Short Communication
Acceptability of COVID-19 Vaccines among Patients on Maintenance Hemodialysis: An Assessment from a Healthcare Center in Karachi
Authors: Fatima Kanwal , Misbah Fatima , Muhammad Wasay Siddiqui
DOI: https://doi.org/10.37184/lnjpc.2707-3521.4.20
Year: 2022
Volume: 4
Received: Feb 09, 2022
Revised: Apr 27, 2022
Accepted: Jun 02, 2022
Corresponding Auhtor: Fatima Kanwal (fatima.kanwal@aku.edu)
All articles are published under the Creative Commons Attribution License
Abstract
Dialysis patients are among the high-risk group to contract COVID-19 necessitating vaccination to decrease mortality and morbidity. We aimed to evaluate the COVID-19 vaccination status of dialysis patients in our institute (NIKUD). Regular hemodialysis patients (n=38) from Sept’21 to Jan’22 were included after taking written consent. The majority (78%) of patients were fully vaccinated and none was partially vaccinated. Sinopharm (36.6%) was the most frequent vaccine received, followed by Moderna (26%). Among vaccinated patients’ families, the complete vaccination rate was (68%) for the COVID-19 vaccine as compared (0%) for the complete vaccination of family members in the unvaccinated group. Non-belief in the vaccine (75%) along with no known case of COVID-19 disease to self or family (100%) were the most common possible reasons for not getting vaccinated. Perceived risk of COVID-19 to themselves as non-dangerous was a concerning belief in the majority (44%) (17) dialysis patients. Approximately 25% of patients did not receive any COVID-19 vaccine including inadequate vaccination among their families. Evidence-Based counseling and education are advised to alleviate any concerns regarding COVID-19 vaccines.
Keywords: COVID-19, COVID-19 vaccination, patient, dialysis.
INTRODUCTION
Almost two years into the COVID-19 pandemic, the development of vaccines and mass vaccination seems to be the only available approach to effectively curb this pandemic. Promising effects of COVID-19 vaccination are already showing and dubiety is dissipating rapidly [1]. Initially, lack of data and emergency use authorization regarding vaccine efficacy in special groups (including pregnant, lactating mothers and immunocompromised patients) were excluded from vaccination. Also, to avoid COVID-19 exposure in the early pandemic drop in regular childhood vaccination was observed in other countries including the UK [2]. However, over time with research and rapidly evolving guidelines, vaccines are showing promising results and now it’s highly recommended to get COVID-19 vaccination, especially for immunocompromised patients including those on maintenance dialysis [3].
Vaccine hesitancy is a real phenomenon and a huge barrier worldwide. Falsified information that disseminates unchecked, fuels vaccine hesitancy. Myths associated with vaccines have played a huge part in the delayed eradication of vaccine-preventable diseases in the past which also includes COVID-19 now in Pakistan [4-6].
Government and private hospitals and other stakeholders have taken many steps to raise the awareness of our population of the necessity of COVID-19 vaccination.
Ensuring proper SOPs, vaccination drives and awareness campaigns via different mediums, and smart lockdowns and restrictions in traveling / other social encounters for unvaccinated are to name a few [7, 8]. So, the only question remaining is to see the trickle-down effect and assess the actual COVID-19 vaccination status of our patients and address their any what’s and whys.
METHODOLOGY
NIKUD Research Hospital is a not-for-profit, OPD-based health care and 10 bedded dialysis center in Karachi. From September 2021 to January 2022, patients enrolled for regular maintenance dialysis were interviewed via a questionnaire to evaluate their vaccination status and acceptability of the COVID-19 vaccine. The interview was conducted after taking personal consent to participate in the survey.
RESULTS AND DISCUSSION
Every 1 in 4 Pakistani potentially suffers from CKD which eventually leads to an increased burden on the already strained health care of our country [9]. When we evaluated the situation in our center, a total of 38 responses were elicited (100% response rate). Ages ranging 20-74 years with the male majority approximately 76% (29). The duration of dialysis ranged from 6 months to 7 years. Hypertension in 33 patients and diabetes in 17 patients were among the major comorbidities. Four patients had other comorbid conditions including polycystic kidney disease and recurrent nephrolithiasis. Of all, only 7% (3) patients reportedly had a history of COVID-19 since the start of the pandemic which was mild, based on a lack of supplementary oxygen requirement and successful
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home management. Fully vaccinated patients were 79%
(30) and 21% (8) never received COVID vaccinations. Perceived risk of COVID-19 to themselves was
Fig. (1): Types of Covid vaccines received by dialysis patients at NIKUD Research Center.
Among the unvaccinated group, beliefs in myths regarding COVID-19 vaccination outcomes, fear of the unknown, and lack of trust in vaccines are among the reasons for not getting vaccinated against COVID-19. Fact that the majority of patients in the unvaccinated group had not witnessed COVID themselves or in their close family members, potentially supplemented their belief. A rapid national survey of the US population shows similar results where more than a fifth of the participants (22%) reported COVID-19 vaccine hesitancy [11]. Vaccine hesitancy in other high-risk populations like health care workers (22.51%) [12], and breast cancer patients 34% [10] is somewhat similar to our findings (21%).
This study delivers insight into the hesitancy for the COVID-19 vaccine among hemodialysis patients. It is concerning that majority of the unvaccinated people believed that there is no need for a vaccine and their perceived risk of COVID-19 to themselves as a non- dangerous disease can lead to the potential downfall of their health as well as risk to their family members and vice-versa. The pertinent need to encourage the COVID-19 vaccination among dialysis patients and their family members was recognized. Frequent counseling with reliable and evidence-based Health-related education among dialysis patients and their family members is suggested to address and alleviate any
considered non-dangerous by 44 % (17) of patients. Other attributes can be seen in Table 1.
A higher proportion of graduates among the vaccinated group (50%) reflect the possible association of education level with COVID-19 vaccine acceptance as shown in another study as well [10]. Among vaccinated patients’ families, vaccination status was almost 100% for childhood vaccines and 96% for COVID-19 vaccination. Some of the non-medical reasons for getting vaccinated reported by 40% (12) participants included fear of bank account/mobile sim block by the Government and travel restrictions. Sinopharm was the most frequent vaccine received by patients followed by Moderna and others ( Fig. 1).
concerns associated with the COVID-19 vaccination.
LIMITATIONS
The limitation of this research was a very small sample, therefore large-scale studies on the subject are needed to attain in-depth insight into the contributing factors to overcome the COVID-19 vaccine hesitancy.
CONSENT FOR PUBLICATION
Informed written consent was obtained from all study participants.
CONFLICT OF INTEREST
The authors declare no conflict of interest.
ACKNOWLEDGEMENTS
Declared none.
AUTHORS CONTRIBUTION
FK: Conception and design, interpretation, critical
revision, final approval.
MF: Data acquisition and analysis, interpretation,
drafting, final approval.
MWS: Data acquisition and analysis, interpretation,
drafting, final approval.
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