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Publication Detail
Outcome and effect of vaccination in SARS-CoV-2 Omicron infection in hemodialysis patients: a cohort study.
  • Publication Type:
    Journal article
  • Publication Sub Type:
  • Authors:
    Ashby DR, Caplin B, Corbett RW, Asgari E, Kumar N, Sarnowski A, Hull R, Makanjuola D, Cole N, Chen J, Nyberg S, Forbes S, McCafferty K, Zaman F, Cairns H, Sharpe C, Bramham K, Motallebzadeh R, Anwari K, Roper T, Salama AD, Banerjee D, pan-London Covid-19 renal audit group
  • Publisher:
    Oxford University Press (OUP)
  • Publication date:
  • Pagination:
  • Journal:
    Nephrology Dialysis Transplantation
  • Medium:
  • Status:
  • Country:
  • Print ISSN:
  • PII:
  • Language:
  • Keywords:
    clinical epidemiology, Covid-19, hemodialysis, vaccination
BACKGROUND: Hemodialysis patients are at high risk from Covid-19, though vaccination has significant efficacy in preventing and reducing the severity of infection. Little information is available on disease severity and vaccine efficacy since dissemination of the Omicron variant. METHODS: In a multi-center study, during a period of the epidemic driven by the Omicron variant, all hemodialysis patients positive for SARS-CoV-2 were identified. Outcomes were analysed according to predictor variables including vaccination status. Risk of infection was analysed using a Cox proportional hazards model. RESULTS: SARS-CoV-2 infection was identified in 1126 patients including 200 (18%) unvaccinated, 56 (5%) post first dose, 433 (38%) post second dose, and 437 (39%) at least 7 days beyond their third dose. The majority of patients had a mild course but 160 (14%) were hospitalised and 28 (2%) died. In regression models adjusted for age and comorbidity, two-dose vaccination was associated with a 39% (95%CI: 2-62%) reduction in admissions, but third doses provided additional protection, with a 51% (95%CI: 25-69%) further reduction in admissions. Amongst 1265 patients at risk at the start of the observation period, SARS-CoV-2 infection was observed in 211 (17%). Two-dose vaccination was associated with a 41% (95%CI: 3-64%) reduction in the incidence of infection, with no clear additional effect provided by third doses. CONCLUSIONS: These data demonstrate lower incidence of SARS-CoV-2 infection after vaccination in dialysis patients during an Omicron dominant period of the epidemic. Amongst those developing infection, severe illness was less common with prior vaccination, particularly after third vaccine doses.
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