia, MD, of Stanford University in Palo Alto, California, and colleagues reported. Half of vaccine-hesitant respondents expressed concerns about side effects. In addition, 19% were concerned about vaccine efficacy.

Vaccine acceptability was lower among women, younger (18-44 year) age groups, and patients identifying as Black, Native American, or Pacific Islander, the investigators found. Although older patients were more accepting, the team encouraged vaccination efforts toward this group because older patients are at higher risk for serious illness.

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Importantly, COVID-19 vaccine hesitancy declined to 18% of all respondents and 26% of respondents aged 18-44 years if the vaccine were offered at dialysis facilities. On March 25, the Biden administration announced that SARS-CoV-2 vaccines would indeed be made available to dialysis facilities for administration.

“We believe this action will facilitate access to vaccines—which seems to be the primary barrier in our population, rather than hesitancy,” Dr Garcia told Renal & Urology News. “However, outreach programs targeted to the groups with lower vaccine acceptability will be crucial to achieving levels of vaccinations high enough to reach ‘herd immunity.’”

Dialysis staff, including nurses, dietitians, and social workers, are among the main sources of information about COVID-19 vaccines, Dr Garcia noted. “We encourage patients to discuss any concerns about the vaccines with their physicians, advanced practice providers, and nursing staff.”  


Garcia P, Montez-Rath M, Moore H. SARS-CoV-2 vaccine acceptability in patients on dialysis: a nationwide survey. Presented at the virtual National Kidney Foundation 2021 Spring Clinical Meetings, April 6-10, 2021. Poster 329.