Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Nephrology Unit, Universiti Teknologi MARA (UiTM), Selangor, Malaysia.
BMJ Open. 2022 Dec 30;12(12):e065112. doi: 10.1136/bmjopen-2022-065112.
Patients with advanced chronic kidney disease (CKD) or kidney failure receiving replacement therapy (KFRT) are highly vulnerable to COVID-19 infection, morbidity and mortality. Vaccination is effective, but access differs around the world. We aimed to ascertain the availability, readiness and prioritisation of COVID-19 vaccines for this group of patients globally.
Collaborators from the International Society of Nephrology (ISN), Dialysis Outcomes and Practice Patterns Study and ISN-Global Kidney Health Atlas developed an online survey that was administered electronically to key nephrology leaders in 174 countries between 2 July and 4 August 2021.
Survey responses were received from 99 of 174 countries from all 10 ISN regions, among which 88/174 (50%) were complete. At least one vaccine was available in 96/99 (97%) countries. In 71% of the countries surveyed, patients on dialysis were prioritised for vaccination, followed by patients living with a kidney transplant (KT) (62%) and stage 4/5 CKD (51%). Healthcare workers were the most common high priority group for vaccination. At least 50% of patients receiving in-centre haemodialysis, peritoneal dialysis or KT were estimated to have completed vaccination at the time of the survey in 55%, 64% and 51% of countries, respectively. At least 50% of patients in all three patient groups had been vaccinated in >70% of high-income countries and in 100% of respondent countries in Western Europe.The most common barriers to vaccination of patients were vaccine hesitancy (74%), vaccine shortages (61%) and mass vaccine distribution challenges (48%). These were reported more in low-income and lower middle-income countries compared with high-income countries.
Patients with advanced CKD or KFRT were prioritised in COVID-19 vaccination in most countries. Multiple barriers led to substantial variability in the successful achievement of COVID-19 vaccination across the world, with high-income countries achieving the most access and success.
患有晚期慢性肾脏病 (CKD) 或肾衰竭接受替代治疗 (KFRT) 的患者极易感染 COVID-19，且发病率和死亡率较高。疫苗接种是有效的，但在全球范围内，疫苗的可及性不同。我们旨在确定全球范围内这组患者的 COVID-19 疫苗的可用性、准备情况和优先级。
国际肾脏病学会 (ISN)、透析结局和实践模式研究以及 ISN-全球肾脏健康图谱的合作者开发了一个在线调查，该调查于 2021 年 7 月 2 日至 8 月 4 日期间以电子方式分发给 174 个国家的主要肾病学领导人。
从 10 个 ISN 地区的 174 个国家中收到了 99 个国家的调查答复，其中 88/174（50%）为完整答复。99 个国家中的 96/99（97%）都有至少一种疫苗。在接受调查的国家中，71%的国家将透析患者列为疫苗接种的优先对象，其次是接受肾移植的患者（62%）和 4/5 期 CKD 患者（51%）。医护人员是最常见的高优先级疫苗接种人群。在接受调查时，估计有 55%、64%和 51%的国家中至少有 50%的接受中心血液透析、腹膜透析或肾移植的患者完成了疫苗接种。在所有三个患者群体中，至少有 50%的患者已在 100%的答复国家和>70%的高收入国家中接种了疫苗。
在大多数国家，患有晚期 CKD 或 KFRT 的患者在 COVID-19 疫苗接种中被列为优先对象。多种障碍导致全球 COVID-19 疫苗接种的成功实施存在很大差异，高收入国家的可及性和成功率最高。
