key: cord-0734988-xq5nwc1i
authors: Bhandari, Sunil
title: Reasons for COVID-19 vaccination hesitancy in hemodialysis patients
date: 2021-07-10
journal: Kidney Int
DOI: 10.1016/j.kint.2021.07.003
sha: 0ab25736f1d2b7574d8248075590206012e67423
doc_id: 734988
cord_uid: xq5nwc1i

nan

To the editor: We read the excellent series of reports and editorial on the effectiveness of vaccination in patients on dialysis. 1 We would concur that although vaccination is less effective in these high-risk patients it remains critical to ensure our at-risk population remains as protected as possible. We would draw attention to the other significant challenge in such a population, namely hesitancy toward vaccination in patients on maintenance dialysis. Vaccine hesitancy is defined by the World Health Organization as a delay in acceptance or refusal of safe vaccines despite availability of vaccine services. We have completed vaccination of our large cohort of patients on renal replacement therapy and have found that while a substantial portion agreed to vaccination, hesitancy still exists in approximately 3% (12 of 378) of our patients. Various reasons for declining the vaccination by these patients are detailed in Table 1 . Because others have reported even higher rates of unvaccinated patients on dialysis (and between 8% and 41% may display vaccine hesitancy, depending on ethnicity, sex, age, and deprivation 2 ), this represents a significant risk to the remaining cohort of patients and staff as we approach considering booster vaccinations this winter to minimize further COVID-19 disease spikes. A mandatory vaccination is a potential solution for minimizing the risk but could be considered a controversial approach that may interfere with patients' autonomy and choice. The nephrology community needs to provide recommendations that involve a universal thoughtful process. Noncompliant with all treatments and did not wish additional treatment. 1

Refused to give reason for not accepting a COVID-19 vaccine. 1

Verbally aggressive to staff when offered and not prepared to give reasons. 1

Believes COVID-19 is just flu and so will not have it-does not take flu vaccine. 1

Refused to consider COVID-19 vaccine and does not want to be approached. Again a patient who has general noncompliance. 3 We are young and we believe the media reports that it is all overhyped and we are not convinced of the benefit. 1

Recovery from a recent long-term illness but may consider it. 1

Stated they are allergic to vaccines, but this is not substantiated.

COVID-19, coronavirus disease 2019.

www.kidney-international.org l e t t e r t o t h e e d i t o r

Kidney International (2021) -, 1

Immune response to SARS-CoV-2 infection and vaccination in patients receiving kidney replacement therapy

COVID-19 vaccination hesitancy