Nephrology, Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy; Clinical and Experimental Medicine Ph.D. Program, University of Modena and Reggio Emilia, via del Pozzo 71, 41124 Modena, Italy.
Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, via del Pozzo 71, 41124 Modena, Italy.
G Ital Nefrol. 2022 Apr 21;39(2):2022-vol2.
Some hemodialysis patients are reluctant to undergo COVID-19 vaccination for the fear of developing adverse events (AEs). The aim of this study was to verify the safety of the mRNA-1273 vaccine in hemodialysis patients. We conducted a retrospective analysis of in-center hemodialysis patients who underwent mRNA-1273 vaccine from March 1st to April 30th, 2021. All AEs occurring after the first and the second doses were collected and classified as local or systemic. Overall, 126 patients on chronic maintenance dialysis without a prior COVID-19 diagnosis were vaccinated with two doses of mRNA-1273 vaccine. Mean age was 68 (IQR, 54,7-76) years and 53.6% of patients were aged ≥65 years. During the observational period of 68 (IQR, 66-70) days, AEs occurred in 57.9% and 61.9% of patients after the first dose and second dose, respectively. The most common AEs were: injection-site pain (61.9%), erythema (4.8%), itching (4.8%), swelling (16.7%), axillary swelling/tenderness (2.4%), fever (17.5%) headache (7.9%), fatigue (23.8%), myalgia (17.5%), arthralgia (12.7%), dyspnoea (2.4%), nausea/vomiting (7.1%), diarrhoea (5.6%), shivers (4%) and vertigo (1.6%). The rates of local AEs were similar after the first and second doses (P=0.8), whereas systemic AEs occurred more frequently after the second dose (P=0.001). Fever (P=0.03), fatigue (P=0.02) and nausea/vomiting (P=0.03) were significantly more frequent after the second dose of the vaccine. There were no age-related differences in the rate of AEs. Overall, vaccine-related AEs in hemodialysis patients seem to be lower than in the general population. The RNA-1273 vaccine was associated with the development of transient AEs after the first and second doses in patients on chronic maintenance hemodialysis. They were mostly local, whereas systemic AEs were more prevalent after the second dose. Overall, all AEs lasted for a few days, without any apparent sequelae.
一些血液透析患者由于担心发生不良反应（AE）而不愿意接种 COVID-19 疫苗。本研究旨在验证 mRNA-1273 疫苗在血液透析患者中的安全性。我们对 2021 年 3 月 1 日至 4 月 30 日期间在中心行血液透析并接种 mRNA-1273 疫苗的患者进行了回顾性分析。收集了所有在接种第一针和第二针后发生的 AE，并分为局部或全身。共有 126 例未确诊 COVID-19 的慢性维持性血液透析患者接种了两剂 mRNA-1273 疫苗。平均年龄为 68（IQR，54，7-76）岁，53.6%的患者年龄≥65 岁。在 68（IQR，66-70）天的观察期内，第一针和第二针后分别有 57.9%和 61.9%的患者发生 AE。最常见的 AE 是：注射部位疼痛（61.9%）、红斑（4.8%）、瘙痒（4.8%）、肿胀（16.7%）、腋窝肿胀/触痛（2.4%）、发热（17.5%）、头痛（7.9%）、疲劳（23.8%）、肌痛（17.5%）、关节痛（12.7%）、呼吸困难（2.4%）、恶心/呕吐（7.1%）、腹泻（5.6%）、寒战（4%）和眩晕（1.6%）。第一针和第二针后局部 AE 的发生率相似（P=0.8），但第二针后全身 AE 的发生率更高（P=0.001）。第二针后发热（P=0.03）、疲劳（P=0.02）和恶心/呕吐（P=0.03）的频率明显更高。AE 发生率与年龄无关。总之，血液透析患者的疫苗相关 AE 似乎低于普通人群。在慢性维持性血液透析患者中，RNA-1273 疫苗接种后第一针和第二针均与短暂性 AE 相关。它们大多是局部的，而全身 AE 更常见于第二针后。总的来说，所有 AE 持续几天，没有明显的后遗症。
