Costantino Andrea, Morlacchi Letizia, Donato Maria Francesca, Gramegna Andrea, Farina Elisa, Dibenedetto Clara, Campise Mariarosaria, Redaelli Matteo, Perego Marta, Alfieri Carlo, Blasi Francesco, Lampertico Pietro, Favi Evaldo
Division of Gastroenterology and Endoscopy, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20214 Milan, Italy.
Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, 20124 Milan, Italy.
Vaccines (Basel). 2022 Nov 10;10(11):1899. doi: 10.3390/vaccines10111899.
Coronavirus disease 2019 (COVID-19) vaccination hesitancy is a threat as COVID-19 vaccines have reduced both viral transmission and virus-associated mortality rates, particularly in high-risk subgroups. Solid organ transplant recipients (SOTRs) are particularly vulnerable, as the underlying causes of their organ failure and the chronic immunosuppression are associated with a lower immune response to COVID-19 vaccines, and with an excessive risk of death due to SARS-CoV-2 infection. We aimed to evaluate COVID-19 vaccination hesitancy and its reasons in a population of SOTRs.
All the SOTRs attending our post-transplant clinics were asked to fill in a vaccination status form with specific validated questions related to their willingness to receive a third vaccine dose. In the case of negative answers, the patients were encouraged to explain the reasons for their refusal. Among the SOTRs (1899), 1019 were investigated (53.7%).
Overall, 5.01% (51/1019) of the SOTRs raised concerns regarding the future third dose vaccination. In more detail, hesitancy rates were 3.3% (15/453), 4.2% (7/166), and 7.3% (29/400) among the investigated liver, lung, and kidney transplant recipients, respectively ( = 0.0018). The main reasons for hesitancy were fear of adverse events (30/51, 58.8%) and perceived lack of efficacy (21/51, 41.2%).
Full adherence to ongoing or future vaccination campaigns is crucial to prevent, or at least reduce, COVID-19-related morbidity and mortality in fragile patients. The identification of the reasons influencing COVID-19 vaccination hesitancy in these patients is very important to establish appropriate and targeted patient-doctor communication strategies, and to further implement specific vaccination campaigns.
2019冠状病毒病（COVID-19）疫苗接种犹豫是一个威胁，因为COVID-19疫苗降低了病毒传播率和与病毒相关的死亡率，特别是在高危亚组中。实体器官移植受者（SOTR）特别脆弱，因为他们器官衰竭的潜在原因和慢性免疫抑制与对COVID-19疫苗的免疫反应较低以及因感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）而导致的过高死亡风险相关。我们旨在评估SOTR人群中对COVID-19疫苗接种的犹豫情况及其原因。
要求所有在我们移植后诊所就诊的SOTR填写一份疫苗接种状况表格，其中包含与他们接受第三剂疫苗意愿相关的经过验证的特定问题。对于否定回答，鼓励患者解释拒绝的原因。在1899名SOTR中，对1019名进行了调查（53.7%）。
总体而言，5.01%（51/1019）的SOTR对未来的第三剂疫苗接种表示担忧。更详细地说，在接受调查的肝移植、肺移植和肾移植受者中，犹豫率分别为3.3%（15/453）、4.2%（7/166）和7.3%（29/400）（P = 0.0018）。犹豫的主要原因是担心不良事件（30/51，58.8%）和认为缺乏疗效（21/51，41.2%）。
完全遵守正在进行的或未来的疫苗接种活动对于预防或至少降低脆弱患者中与COVID-19相关的发病率和死亡率至关重要。识别影响这些患者对COVID-19疫苗接种犹豫的原因对于制定适当且有针对性的医患沟通策略以及进一步开展特定的疫苗接种活动非常重要。
