Relation between COVID vaccine and Kidney Disease

Dr. Sunil Prakash, Senior Director & HOD, Nephrology & Renal Transplantation, BLK Super Speciality Hospital on relation between COVID vaccine and Kidney Disease:

Q1. There is a rising concern in the community of patients with Chronic Kidney Disease (CKD) on getting Covid vaccination as raised levels of blood and use of immunosuppressive agents can potentially hamper vaccination responses, do you think these fears are true? 

Ans1. This is true that patients with Chronic Kidney Disease (CKD) will be less responsive to the drugs, but this patient also has more susceptibility to get very bad infection. They must get the vaccine. If a normal person gets vaccinated, 70% will get a good/immune response. In CKD patient, immune response will be less but they should take it, as the benefit is more and the risk is less.  

Q2. Will vaccination help lower infection rates and reduce morbidity and mortality rates? 

Ans2. Absolutely, it will. Although it may not be as effective as in normal people but will certainly help a CKD patient. In India, 2-3% of normal people die because of Covid. But in my own experience, if a CKD patient gets Covid then the mortality is 8-10%, more on the higher side and if a transplant patient gets it then it is as high as 25%. So, CKD patients must take vaccine and that is why they are given priority.  

Q3. Should patients with Chronic Kidney Disease (CKD), including those on dialysis or living with a renal transplant take Covid-19 vaccination? 

Ans3. Absolutely, because they have very high chances of mortality. Although, immune conversion will be less but whoever gets vaccinated can still be saved.  

Q4. How should transplant candidates go about getting the vaccine? 

Ans4. Transplant patients should get the vaccine in the same way as non-transplant patients, but the conversion will be less as in CKD because they are taking immunosuppressive medicines so that immunity is hampered and their chances of that is less.  

Q5. Has the morbidity and mortality rate in patients of CKD been higher due to Covid vis-à-vis the rest of the population?  

Ans5. Yes, mortality in CKD patients has been much higher. Because if they get Covid, their immune system is not so competent to fight it away and they have many other comorbidities as well like diabetes, high blood pressure, they are taking other medicines. All this is also there and that is why they should get the vaccine.  

Q6. Is the vaccine especially important for kidney transplant patients and other immunocompromised patients? Are they at greater risk of severe complications of Covid -19? 

Ans6. Yes, 25% mortality in transplant patients which is extremely high –which is an important point.  

Q7. Are Covid vaccines safe to be given to transplant recipients Are Covid vaccines safe to be given to kidney donors? 

Ans7. With Covid vaccine there is a lot of worry that some side effects are coming but my take on this is a little philosophical. I believe that there is nothing in this world which is 100% safe. If you leave home for work, there is fear of road accident, our food may contain pollutants, there are so many things. With Covid vaccine the side effects may be there, but the benefits are also there. It is a situation of 70% benefits and 10% side effects, but these side effects are not very severe.  

Q8. After getting the vaccine, will patients of CKD be totally protected from contracting the infection? 

Ans9. No, the conversion rate is 70% but still some people can get Covid even after getting vaccinated. Suppose 100 people get the vaccine, 30 will get the infection, 70 will not. In CKD patients, if 100 get the vaccine, 70 can get the infection, 30 will not. Such is the ratio. The benefit is in taking the vaccine. 

https://www.blkhospital.com/doctor/sunil-prakash