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ISN Calls for Urgent Prioritization of Dialysis Patients in COVID-19 Vaccination Programs

The ISN has written to the WHO requesting its support in convincing policymakers worldwide to immediately prioritize the vaccination of patients with advanced chronic kidney disease undergoing dialysis. The request has been made in light of the recent ISN paper published in Kidney International, “The urgent need to vaccinate dialysis patients against SARS-CoV-2: A call to action.”

Dialysis patients have specific circumstances that lead to an increased risk of SARS-CoV-2 infection. Most patients need to receive in-center hemodialysis (ICHD), which forces them to travel to a dialysis center three times a week and attend dialysis sessions for at least 3-4 hours surrounded by 20 (or more) other patients, as well as staff members. Consequently, dialysis patients are up to 20 times more at risk of contracting the SARS CoV2 infection than the general population.
In addition to being exceptionally vulnerable to infection because they cannot self-isolate, people receiving ICHD who develop COVID-19 have a much greater risk of dying. The higher risk of death from COVID-19 is also observed in non-elderly patients on dialysis, with exceptionally high mortality rates exceeding rates observed in the elderly population. A 40-59-year-old dialysis patient, who contracts COVID-19, has a 94-fold increased risk of dying than patients who are not on dialysis (after adjusting for age).

For dialysis patients infected with SARS-CoV-2, the higher risk of death may be due to impaired immune function and the prevalence of well-established risk factors for death from COVID-19, including hypertension, diabetes, and heart disease.

People aged 80 and over are generally prioritized in vaccination programs. However, most dialysis patients are, on average, younger (mean age 65-70 years) than this classic high-risk group; therefore, they are not included in priority vaccination categories causing considerable losses in life-years that the vaccine could save. That is why the ISN calls on health authorities to vaccinate all dialysis patients against the COVID-19 immediately. Since patients come to a dialysis center three times a week, all patients can receive their first dose in less than a week.

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