Authors' Reply: Clinical studies of vaccine efficacy

Abstract

We thank Ashby for his interest in our study. Our data clearly demonstrate a two-dose coronavirus disease 2019 (COVID-19) vaccination regimen is insufficient protection for patients either on dialysis or with a kidney transplant. This finding is entirely in keeping with other emergent data demonstrating higher COVID-19 mortality in double-vaccinated patients with kidney failure when compared with other patients who are clinically vulnerable. Vaccine efficacy differs between studies in patients with kidney failure depending on the population studied, degree of immunosuppression, vaccination regimen, mechanism of reporting of positive COVID-19 infection, and infectivity of the prevalent variant of severe acute respiratory syndrome coronavirus 2. However, the totality of evidence supports that, although two-dose vaccination may improve outcomes to some degree, there is still an unacceptably high proportion of double-vaccinated patients with kidney failure dying or being hospitalized within 28–30 days of a positive COVID-19 test; this proportion is reported at 9% and 34%, respectively, up until September 21, 2021 in our study and 9.5% and 30%, respectively, in Canada, albeit with a follow-up only until June 30, 2021. To date, there are still comparatively few reports of the effect of COVID-19 vaccination on clinical outcomes rather than serologic markers of response in this population.

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Copyright © 2022 by the American Society of Nephrology

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DOI

https://doi.org/10.1681/ASN.2022030382

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https://discovery.dundee.ac.uk/en/publications/26f7b7f4-6fd9-4759-ae02-542f905b30f7